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Warnings and policies for black and brown communities with COVID-19

Mourning is still occurring in America, particularly among people of color. Former President Barack Obama highlighted it in his speech to the Class of 2020, saying that the “pandemic has shaken up the status quo and laid bare a lot of our country’s deep-seated problems.” When Chicago mayor Lori Lightfoot was recently asked about the fact that 70% of those who have died from COVID-19 in Chicago are African Americans, she called the news “absolutely shocking” and “really hard for me to take…in.” 

While I appreciate Mayor Lightfoot’s emphatic response, as an African-American health professional I must disagree with her on one critical point: Nothing about this outcome is shocking. COVID-19 may not discriminate who it infects, but racial disparities and inequalities are making black and brown communities more vulnerable to its effects. 

Although those with pre-existing conditions are known to be impacted by COVID-19 at a higher rate, the deadliness of COVID-19 isn’t merely an issue of pre-existing medical conditions. Also importantly, black and brown communities have long been victimized by institutional racism and inequality, and that is now being exacerbated by this pandemic. 

Everything from the testing center locations to the availability of testing to the access to basic care are disproportionately impacting black and brown Americans in alarming numbers. While African Americans make up only 30 percent of Chicago’s population, they account for more than half of the deaths from COVID-19. Latinos are not dying at the rate of African Americans, but now make up the largest percentage of cases in the state. 

These statistics are not unique to the Chicago area but are reflected in other metropolitan areas across the nation where larger populations of African Americans are showing consistent data. And these are numbers that we already know are underreported, so those who are not tested or admitted for COVID-19 will die without having been accurately counted.

To be sure, the higher COVID-19 death rate among black and brown Americans can largely be accounted for by a higher prevalence of chronic conditions in that population. But a narrative that centers solely on this fact misses the bigger picture. That this higher prevalence of chronic conditions is not due to biology, but rather is the result of gross disparities in access to medical care, healthy food, and stable housing. These disparities existed long before COVID-19, and will continue to exist without intentional intervention. As stated by Congresswoman Alexandria Ocasio- Cortez said, “COVID-19 is not creating new problems, but its pouring gasolines on existing ones.”

Chicagoans’ responses to this pandemic must consider the racial disparities and inequalities that have become part of our society and our city due to years of structural racism causing black and brown people to be “socially distant” and “quarantined” from resources. Testing and treatment for COVID-19 must be attainable and accessible to those most vulnerable to its effects.

Some Chicago areas have created drive up testing sites, but participating in this type of testing requires access to an automobile. Communities of color have been criticized for not taking shelter in recommendations seriously, however, according to the Economic Policy Institute, one in five African Americans and one in six Latinos do not hold the type of jobs that would allow them to do so.

In addition, studies have shown that black and brown people are more likely to live in densely populated areas or in multigenerational housing, making social distancing harder to do. Unclear and inconsistent messaging from federal leaders and myths that were slow to be debunked about African Americans being immune to COVID-19 were also slower to be dispelled. 

Sensitivity must be shown when providing education for wearing face masks in public since many African American men fear that it increases their risks of being further criminalized and victimized by police. Targeted educational campaigns directed at this fear may help mitigate this narrative. 

In an attempt to prevent the uptick of COVID-19 among communities of color, specific actions can be addressed. Engage and empower trusted faith leaders to expand culturally specific messaging and help to distribute healthy food choices. Increase the availability of convenient and free testing in predominantly black and brown neighborhoods. 

Encourage social distancing, masking, and hand hygiene campaigns in culturally sensitive and specific ways, while also providing the necessary materials to be successful. Immediate strategies for increasing wages and benefits and offering hazard pay to low income, essential workers must be considered now. COVID-19 has shed a harsh light on many issues in black and brown communities that need to be addressed.

The time for intentional intervention in minority communities is now. Without it, thousands of more minorities will die.

Christie Lawrence, DNP, is an assistant professor in the Department of Women, Children, and Family Nursing at Rush University College of Nursing and a public voices fellow through the OpEd Project.

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