Racial Disparities and COVID-19

May 13, 2020

Source: % COVID-19 Cases and Population by Race in the US, NCDP

As the world scrambles each week to grapple with the seemingly insurmountable number of positive cases and deaths from the COVID-19 pandemic, public policy is failing some of America’s most vulnerable communities. Although COVID-19 has been called the “great equalizer” on different media platforms, the data tell a different story. The Centers for Disease Control and Prevention has begun publishing nationwide metrics on those who have tested positive, and thus far African Americans make up 27.5% of the positive cases with race specified, but just 13.4% of the population overall, a ratio of 2.13. Hispanics or Latinos have a case to population ratio of 1.39, while in contrast and Whites have a case to population ratio of 0.86, and Asians have a case to population ratio of 0.81(all of these percentages of positive cases are current as of 5/13/2020). Stark numbers like these from the COVID-19 pandemic have been awakening the public to dramatic inequities and socioeconomic class lines in the US.

COVID-19 is disproportionately impacting communities of color and the working class. Thematic maps showing positive cases per thousand residents in each New York City (NYC) ZIP code bears remarkable similarities to maps showing neighborhoods with the highest number of rent burdened households, people of color, and service workers. Staten Island is an exception, with exceedingly high COVID-19 cases, but a population that is 75.2% white, potentially owing to the high number of police, firefighters, and EMTs in comparison with the rest of the city. Communities of color and undocumented workers are comprised of a significant number of service workers including grocery clerks, home healthcare workers, restaurant workers, and subway operators. Despite being deemed essential workers, many are not provided with personal protective equipment (PPE), hazard pay, or in many cases union protections. State and local governments have offered varied support, from limitations on foreclosures and evictions, to utility disconnection suspensions, and limits on debt collection. More can certainly be done in many states and this leaves communities to fend for themselves in addressing these unmet needs.

Source: Association of Housing and Neighborhood Development; https:/anhdnyc.carto.com/builder/f7994ecc-fc14-4e3c-a5d6-c90196e20b2f/

Essential workers in many cases are forced to make the arduous choice between their financial survival and outsized risk to their health. This choice is especially pronounced in the NYC borough of the Bronx which has a Latino majority and the smallest white population in NYC. Subway ridership, which plummeted 87% in the borough of Manhattan by the end of March, only reduced by 55% in the Bronx, which has a median income of $38,000 in comparison with Manhattan’s $80,000. Likewise, the rate of positive cases of COVID-19 in the Bronx has been the highest among the five boroughs. Beyond the Bronx, minorities in the US are nearly twice as likely as whites to suffer from chronic health conditions and in NYC African American and Latino adults are more than two times more likely than white adults to have diabetes. Diabetes is the second most likely comorbidity to affect patients who have died from COVID-19 in NYC. Compounding this, African Americans and Latinos on average have lower insurance coverage rates. As a result, access to quality healthcare is a major issue, with a quarter of African Americans lacking a primary care physician and not seeking care due to cost. The environments that families live in are also impactful. Black families in the US are more likely to live in poorer neighborhoods than socioeconomically matched white families, regardless of their income or educational attainment. These neighborhoods are more likely have to have more pollution, fewer supermarkets with healthy options, and high levels of lead paint, which can lead to cardiovascular disease and hypertension, two comorbidities associated with COVID-19 mortalities. All of these factors have likely contributed to the disproportionate number of positive case and mortality rates of minorities in the US.

Source: CUNY School of Public Health; https://sph.cuny.edu/research/covid-19-tracking-survey/week-3/

Among the most vulnerable communities in NYC and the country, the burdens from COVID-19 have been exacerbated by a lack of comprehensive policies to address underlying vulnerabilities. In a survey representative of NYC conducted in late March by the CUNY Graduate School of Public Health and Health Policy, 44% were worried about housing, 27% feared they would not be able to pay their rent and 59% of those who worried about their next rent payment, feared eviction. These housing fears were coupled with job loss, which has disproportionately impacted minority communities in NYC with job loss among African Americans increasing from 17% to 35% between weeks 2 and 6 of quarantine. For those essential workers still with jobs, they often must risk illness and transmission to fulfill those duties without basic worker protections and paid sick leave. On May 1st, essential workers around the country staged a strike in demand of some of these rights.

Lawmakers and community advocates should work with communities to demand policies that address systemic racial disparities, protecting housing for both homeowners and renters, codifying worker protections, and making healthcare accessible. COVID-19 is not only exposing but may very well be widening the socioeconomic gap in America in the absence of policies that protect the most affected communities.

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