COVID-19: The Many Hurdles in Black and Brown Communities.

Right in the middle of a pandemic caused by a killer virus that loves groups and people in close quarters, there is an outbreak of protests in response to a broad daylight public display asphyxiation murder of George Floyd, a black man by four Minnesota white policemen. The streets are flooded by sheets of outraged protesters. Epidemiologists brace up for an imminent uptick in transmission and cases of COVID-19 infection. The struggles and history of ethnic minorities and persons of color have always been told, but never has it been so downright draped on ones consciousness, especially for the generations that did not witness the civil rights movement past, the gaping wounds left behind by a long unrelenting history of disparity that is so evident in a society. The link has never begged to be made that always has existed of a not-so-novel a "virus" of disparities, of social and economic inequities, pervasive injustices, inequalities in educational opportunities. These social ills leave in their wake a roadmap for the lethal effectiveness and pathogenesis of COVID-19, the real novel virus that followed . A disease, a new enemy virus, that seemed to have earmarked whom, where and how it would hit the hardest, communities of color, knowing how those have been forced to live, breathe, eat and the work in America, a nation that once boasted a promise of greater life for those who set foot on its shores.

The old virus, the true “preexisting conditions” happens to be the social inequalities, disparities, unequal educational opportunities and injustice, hurdles that seem not go away. These hurdles give birth in communities of color to:

  1. Inescapable urban living as against suburban or rural living, in crowded cities, multi-dweller apartments , close quarters and overcrowded cross-generational households with parents, grandparents and grandchildren, that promote disease transmission, difficulty practicing household hygiene and social distancing necessary to fight COVID-19 transmission . According to a national survey, 56% of residents of urban counties are non-White, compared to 32% non-White in suburban counties and 21% non-White in rural counties. This is largely because black families earn less thatn white families and the wage gap has grown relentlessly. While the nations poverty rate has trended down in recent years from the lows of more than a decade ago, poverty for blacks stand at 20.8% compared to 8.1% for non-Hispanic whites.
  2. Jobs and high exposure duties , low level, mid level and frontline employment that must remain attended, essential, even when there is a lockdown and other workers stay home. These include our bus drivers/conductor, nurses, hospital janitors , postal/mail delivery worker. It may be true that many were able to keep their jobs in pandemic but at the increased risk of catching the COVID-19 virus bringing it home and paying with their lives.
  3. Poorly educated and skilled persons . They are the members of society who have been robbed of occupations, operations and work tools that otherwise make it possible to effectively telecommute, telework and remote work from home.
  4. High consumption and dependence on public amenities including public transportation that increase exposure to disease and contamination. People and families of color are more likely to use public transportation to commute to work , church and shopping than their white counterparts.
  5. Food insecurity and inability to access healthy diet and nutritious food leading to obesity, diabetes and high cholesterol.
  6. Poor access to health services. Even with improvements in health care coverage for all racial/ethnic groups after passage of the Affordable Care Act in 2010, the statistics show Blacks (15%) and Hispanics (27%) were still significantly more likely than Whites (9%) to be uninsured in 2018. The Economic Institute found that black workers are 60% more likely to be uninsured than their white conterparts.

Constant accompaniment of the highlighted socio-economic predicaments confronting the communities of color are hypertension, obesity, heart disease, and diabetes, and remain the foundations and etiology of our medical confounding features, the so called co-morbid conditions in the black and brown communities.

New Jersey for instance with its estimated population of nearly 8.9 million, white alone 72% and black people contributing 15%, reported more than 11,700 deaths of which a disproportionately higher percentage of 18.5 % was black followed by Hispanic or Latino. Whites comprised a disproportionately 53% of COVID-19 deaths. The unemployment among blacks soared nearly 17% as a result of the pandemic. If not for these socio-economic, educational “preexisting ” inequities of over 200 years in America , there will not be the glaring disparities in COVID-19 transmission, morbidity and mortality in the communities of color vs white communities as seen in this pandemic.

The post COVID-19 era must be prescribed differently for the brown and black communities. Mitigation must carry on and continue into the future post COVID-19 for those who will be left to carry on. Measures to get people of color out of poverty, improve education and skills acquisition, better housing must intensify and endure. Focus must be on social justice for all, opportunity, fairness and equity.
The fight to control obesity, hypertension, heart disease, diabetes and kidney disease are ineffective without surgically addressing the preexisting inequities of the black and brown experience in America and the world at large. For their part providers , physicians and health officials cannot fully discharge their role without embracing fully the advocacy for this segment of our society who bear the brunt of inequity, one that continually invites the greater burden of disease, morbidity and mortality.