BY: NONI MUNGAI
As COVID-19 data is collected many are shocked by the connection to race, but health disparities among Black individuals are far from new. A brief look at America's history of public health demonstrates how COVID-19 is unveiling the lack of attention to the Black community, and how historical racially rooted injustices have impacted modern health.
A couple of weeks ago as I logged into Facebook, I viewed a post in my "Black Ladies in Public Health" group. Daphne Robinson, an Attorney and active member of the group posted: "Are we the only ones that knew about health disparities? Why does the rest of America seem so shocked?". The post got close to 500 likes, dozens of comments, and reactions ranging from "laughing", "anger", and "love".
This post caused me to ponder why America is just starting to realize how health disparities are affecting the Black community nationwide. As a public health student, health disparities and the Social Determinants of Health are something we often talk about in classes, but this is not the case for most individuals. The Social Determinants of Health, as defined by the American Academy of Family Physicians are "the conditions under which people are born, grow, live, work, and age that strongly influence health outcomes". And according to Healthy People 2020, health disparities are defined as "a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.
While Black Americans are more likely to suffer from comorbidities , the presence of two chronic diseases or conditions in a patient, that make COVID-19 more deadly, these conditions are often tied to the social determinants that mark their communities. Social determinants, built upon racial inequality, have historically perpetuated poor health outcomes within the Black community. COVID-19 has begun to bring this issue back to light. Race still matters, and race still affects health outcomes.
Looking at America's history, there are strong examples of unjust medical treatment in the Black community and how these determinants played out. From the Tuskegee syphilis study, to Henrietta Lacks stolen cells, to Serena Williams pregnancy complications, and now COVID-19, the history of Black Americans being subject to unethical treatment has resulted in not only distrust in the medical system - but health disparities arising. These discrepancies did not come out of the blue, rather they arise from deeply ingrained biases, segregation, and discrimination since the start of this nation.
In 2020, there has been an emergence of familiar patterns of biases in the response to the COVID-19 pandemic. Evelynn Hammonds, a professor from Harvard University, stated during a webinar entitled "Epidemics and the Effects on the African American Community from 1792 to the Present" that, "As someone who has studied the devastating and fragmented HIV epidemic in African American communities, I had become increasingly concerned that something similar might be happening with the spread of the coronavirus, in other words, that communities of African American people are at risk".
In Louisiana today, Blacks account for 58% of COVID-19 deaths but make up only 33% of the entire population. This is a recurring theme in southern states. Both Illinois and North Carolina have published statistics on COVID-19 cases by race, two of the few states to do so.
These disparities are why Black Americans are at risk and dying at such alarming rates. According to the CDC, underlying health conditions and lower access to care, work circumstances, and living conditions are all determinants which have implications that put people in certain zip codes, environments, careers, and more.
As I start my career as a public health professional post-graduation, COVID-19 and health disparities are not going anywhere anytime soon. But I am left to wonder if people will care about Black health disparities in the future? And why hasn't public health for Black individuals been prioritized in the first place?
There is a need to address inequality embedded in all aspects of American society - in relation to health and beyond. The larger issue at hand is addressing the overarching determinants which are allowing these health disparities to grow. Our healthcare system, food access system, political system, education system, and more all must change in order for the trajectory of health for Black individuals to take a turn in the right direction. The length of time that this has been occurring is an impetus for change. This isn't an issue that can be fixed overnight, but rather by revamping the systems altogether. Although a lofty mission...this pandemic is a reminder of what is needed to be done.
