Structural Racism Helps Explain COVID-19 Disparities

The COVID-19 crisis gives us an opportunity to make structural changes for a better society

While some people are practicing social distancing by lounging in their multi-million vacation homes, others continue to work on the front lines risking their health and safety. Those at the front-lines are primarily people of Color.

These are volatile, minimum-wage positions, and people with no option but to stay at work. While those with higher incomes, job stability and wealth adapt to working from home, essential workers expose themselves daily on their commute and at their jobs. 

Because of this, people of Color are disproportionally more likely to test positive for and die from COVID-19, according to data from about 51 percent of total cases in Washington. 

King County’s Hispanic or Latino population makes up approximately 17 percent of confirmed coronavirus cases despite making up only 10 percent of the total population. For Native Hawaiian or Pacific Islanders, it’s 1.7 percent of confirmed cases and 0.8 percent of the population. For African Americans, it’s 7.5 percent and 6.4 percent.  

Institutional and structural racism underlie these disparities, but the federal administration is focusing solely on individual behavior. Surgeon General Jerome Adams has argued that Black people are “socially predisposed,” urging Black people to stop drinking, smoking or doing drugs. He has also stated that “people of Color are more likely to live in densely packed areas and in multigenerational housing situations, which create higher risk for spread of highly contagious disease like COVID-19.” 

Adams is wrong because the strongest predictors of health are socioeconomic status and race, not alcohol use or family size. Financial instability can lead to volatile health care coverage and sub-par housing situations in which water and air quality are low, leading to a variety of health outcomes.  

The current crisis highlights the racism embedded into our structures and institutions, and how race significantly impacts health outcomes at all socioeconomic levels. It also gives us the opportunity to begin making the structural changes necessary to come out of this into a better “new normal.” 

In the past, the medical field has failed to deal with its history of the exploitation of Black and brown bodies to advance science. For example, the ‘father of gynecology’ experimented on a number of women to treat fistulas between 1845-1849. These enslaved women receive little to no pain medication, suffered greatly, and could not consent.  

To this day, medical professionals receive training that leads them to believe Black people less when they express symptoms of pain. The idea that Black people’s pain is not real is a remnant of the commodification and dehumanization of Black bodies throughout the world. Western colonizers described native peoples of various continents as savage, sub-human, and otherly. 

Washington, like many other states, also has a long history of racially restrictive covenants and red-lining that have kept people of Color in limited and specific neighborhoods. These neighborhoods were restricted from accessing essential financial capital to build their communities. While these formal policies are no longer legal, their impact continue today, as people of Color instead receive highercost and higherrisk mortgages.  

This government-backed discrimination has led to an array of problems correlated with poor health. Communities of Color live in food deserts and have less access to healthy food options. They are also more likely to live in close proximity to waste facilities and factories. As a result, people may suffer from respiratory health problems, diabetes, and heart disease.   

Racial segregation has also resulted in educational segregation, limiting communities of Color to low-resourced schools, from which their children are more likely to drop out. 

Still, people of Color across all educational levels continue to make less than and accumulate less wealth over time than their white counterparts. In addition to limited opportunity, people of Color experience pay discrimination and discrimination in the workplace, including being policed more strictly for their behavior, often under the guise of professionalism. For people at the intersection of racial and gender discrimination, the path to economic security can be even more shaky.  

In addition to the human crisis this reality presents, these gaps are significant dangers to our public and economic health. This is clearer today than ever before.

Rather than blaming individual behavior, it is essential that we reckon with the continuing impact of institutional and structural racism. COVID-19 continues to highlight this.  

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