“Biological race alone is not a risk factor for Covid-19, it is the racist practices at an individual and systemic level that place an undue burden on minority communities,” says Dr. José Ramón Fernández-Peña, director of Northwestern Health Professions Advising and the president of the American Public Health Association.
On Nov. 11, HPA, in association with Multicultural Student Affairs, moderated a virtual discussion with four health experts about the role of racism in the spread of Covid-19 as part of the HPA Speaker Series.
The panel and Q&A were moderated by Fernández-Peña, who says that pandemics have a powerful way of unearthing the institutional factors that underlie existing racial health disparities.
“If we’re really serious about reducing health disparities, we need to start speaking about what are the structures in place to create those disparities, and the place to start is racism, historical racism,” he says.
The panel focused on the fact that Covid-19 presents a live case study on how racism and racist practices have made historically marginalized communities more vulnerable to the impacts of the coronavirus. Each of the four panelists focused on a different racial/ethnic minority and how each group was significantly more vulnerable to the spread of the coronavirus compared to white Americans.
All racial/ethnic minorities in the U.S have fared worse under Covid-19 when it comes to cases and hospitalization compared to whites, according to the Centers for Disease Control and Prevention. Black Americans have seen the worst outcomes of all, with at least 45,511 Black lives lost to Covid-19 to date, according to the Covid-19 Tracking Project.
Black Americans (2.1 times higher), Indigenous Americans (1.4 times higher) and Latino Americans (1.1 times higher) are also dying at disproportionate rates compared to whites, according to the CDC in August. Nationally, Asian Americans have seen no increase in death relative to whites, but they are at an increased risk for Covid-19 infection, transmission and hospitalization.
Norma Marshall, a sophomore studying biology and global health, attended the speaker event and says she appreciated the diversity among the panel.
“The global health department is entirely white and it’s nice to see doctors and professors of the communities that they’re talking about, talk about the disparities and the racism of Covid-19, rather than hearing just a white professor talk about it all day,” she says.
Dr. Sunmin Lee, a professor at the University of California, Irvine’s Department of Epidemiology, began with a broad overview, explaining how people of color in general face higher Covid-19 infection rates because they tend to be more exposed to the disease and less protected from it. This is because there is a higher representation of people in color in high risk industries, like healthcare and retail, as well as a lack of protective policy measures for these vulnerable groups, she says.
To explain the high death rates among people of color with Covid-19, Lee points to systematic racial healthcare disparities, specifically poor access to healthcare and a disinvestment from minority communities. Given low insurance rates and a lack of culturally adapted health facilities, people of color have trouble seeking and navigating essential health services. In 2017, only about 6% of white people were uninsured, while the rate was nearly 18% for Latinx Americans and 10% for Black Americans, according to the CDC.
While specifically discussing how Asians are more vulnerable to the effects of Covid-19, Lee also says that Asians are perceived as Covid-19 “disease carriers” who are framed as the “cause” of the virus by President Trump.
“Asian Americans bear a unique burden of Covid-19 related to prejudice, racism, discrimination, xenophobia and others,” she says.
Olivia Denise Carter-Pokras, a professor of epidemiology and biostatistics at the University of Maryland School of Public Health, focused on how Latinx communities, particularly Latinx immigrant workers, are more susceptible to the impacts of Covid-19.
“Immigrant workers in the hardest-hit industries tend to have lower incomes than their US-born peers, and are more likely to lack health insurance and/or have a minor child,” she says.
Latinx workers are also overrepresented in sectors experiencing mass layoffs, such as restaurants, hotels and cleaning and professional services, she says. For those who are lucky enough to access health insurance through their employers, these layoffs are synonymous with a loss of healthcare.
Sarah Hatcher, an epidemiologist at the National Institute for Occupational Safety and Health, focused on Indigenous communities, saying that “a greater proportion of American Indian and Alaska Native people, or Indigenous people, in the United States have underlying health conditions compared to whites, and that’s a result of structural racism.”
Native Americans are hospitalized at 5.3 times the rate of whites, according to the CDC. Hatcher says that rural tribal reservations lack health resources, so by the time Indigenous people seek care for Covid-19, they have more severe illnesses that require hospitalization, and thus have higher hospitalization rates compared to whites.
The panel concluded with Dr. Linda Rae Murray, an adjunct assistant professor at the University of Illinois School of Public Health, who focused on the Black community. She echoed that Black people are at a higher risk of infection and death from Covid-19 for the same reasons explained by other panelists for other minority groups, whether that refers to working in high risk industries, dense living conditions, underlying health conditions or lack of insurance. Murray also emphasized the role of mass incarceration in increasing the risk of exposure to Covid-19.
“[Black people] are more likely to be impacted by incarceration, both as prisoners in the prison system with disproportionate Black and Brown people in there, as well as people who work in the prison system,” she says.
In order to address these racial health disparities when it comes to Covid-19, Lee says that a multi-level strategy is necessary. This process involves government investment in community care, greater focus among clinicians in the prevention and treatment of pre-existing conditions rampant in minority communities, and the release of specific racial/ethnic data on Covid-19 infection and mortality.
“The challenge for us, and especially those of us that work in healthcare, is how to recognize these structural problems that create these patterns of disease, and how to try to correct some of those structural problems as we battle [Covid-19],” Murray says.