By Mayowa Sanusi, MPH
In the past few weeks, data from multiple cities, states and counties across the nation have revealed how COVID-19 is disproportionately affecting communities of color. An analysis done by the Washington Post reveals that in places like Louisiana, Michigan, Chicago and Milwaukee county, Black people were over-represented among COVID-19 deaths compared to their population size. In Milwaukee County, Black people comprise about 70 percent of the dead but just 26 percent of the population. A similar trend is seen in Louisiana, where 70 percent of the people who have died were Black, although African Americans make up only 32 percent of the state’s population.
During a press conference last Tuesday, President Trump and Dr. Anthony Fauci acknowledged that COVID-19 is disproportionately affecting communities of color. Dr. Fauci stated that, “We have known literally forever that diseases like diabetes, hypertension, obesity and asthma are disproportionately afflicting the minority populations” but he gave no context as to why. People of color are not genetically predisposed to developing these diseases, so why are these communities disproportionately affected by chronic disease and COVID-19?
The primary reason for racial inequalities in health outcomes is differences in social conditions, and at the root of these disparities in social conditions is racism. The type of racism that set the scene for these social conditions is structural racism, also referred to as systemic or institutional racism. It is pervasive, sometimes obscure, and quiet literally deadly in situations such as the COVID-19 pandemic. Institutional racism is defined as, “differential access to the goods, services, and opportunities of society by race….institutionalized racism is often evident as inaction in the face of need.”
COVID-19 has put a spotlight on the disadvantages that people of color face in this country, the shortcomings of the systems within the United States when it comes to protecting people of color and other marginalized populations, and the inaction by systems and government during this crisis. In the city of Chelsea, Massachusetts, which is predominantly Latino, essential workers make up approximately 80% of the population and the infection rates occurring in this community are comparable to some places in New York City. Chelsea residents are even more at risk because of the environmental injustice that has happened over the years causing the community to have high rates of asthma.
Unfortunately, the effects of systemic racism are far reaching, and no institution is spared even in the most “progressive” of states like Massachusetts. This is evident by the way that the Massachusetts Department of Public Health has handled this epidemic when it comes to data collection.
On April 9th the Massachusetts Department of Public Health released race/ethnicity data for the state and nearly 70% of race/ethnicity for COVID-19 cases and deaths were either missing or unknown and no race/ethnicity data related to testing was released. On the same day, Secretary Marylou Sudders issued an order that labs and healthcare providers start collecting this data and that the Department of Public Health would issue guidance on how to do so. Still, over a week later there is still nearly 60% of death and case data unknown or missing and there have been no guidelines issued to labs or healthcare providers on how to collect this data.
Some would wonder how not collecting this data is “racist” but this failure is but a small part of a larger system that devalues people of color’s needs. The fact that we know that communities of color are often times most impacted by crises, evident by H1N1, the HIV epidemic, and Hurricane Katrina, and still did not collect race/ethnicity data is a clear example that we are all not all in this together and that some lives mean more than others in the eyes of our systems.
Dr. Fauci stated the other week during a White House press conference that, “There is nothing we can do about it right now except to give them the best possible care to avoid complications” when referring to the impact that COVID-19 is having on communities of color, but this is not true.. We need our leaders to do better, we need our systems to do better, and we need our country to do better.
Mayowa Sanusi, MPH is a public health researcher with a passion for social justice and addressing health inequities in communities of color. His expertise includes survey development, focus group facilitation, qualitative and quantitative data analysis, and community organizing.Ê Currently, Mayowa is employed at Health Resources in Action as Research Associate where he supports several public health assessment and evaluation projects. Mayowa earned his master’s degree in public health from the Boston University School of Public Health with a focus in Community Assessment, Program Design, Implementation, and Evaluation.