There is a very important article in Slate that everyone should read.
When two colleagues and I started examining infectious mortality rates during the early 20th century, we were looking for regional differences in how the United States handled influenza, tuberculosis, and other kinds of infections. Of course, we were especially interested in that era’s deadly pandemic. The 1918 flu had killed on a scale that’s hard to fathom: an estimated 50 million people worldwide, and half a million in the U.S.
To get a detailed look at infectious disease mortality in that era, we digitized and carefully checked old public health records, linked them to census population estimates, and categorized the causes of death. We didn’t believe the results. We discovered that white mortality during the 1918 flu pandemic was still lower than Black mortality, up to that point, had ever been. This wasn’t only true in the South, but in every region of the United States. This wasn’t about regional public health—it was about racism.
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This spring, while recovering from my own COVID-19 infection, I wondered whether the same thing would still be true today. I found it unfathomable that the disaster unfolding around me that spring in New York, where my parents live and where I had become sick, could bear any resemblance to more typical life in the United States. And yet, thinking about how the 1918 results had stunned me, I wanted to see for myself. As life ground to a halt in the midst of another cataclysmic pandemic, how did the toll of this one compare to that of the more ordinary, ubiquitous catastrophe? Will white mortality during the coronavirus pandemic still be less than what Blacks experience routinely, without any pandemic? I began to work out equations and search for data.
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If the Black population did not experience a single death due to COVID-19, if the pandemic only affected white people, Black mortality in 2020 would probably still be higher than white mortality.
This is a thought experiment. In reality, of course, COVID has hit Black populations hardest, and the inequality in death rates is likely to greater than it has been in many years. Racism is making Black Americans, along with indigenous and immigrant populations, most vulnerable to the pandemic. But the hypotheticals give us an important perspective on the reality: Racism gave Black people pandemic-level mortality long before COVID.
And it is racism that is killing Black people. “Mortality modelers” like me know that there are an awful lot of reasons one person might live longer than another. But when we see that one group in a society consistently dies at younger ages than another, we can look for trends. America excludes Black people from mechanisms of generating wealth, consigns them to the worst schools, confines them to neighborhoods with more pollution and more poverty, targets them with routine violence by state authorities, and treats them with suspicion and hostility when they seek medical care. There is no mystery in those early deaths.
We all know the devastating cost of COVID-19, yet as the article makes clear, the cost of racism on the Black communities is as high, or even higher, year after year.
This has to change. As the article states:
It is time we honestly confront the magnitude of racial inequality in the United States: a pandemic’s worth of death, every single year. Once we do that, our question about radical proposals to combat racism should shift from what is politically palatable to, simply, what will work.
There’s also the fact that the medical infrastructure in the majority Black areas is much thinner than in the majority white areas. In my own state, New York, the state government greatly reduced the number of beds in hospitals in the poorer areas of cities in NY, with the result that when COVID hit, they were more overwhelmed than other hospitals. Many seriously ill COVID sufferers were sent home because there were so many even more seriously ill patients filling up all the beds.
In a majority-Black city in my area, the corporation that owns the one hospital in town wants to close it and replace it with a clinic, so that people needing serious medical care will have to be transported to NY City for care. The people in the city are fighting it, it’s not clear whether they have a chance, though.
There’s also the well-known racism in the medical profession, which is the main reason that the maternal mortality rates for black mothers is substantially higher than for white mothers in the same hospitals. Our local newspaper ran a series of stories on the subject with a number of horrifying examples. Not to mention the widespread belief among doctors that Black people are not as sensitive to pain as whites, resulting in undermedicating pain.