As the spread of the coronavirus exponentially increases by the day, so does its toll with 1,678,843 total cases and 99,031 deaths in the U.S. alone. Despite making up only 13.4 percent of this nation’s population, the Black population is seen to be disproportionately victim of more than 50% of reported cases, 33 percent of hospitalizations and approximately 60 percent of the deaths from the pandemic. Though these reports are often deemed related to health comorbidities prevently experienced amongst the Black community, the social inequities experienced by race are more to blame.
A recent study conducted by Sutter Health Center for Health Systems Research expressed in their retrospective cohort analysis of COVID-19 that “African Americans had 2.7 times the odds of hospitalization compared with non-Hispanic white patients.” While findings indicated that age (39 years+), sex (male), income status (low-income) and insurance status (Medicaid, self-pay, or no insurnace) did increase the odds of hopsitalization, race independently influenced susceptibilty to hospital admission because of COVID-19.
While the public seems to be surprised by the health disparities presented during this pandemic, the health burden as a person of color in America is anything but unordinary. The most prevalent health inequities experienced in this country are perpetuated by the systematic barriers that racism has inspired. The color of your skin ultimately warrants restrictions in health security to attain this country’s unalienable rights of life, liberty and pursuit of happiness. Race and ethnicity are crucially related to access to care, resources to treatment and health outcomes defined in social determinants of health.
Social determinants of health express the everyday social and physical conditions in which people play, work and live. According to HealthyPeople.gov, these factors express how individual health outcomes intersect with underlying issues that stem from economic stability, education, neighborhood and built environment, health and healthcare and social and community contexts. It standardizes the quality of living people are able to achieve and afford. The historically racist subjugations in the foundations that this country was founded upon leaves communities of color disenfranchised to suffer worse health outcomes.
The health outcomes of marginalized communities presenting at the top of COVID’s food chain are driven by poverty and food insecurity and bisected by housing. The majority of the 13.4 million low-income American families are racial or ethnic minorities: Four million (30 percent) are hispanic, 2.9 million (22 percent) are black, and about 800,000 (6 percent) are other nonwhites. According to the CDC, these families make up the majority of overpopulated American metropolitans due to institutionalized residential housing segregation and often live in multigenerational households with poor access to resources to drive quality of living. Racial and ethnic minorities often live in these conditions not as a means of personal choice or financial means, but by legislatively deliberate racial de facto segregation and redlining that affect residential housing and school systems, especially from the 1950s to 1970s. Though many people are unaware of the impacts legislative discrimination has played in the history of this country, it still plays a major part of current standards of health and implicitly influenced by private discrimination in real estate, banks, clothing, food and more.
These households, in which the majority of essential workers arise from, are often subjected to food swamps, poorer physical housing and neighborhood infrastructures, limited occupational mobility and opportunity, and higher rates of stress. This then plays into increased prevalence and comorbidities with higher rates of obesity, asthma rates, hypertension, diabetes and other health conditions due to poorer housing conditions and access to care. Therefore, the overall risk of infection is not only more prevalent in communities of color, but these communities also have pre-existing health disadvantages that have suppressed their immune systems. While the essential work of racial and ethnic minorities might currently carry the nation, it is at the cost of their lives.
Healthcare in American is treated as a commodity. So many people are fighting to have the country be opened back up due to restrictions of personal freedom at the cost of saving lives. While people argue that only a small percentage of people will stand to lose out, those who stand to suffer the most will be communities of color. While the symptoms referenced to COVID-19 are often appointed to the underlying health conditions, it is hard not to feel like the color of your skin is a symptom of illness.
Izza Ahmed-Ghani can be reached at iahmedgh@umich.edu