The Profound Impact of COVID-19 on African Americans in the U.S

As the influence of COVID-19 escalates across the world, the impact of the disease on different sub-categories of the population is being increasingly reported and documented. In the U.S, where the huge numbers of cases and deaths are being declared on a state-by-state basis, racial disparities are cause for huge concern. It is becoming alarmingly apparent - not only from looking at raw data from the C.D.C but also according to medical and health experts – that there are a disproportionately high number of African American citizens contracting and dying from COVID-19 in comparison to white Americans.




In the U.K, thanks to our National Health Service, emergency and routine medical care is regularly accessible to the entire population. In this time of crisis, the gov.uk website even details that immigration checks have been suspended to allow anyone who is only receiving treatment for COVID-19 to be treated without charger under the NHS. However, in the U.S, there is no universal healthcare system and medical care is largely privatised - often medical insurance is offered as part of an employment package from employers. This article does not have the scope to explore the hugely complex U.S medical system in particular detail, but put simply there are significant barriers to healthcare for those who live below the poverty threshold or are unemployed. Due to the employer-dependent aspect of healthcare, and the unprecedented loss of jobs due to COVID-19, the numbers of medically uninsured people are rising. A VICE article on the American healthcare system states that 'the pandemic has clarified just how much our system is a complete failure; not only during a nation-wide health crisis, but also in “normal” times too'.


Much of the U.S already suffers from evident race and class inequalities, with historical influences at the root of the disparities in COVID-19. In New Orleans, Chicago and Detroit, where larger communities of African Americans live in more densely populated cities, the high percentage of deaths is alarmingly apparent. In Chicago, black residents make up 29% of the population. However, they account for 70% of the 86 deaths recorded by the state. Similarly, 70% of deaths in Louisiana are African American. In New York City, black people are twice as likely to die from the coronavirus as white people.



Underlying these statistics sit some basic facts:


- in the U.S around 80% of the people dying from coronavirus have underlying health conditions of either hypertension (more commonly known in the U.K as high blood pressure), diabetes or both;


- neighbourhoods with the most confirmed coronavirus cases are considered low-income areas home to predominantly black communities;


- the U.S healthcare system was already overwhelmed, and the coronavirus pandemic is exacerbating deep-rooted issues that already exist


If you can stick with me for a few minutes, I would like to delve deeper into these basic facts and attempt to provide an analysis and an explanation.


Last week the Centre for Disease Control (CDC) released their Morbidity and Mortality Report for March, which covers a total of 14 states. The report details that 89.3% of deaths occurring from coronavirus had underlying health conditions, with hypertension, obesity, chronic lung disease and diabetes all prevelant issues.

So, on deeper exploration of the CDC website I had a look at some specific data for hypertension, obesity (not only a predominant cause of high blood pressure but also an indicator of generally poor health) and diabetes - the prevalent underlying health conditions responsible for increased COVID-19 deaths. Firstly, in October 2017, hypertension was recorded to be higher among non-Hispanic black people than non-Hispanic white, with 40.3% and 27.8% respectively. Also in 2017, 8.0% of white Americans were diagnosed with diabetes, compared to a larger 10.9% of black Americans. This 10.9% is likely to be even higher than has been recorded when a reduced access to healthcare is taken into account, meaning a high number may remain undiagnosed. And, unsurprisingly, the data for obesity shows that it is hugely more prevalent in black Americans.


'Regular access to health-care services in the U.S exists along interlinked racial and economic lines; inadequate financial and political investment, decades of systemic racial discrimination, and negative socioeconomic indices have left black communities more vulnerable to underlying health issues which predispose them to the coronavirus. '

In the graph to the right the green line represents non-Hispanic blacks diagnosed with diabetes, and the blue line non-Hispanic whites. Although the data is over 2 years old, the general trend since 1980 shows consistent significant disparities between white and black populations diagnosed with diabetes. For example, in 2016 the gap was at 4.5%, and in 2001 it was nearly double. One small positive is that since this particular record began, there has been a very slow but nonetheless significant closure of the huge inequities apparent at the start of the millennia. Despite this, it doesn’t take a scientific analyst to recognise that this data is alarmingly problematic. The data shows that far before the onset of the pandemic, African Americans were suffering with hypertension and diabetes in much higher numbers than their white counterparts. When underlying health conditions are the major problematic complication that leads to death with coronavirus, this leads to increased deaths of people of colour.


Explaining these raw statistics and the disparities in the numbers requires us to view the coronavirus through a lens of pre-existing inequalities. The health outcomes for communities across the U.S were already different before the outbreak of COVID-19. When you acknowledge this, the current experience of the pandemic becomes just an exaggerated example of health inequity. Regular access to health-care services in the U.S exists along interlinked racial and economic lines; inadequate financial and political investment, decades of systemic racial discrimination, and negative socioeconomic indices have left black communities more vulnerable to underlying health issues.

'To some people the risk of coronavirus is simply overshadowed by other struggles they face in their lives.'

Issues such as poverty, environmental pollution, access to medical care and overcrowding disproportionately affect black communities. People of colour are also more likely to hold service sector jobs that under the current lockdown conditions do not allow them to stay at home. Social distancing is impossible when the option to do so is removed. To some people the risk of coronavirus is simply overshadowed by other struggles they face in their lives. A deeply inegalitarian U.S society keeps black Americans predominantly at the bottom of the social and economic ladder, and the differing experiences of COVID-19 is starkly exposing this fact. When combined with the data on underlying health conditions, it shows that communities of colour were always more likely to suffer the worst of COVID-19.


Another aspect of the racially divided experience of the U.S pandemic is the problem of ongoing gun violence. Amnesty International has published an entire campaign aimed at targeting the way that gun violence is intersecting with COVID-19. They state that ‘communities disproportionately impacted by gun homicides are concerned about the impact of a severe economic fallout’.




It details that 40,000 people lose their lives to gun violence every year, with an additional 133,000 surviving from bullet wounds. Compounding these statistics is the fact that African Americans are ten times more likely to be victims of gun homicides than white Americans. And, most alarmingly, gun homicides are the leading cause of death among black men aged 15-34. Let that sink in … The leading cause of death.

Like COVID-19, issues of gun violence in communities of colour are a multi-faceted. There is no simple explanation. Deep-rooted problems of poverty, socioeconomic discrimination and cultural history are all important factors. 'Anger, frustration and depression doesn’t get put on hold whilst there’s a pandemic going on’, says Pastor Michael Pfleger of Chicagos' South Side, ‘its still there, and it’s heightened right now. All it does is heighten the reality of the neglect’.


Where it becomes linked to the pandemic is both in the fact that the hospitals of these African American communities are being overwhelmed by not only the pandemic, but by the regular influx of gun violence victims which already challenged healthcare facilities stretched to their breaking point.


'It's not that coronavirus isn't disastrous no matter what your race. It is that additional challenges, embedded into the structure of American society, leave certain communities more vulnerable to the pandemic.'

You cannot make up for decades of unequal access to healthcare in a few weeks. However, the devastating impact of COVID-19 on people of colour in the United States is a massive wake up call, not only to their government, but also to the world. We need a continuation of transparent demographic data to establish a solution to these health outcomes. It's not that coronavirus isn't disastrous no matter what your race. It is that additional challenges, embedded into the structure of American society, leave certain communities more vulnerable to the pandemic. What is most pertinent is that this could have been predicted. It's been widely labelled as a disease that 'doesn't discriminate'; an equaliser. And yet, people of colour in the U.S are being more profoundly impacted because of deeply embedded and structural racial discrimination that impacts every aspect of their lives.




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