By Megan Kirk
COVID-19 has claimed more than 670,000 lives nationwide and the numbers continue to climb. For communities of color, the pandemic has had a damning effect. Approximately 73,000 African Americans have lost their battle with the virus and account for 15 percent of cases to date. With higher rates of hypertension, diabetes and stroke, the effect of the coronavirus on African Americans is a multi-level system of health disparities; and the pandemic helped to uncover them.
African Americans account for just over 13 percent of the United States population. However, the infection numbers for COVID-19 and the death rates for Black communities have surpassed all other ethnic and racial groups. While the virus is equal in its approach, it is not equal in its outcomes.
Historically, African Americans have faced greater barriers in their access to affordable healthcare. Lower rates of access or insurance coupled with high rates for certain ailments puts Black and Brown communities at a higher risk for lasting health impacts caused by COVID. With the national average of African Americans without health coverage standing at 11 percent, disparities in health coverage directly contribute to disparities in overall health and wellness.
“Disparities are not new. We’ve seen many diseases that affect Black and Brown communities at a much higher rate. When you think about diabetes, hypertension and cancer, I think what this pandemic did was really shine a light on those issues, and it’s multi-factorial,” says Dr. Denise White-Perkins, director of healthcare equity initiatives and office of system diversity equity and inclusion at Henry Ford Health System. “Part of it has to do with the fact that there are certain conditions that make you more at risk for contracting it or having a more difficult time if you get it.
Also Vice Chair of Academic Affairs for the Department of Family Medicine for Henry Ford Health Systems, the doctor noted issues with high blood pressure and obesity can also contribute to the effects of the virus. In addition to health issues, socio-economic standing also factors into the spread of COVID-19. Barriers in access to healthcare often start with income at its base. For people of color, low wages leave the door closed for private insurance. While affordability plays a key role in health, there are also workplace vulnerabilities at play for communities of color.
“There are also some very real social factors that have played into the higher risk. We have a higher proportion of Black and Brown people working in those entry-level jobs that put them directly in the face of increased risks. If you think about our bus drivers, our housekeepers, service workers, people who are working in close quarters in manufacturing — those occupational risk factors make it greater for our Black and Brown people,” says Dr. White-Perkins.
If income and accessibility did not serve as enough roadblocks, general mistrust of the medical system is also a major factor in healthcare for communities of color. Through generations of medical missteps, people of color have developed a disdain for medicine and its professionals; a leery sense that could spell demise for their overall wellness.
“Although Tuskegee happened and there have been other things that have gone on to undermine trust, we are at a point where we have Black and Brown physicians, researchers and health administrators who are involved, and in some cases, leading the fight against COVID. We’ve really got to move into greater trust and take advantage of what’s available. That’s a call to action I want to make to each reader,” says Dr. White-Perkins.
The State of Michigan launched the Coronavirus Task Force on Racial Disparities in 2020 to research and examine the causes and effects of racial disparities in the impact of COVID-19 on Black and Brown communities. With one million confirmed cases in the state to date, the task force is focused on targeting traditionally underrepresented communities. Measured from March 2020 through October of the same year, the task force helped to shrink COVID numbers in underserved neighborhoods; beginning with 176 per million population per day in March 2020 to 59 per million population per day in October 2020.
Chief Medical Executive Dr. Joneigh Khaldun helps lead the task force along with several doctors across the state and Lt. Governor Garlin Gilchrist. Together, the team tackles ways to educate the community while working with community leaders and faith-based organizations to reach the Black and Brown communities on a more personal level — right in the heart of their own community. However, numbers are still on the rise across the state.
“Cases per million are also increasing for all races and ethnicities and it remains highest for Hispanics, Blacks and actually, whites, now, as well. And in the past month, Blacks and African Americans as well as other races have been flagged as having more than their expected share of hospitalization,” says Dr. Robert Orellana, an Epidemiologist, during a virtual task force meeting in August.
Statistically, Black and Brown families are more likely to live in low-income or subsidized housing. Coupled with multiple family units living and maintaining under one roof, it can help create massive spreading within the family.
“There are some communities that live in intergenerational households, either for cultural reasons or for economic reasons. When you have intergenerational households, you have younger people who are out there more bringing back home COVID to older family members,” says Dr. White-Perkins.
Though a number of factors contribute to the growing number of cases for communities of color, doctors continue to advocate for the vaccine. With just half of the state fully vaccinated, Detroit’s majorly Black population accounts for just 32 percent of those fully vaccinated (when race was recorded).
“We are now realizing the accountability for addressing some of these social and public health issues and we can’t just wait until people walk through the hospital or clinic to start thinking about health. We realized we need to start addressing these disparities and continue to pay attention to those disparities,” says Dr. White-Perkins.