Covid-19 and racial differences in the United States - which racial groups are hit harder and why?

An article by Jessica Boehme

This article consists of two parts with the aim to show which racial groups in the US are most affected by Covid-19 and why. While the first one shows that African Americans, Latinx and Indigenous people have the highest Covid-19 infection and mortality rates, the second part focuses on possible explanations for that.

In the US, statistics show that Indigenous, Latinx and African American people are at increased risk of getting sick and dying from Covid-19 compared to the White or Asian population (Brooks, 2020). In Missouri, for example, 31.2% of those who died because of Covid-19 were African Americans, despite them making up only 11.8% of the population. This is even more drastic in Wisconsin where 36% of Covid-19 related deaths were registered among African Americans, although they make up only 6.7% of the population (all data: 24 April 2020) (Brooks, 2020). Data from the City of St. Louis shows zip code specific highs with areas such as 63115 and 63103 having the highest number of Covid-19 cases, both being mainly populated by African Americans (Grinstein-Weiss & Gupta, 2020).

Figure 1 (Grinstein-Weiss & Gupta, 2020)

A comparison of this map (Figure 1) to the one below (Figure 2) illuminates the total inequality and racial polarization in St. Louis where we witness a considerably greater amount of positive Covid-19 case counts in poorer and highly segregated zip codes (Grinstein-Weiss & Gupta, 2020).

Figure 2 (Grinstein-Weiss & Gupta, 2020)

More recent updates by the APM Research Lab predict that this trend is likely to continue. Adjusting the data for age differences in race groups shows an increase in the overall mortality rates. Latinx, Indigenous and African American groups have a Covid-19 death rate of triple or more than Whites and this gap is still widening (APM Research Lab, 2020):

Figure 3 (APM Research Lab, 2020)

Across the US, African Americans have experienced 18,5% of all deaths compared to other races even though they represent only 12.4% of the entire population. For Latinx and Indigenous groups, there is a similar trend. Indigenous people represent 0,8% of the population, but 1,4% of the Covid-19 deaths compared to other races. In November, the Covid-19 mortality rate of Indigenous people exceeded the rate for African Americans for the first time since the tracking began in April 2020, but both remain on a high level (APM Research Lab, 2020).

Figure 4 (APM Research Lab, 2020)

Studies have shown that this inequality could likely result from long-standing systemic health and social inequities. For instance, according to the Kaiser Family Foundation, 11.5% of African Americans do not have any health insurance. The same number is far lower for white people (Cassidy, 2020). Many Black, Indigenous and (other) People of Colour (BIPoC) do not go to the doctor at all or very late. Some of many reasons for this could be lack of money, childcare, language barriers, cultural differences between patients and providers or historical and current discrimination in healthcare systems (Brooks, 2020; CDC, 2020). The last point refers to the distrust by some racial groups against the health care system and government because of systemic racism, discrimination in treatment and historical events in the past like enforced sterilization or mandatory testing for sickle cell disease among African Americans (CDC, 2020; Fulda & Lykens, 2006). The economic crisis which comes with the pandemic may only exacerbate these problems, considering that many US citizens receive health insurance through their employer and with businesses struggling, many have faced unemployment or cuts to their benefits.

Furthermore, African Americans are more likely to suffer from pre-existing conditions such as high blood pressure, diabetes, asthma, or obesity than Whites - which stems from poverty or the lack of health insurance and therefore a worser medical treatment as well as poorer access to the health system. This situation increases the Covid-19 mortality rate of African Americans (Brooks, 2020; Grinstein-Weiss & Gupta, 2020) and makes people-at-risk even more vulnerable to a severe and often fatal course of the disease.

Figure 5 (Brooks, 2020)

Like Burmina (2020) mentioned in her article, the inequities are also visible at the education level: the groups mentioned above often have lower high-school completion rates, which can limit future job options and lead to lower-income or less stable jobs. This means they have lower flexibility to opt for a job which enables them to work from home because many BIPoC work in essential work settings where social distancing is difficult to implement (CDC, 2020). Something which has also been proven to be the case in the UK as evidenced in Vestergaard’s article (2020) on "the inequalities of infection and disease control". Other factors that may contribute to an increased risk are the closer ties with family, friends and churches in their communities, the higher use of public transportation or the inability to order food online because of an inferior financial situation (CDC, 2020; Grinstein-Weiss & Gupta, 2020). In some cultures, it is also common that several generations share housing, which makes following prevention strategies more difficult. That increases the risk for vulnerable groups to get infected with often severe consequences (Brooks, 2020). Growing unemployment rates due to economic struggle can then further aggravate this situation as people need to share housing and use public transport more often consequently.

The differences between the races detailed above are a perfect example of “Racial Capitalism” a concept explored by Robinson (2001) in his work on“The Invention of the Negro”. Racial Capitalism describes the process of extracting social and economic values from a person of a different racial identity, referring, predominantly to the extraction of values from those of a non-white identity (Robinson, 2001). Burden-Stelly argues in her monthly review in this regard that modern Racial Capitalism in the USA is rooted in the overlap of anti-Blackness and antiradicalism (2020). Thusly, anti-Blackness describes the reduction of Blackness to an inferior class in the hierarchy compared to “white” people, a group which enjoys more power and privilege because of this historic hierarchy. As a consequence, the government, which consists mainly of white people, does not use their efforts to improve the situation of African Americans or other People of Colour, because those people are not the population to be cared for (Burden-Stelly, 2020). In this case, race emerges as a class due to the historic and systemic inequalities present in the US between White Americans and BIPoC, indicated by the increased Covid-19 mortality rate among these groups. All these factors mean that African, Latinx, or Indigenous Americans are more likely to become infected with the virus, often with an increased risk of facing fatal consequences.

References:

APM Research Lab. (2020, December 12). COVID-19 deaths analyzed by race and ethnicity: The color of coronavirus: COVID-19 deaths by race and ethnicity in the U.S. https://www.apmresearchlab.org/covid/deaths-by-race (last access: 20.12.2020)

Brooks, R. A. (2020, April 24). History & Culture: African Americans struggle with disproportionate COVID death toll. https://www.nationalgeographic.com/history/2020/04/coronavirus-disproportionately-impacts-african-americans/

Burden-Stelly, C. (2020). Modern U.S. Racial Capitalism. Monthly Review, 8–20. https://doi.org/10.14452/MR-072-03-2020-07_2

Burmina, I. (2020) Teleworking during the pandemic and access to it among different ethnic groups https://raceandthepandemic.wixsite.com/home/post/teleworking-during-the-pandemic-and-access-to-it-among-different-ethnic-groups

Cassidy, A. (2020, April 10). Coronavirus in den USA: Warum Schwarze öfter sterben. Süddeutsche Zeitung. https://www.sueddeutsche.de/politik/coronavirus-usa-schwarze-sterberate-1.4872535

CDC (2020). Community, Work and School: Health Equity Considerations and Racial and Ethnic Minority Groups. Center for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html (last access: 20.12.2020)

Fulda, K. G., & Lykens, K. (2006). Ethical issues in predictive genetic testing: A public health perspective. Journal of Medical Ethics, 32(3), 143–147. https://doi.org/10.1136/jme.2004.010272

Grinstein-Weiss, M., & Gupta, B. (2020, April 6). We don’t need a map to tell us who COVID-19 hits the hardest in St. Louis. Brookings. https://www.brookings.edu/blog/up-front/2020/04/06/we-dont-need-a-map-to-tell-us-who-covid-19-hits-the-hardest-in-st-louis/

Robinson, C. J. (2001). The Inventions of the Negro. Social Identities, 7(3), 329–361. https://doi.org/10.1080/13504630120087208

Vestergaard, M. (2020) Who gets sick matters – the inequalities of infection and disease control. https://raceandthepandemic.wixsite.com/home/post/who-gets-sick-matters-the-inequalities-of-infection-and-disease-control