By D S Grant
First published 16 April, 2020
The effect the coronavirus has on minority communities is just the latest consequence of inequalities in health care and the workforce and the treble trouble of sustained racism.
African Americans, especially men, are disproportionately contracting and dying of the coronavirus. For many in the black community, that’s no surprise. The pandemic is producing the kind of league tables that nobody wants. Black people in the UK and African Americans are sharing similar positions at the top of the Covid 19 Deaths Table.
A provisional analysis by the ONS has shown that the risk of death involving the coronavirus (COVID-19) among some ethnic groups is significantly higher than that of those of White ethnicity.
When taking into account age in the analysis, Black males are 4.2 times more likely to die from a COVID-19-related death and Black females are 4.3 times more likely than White ethnicity males and females.
The reasons why black people are dying more in comparison to other races are many and varied. We know the mainstream reasons, and they are listed below. But we also point out the less obvious reasons which need to be taken on board by anyone looking to develop solutions.
Racism is an additional stress that eventually leads to a slow earlier death. A growing body of research now links experiencing racism to poorer health outcomes. The more racism you experience, the worse your health. Stress from regular racists incidents means more cortisol in the body which means a higher incidence of inflammation, cancer, cardiovascular disease, diabetes and high blood pressure. Even witnessing, or hearing about racism in the news causes trauma to a BAME person. There is physical damage that racism inflicts on your brain and body.
In a study, unexpectedly, a highly publicized real-life racial stressor, caused black participants to have highly elevated cortisol levels. Blacks in Europe, America and South America who have to cope with daily discrimination, be it overt or subtle have cultivated superhuman strength by strong passionate friendship groups, strong family units, belonging to a church, praying, meditating, hobbies such as sport or music or developing strong social media attachments. Some of these activities have been shown to buffer against some of the long-term effects of stress. But even as we bottle up the pain, it slowly affects our bodies. We fix our face – that poker face to indicate strength, but sometimes the mask slips. P. Diddy spoke in 2019, of the stress of racism he experiences. Who would have imagined that he too – worth a billion – would experience racism?
There is an epidemic of silent suffering which takes its toll on the insides of blacks in the West. So any illness that comes along – we may appear to succumb more than other races. And it’s not just about poverty. Professional BAME people have similar stresses and this explains why middle class people of colour such as doctors suffer more than white doctors. Their immunity would have been weakened over the years through negative experiences of racism. Lack of promotion, micro-aggressions, office bullies and more, come back to haunt.
Experiencing racism, whether it’s violence or insults or more subtle snubbing, makes life more difficult. That added stress becomes “allostatic load,” which disrupts the normal function of the body: more stress means more cortisol in the body means more cardiovascular disease. “You’re continually having to respond to this kind of stress in the body and this kind of wear and tear,” says Kwate.
Duke sociologist Sherman James has coined another, more evocative term for this: John Henryism. It refers, of course, to the African American folk hero John Henry, who raced against a steel drill blasting rock through a mountain. He wins, but his exhausted heart gives out.
Overwork affects the immune system. Black people are not known to refuse overtime. At the height of the pandemic they would have worked longer hours. Extra hours means extra pay, and they would have had little sleep. Some may not have been so willing, but realised they would lose their jobs or be demoted, if they refused to work extra shifts.
Black people are particularly warm and tactile, just like the Italians. They enjoy hugs and handshakes and close relationships. Social Distancing is not our norm. We are caring people. We are likely to rush in and help when someone needs us. Many would have quickly helped others, long before we all knew how dangerous the virus was. Thus they became infected, and proceeded to infect others back home in the family or close friends.
4. Religious Gatherings
Church going or Mosque prayer sessions are popular in black communities. BAME people tend to be more Spiritual beings. After religious gatherings comes much socialising, sometimes with hugging and close catching up in pairs or small groups. During a service, sitting in the pews is a 2 hour task. If someone nearby has the virus, after all the singing and praying out loud, about 20 people sitting within 2 metres of that person could have be infected.
5. Diet and Obesity
Obesity is more common in black communities than in white communities. The healthy food options are not always chosen by African Americans, in that fruits and vegetables are non made a priority either because of cost or preference. Healthy food shops such as Whole Foods are not available in certain neighbourhood. For poorer families, it may be cheaper to buy a burger or pizza than to buy a basket of fruits, and it is more likely to fill them up. The style of cooking which involves fried food, and much starch leads to poorer outcomes later on in life.
Young people (of all races) initially had a bravado attitude thinking the disease only affected old people, but they did not realise that if caught the virus though not suffering themselves they could easily pass it to their mums, dads, aunties, uncles and grandparents – who might die very quickly.
7. Disconnected from News
A percentage black families do not listen to the news, preferring to listen to music, gospel channels or watch movies and drama series – and may not have heard of the build up to the crisis, or the subsequent warnings. This was particularly true of Jewish communities in North London who suffered through lack of knowledge about current affairs. With many in that community only listening to Jewish religious radio or reading an irregular Jewish newspaper.
8. Funeral Crowds
Funerals are big events in black communities. Its likely that early funerals from Covid 19, generated more confirmed cases and more deaths. After deaths, there are regular visits to the home of the deceased. The family were probably contaminated and did not know. Their well-meaning guests then contracted the virus, and took it back to their homes.
9. Inequity of Healthcare
Contrary to popular belief, black people do not receive equity of treatment when attending a hospital. They may be turned away if their symptoms don’t seem “bad enough”. They might not be picked up by ambulances. Medicine trials may not be offered to them. ICU may be delayed for them. Ventilators may not be attended to in a meticulous fashion.
Not all doctors and nurses are Angels. This was illustrated in Italy when the video of a black man emerged who was being told by a nurse that she was not treating him because he deserved to die. Did she know him? No. She called him a black dirty dog, and left him without treatment.
Black Twitter exclaimed when the ONS disparity figures were published, “black people are 4 times more likely NOT to be treated” and are “more likely to be killed in the hospital” when compared to other races.
A husband of a black British woman had called an ambulance for his wife as she was having difficulties breathing. The paramedics said she did not look sick enough, and refused to take her to the hospital. The next day, she was dead.
There’s a level of mistrust among some black people toward public health agencies due to past injustices, that you won’t read in the newspapers and most tend not to have the money to sue a hospital or a doctor.
See a number of racial bias in medical treatments links at the end of this article.
10. Unable to afford healthcare
With no universal healthcare system in America, many black families are left behind if they do not have a job which guarantees healthcare. Some cannot afford monthly insurance premiums which can typically be $833 per month per family according to CNBC. This is equivalent to another mortgage or slightly less than rent. Hence those people with underlying problems do not get the regular drugs they need to keep their sickness under control. This would include those suffering with diabetes, hypertension and heart disease.
A healthcare worker recently expressed that one of her tests for coronavirus cost her $9000. She had 3 tests. She had insurance – so that was taken care of. But imagine others without the funds – not even showing up for a test, because they know the bill will soon follow.
Structural inequalities have also put black communities at a disadvantage in fighting the virus. In America, African American communities are less likely to have insurance and typically have poorer quality health care, which means they may delay seeking medical help.
It also means that they did NOT get regular medications which they should have been taking over the years because they could not afford the monthly costs for each perscription.
11. Vitamin D
Lack of Vitamin D may be a problem. It is converted to its active form by the action of sunlight on the skin. This is impeded by having dark skin and leads to low levels of vitamin D in colder climates during the winter. Vitamin D is needed for many reasons, including correct functioning of the immune system. Damage to health of an unhealthy lifestyle is being magnified by the pandemic, not least to black people. Healthy vitamin D levels might well make a difference. Supplementing with vitamin D3 at 5000iu daily corrects this deficiency, and it is now an urgent need for all people with dark skin. There is a reasonable chance that vitamin D replacement could help reduce the risk we are seeing playing out so tragically in the BAME community. Mainstream Reasons – noted by the media.
12. Frontline Workers
Black employees deemed “essential” during the crisis are being exploited for their services. , and many working in service sector jobs like healthcare, care, postal services, fast food delivery, public transport, big chains and grocery stores. Working from home and avoiding that exposure is a luxury many African Americans or European blacks do not have. Blacks have therefore been exposed to the virus far more than other communities.
13. Work or Lose job
For some workers its a case of “do I shelter from the virus, or do I work to pay my bills and feed my family.” Black workers on the front line had no choice – and they could only pray that God would protect them, especially with the lack of PPE early one in the crisis. One victim said – “God has blessed my hands,” she said. “I keep moving and keep praying.”
14. Underlying Health Conditions
Underlying health conditions like diabetes, heart disease, hypertension, obesity and asthma are more prevalent in black communities, and this fact makes it more likely that complicatons will develop from the disease – according to DHEC officials. For instance, the rate of diabetes in South Carolina is higher among black adults, at around 18 percent, than for white adults, at around 12 percent.
15. Urban Density
Black communities also more likely to be exposed to the virus by living in cities which densely populated. Poorer people of whatever colour are more likely to be exposed to others with a disease. The idea of social distancing is really a privilege for those who have money and resources
16. Testing Disparities
Access to testing was not always equitable. In the UK, test centres were typically out of town areas where people had to drive to. It was the same in America. Some black areas initially had NO testing stations near them, and also had no transport to get across town to be tested, and not enough money to take public transport. For those who had no car – the 20 mile journey would seem onerous. For a long time, it was unclear who was being tested and who had access to that testing, even in locations which had 41% black population.
Research shows that people of colour are less likely to be tested, especially those who live in rural areas or work full-time. It’s very much likely there were more people of color infected by the virus than was being reported. If you do not know you have the virus, you will not self isolate and so the virus spreads unchecked.
Governments need to target those communities for testing and must prioritize dismantling the structural inequalities that have made the black community more vulnerable — or this crisis will all too easily happen again. It’s really the low-wage workers who are keeping the economy going. We need to acknowledge that these people put their lives on the line, when working in grocery stores, or on public transport, or warehouses.
17. Poverty – Underlying Social Conditions
Underlying health conditions are created by underlying social conditions. Poverty, uneven access to quality education, health care and insurance exacerbate excess rates of death across a range of health conditions for black people and low-income population. Many people in those communities face greater unemployment and are low-wage earners without disposable income. In some areas in the UK, black young men have a 50% unemployment rate.
18. Black Immunity Rumour
There was an early myth being spread around. It suggested blacks couldn’t contract the virus. Young people especially thought they were immune.
Smokers within the community may be affected more with Covid 19. This would apply to smokers of cigarettes and weed and other substances, and the use of these are rife in poorer communities of all races. The socialites and party goers who regular smoke may have been more likely to have mixed with people who had the disease and may have been smokers or regularly inhaled third party smoke.
Alcohol could be an issue for some. Its consumption could well reduce a person’s immune system’s ability to fight off infectious diseases. Downing too much alcohol over a sustained period of time will make you less resistant to diseases including COVID-19. Once again alcohol misuse is common in poorer communities of all races – and even middle class people may be guilty of this. However it must be noted that white men in particular drink far more than black adults – but black people are still more likely to catch coronavirus – and become critically ill or die from it.
Black people in prisons are in imminent danger because social distancing is near impossible in shared cells. Sadly we know there are proportionally more black people in prisons, because of poverty (they cannot afford good lawyers) and a justice system which is weighted against them and locks them up for minor infringements that a white person would get away with.
When a young man for instance goes to prison his parents and the whole family is affected with shame and stress, and a waste of the resources of a man. Mental health is damaged, PTSD occurs and when the man leaves prison, no employer will give him a job. Every other job needs a dbs check now.
The number of prisoners dying from Covid19 is a closely guarded secret. It is so sad when a low level crime receiving incarceration for a couple of years, ends with the prisoner dead because the prison could not keep him or her safe. It is even more tragic when the prisoner was innocent, but was persuaded to plead guilty to expedite the case. Then he died in prison.
Other Points to Note:
Many of the problems suffered by black people in America is mirrored in the UK. Though the United Kingdom has universal healthcare – there is still a higher percentage of people of BAME dying from the disease. Jews make up 0.3% of the population, but have 5% of the deaths from Covid 19. Asians also have a higher death rate than the white population.
According to the Economist, figures from June 1919 indicated that in Harlem, “life expectancy for black men is 76.2 years. That is still five years behind the rest of the indigenous New York, and still the lowest in the list of all races. But the gap is not as outrageous as it used to be. In 1900, the gap was 14 year gap between black men and white communities. Time will tell what this figure will look like with 2020 Covid19 statistics is included.
Professor David Williams of Public Health and African American Studies said recently, every police killing of a black person causes 3 months of mental health difficulties for the black community in the same town. He also said that one in four of black people experience racism at least once per week. This can be every day discrimination, poorer service at restaurant or in a store, disrespect. These lead to worse mental health and physical health. The stress of discrimination eventually takes a toll.
What must be emphasized is that black people are not wallowing in emotional pain everyday. We rise above the pain – until it occurs again. Many are finding ways to rise above the storms with their talents, hard work and connections. Young people are forging new paths, that their parents could only have dreamed of. We are warm, loving and caring and the best friends you could ever have.
Suggested Solutions to redress the inequality balance.
- Stress Management Techniques
- Healthy Eating Education
- Leadership Programmes
- Diversity and Black History Training for Employers and employees
- Reparations Payments
- Funding made available for empowerment programmes
- Talent Development Funding
- Business Development Programmes
- Career Progression and Recruitment Drives
- Exercise plans
- Widespread dissemination of information
- Mentorship and Coaching partnerships
- Angel and VC investments in minority-owned businesses
- Skills Apprenticeships for all unemployed
- Tech Education
- Progress Hubs
- Inventions and Product development and marketing
- Mastermind groups
(C) BlackEconomics April 2020