On April 10, Surgeon General Jerome Adams made public remarks about how the coronavirus pandemic is disproportionately affecting minority groups in the U.S. He is one of the few federal level health officials who have displayed the courage to acknowledge the outbreak’s impact on communities of color.
While it appears that black communities are being harder hit by the outbreak, robust demographic information has been a missing piece to the understanding of the virus. According to data released by the Centers for Disease Control and Prevention (CDC) recently, 65 percent of the cases had no specified race.
Kristen Clarke, executive director of the Lawyers’ Committee for Civil Rights Under Law, said it was “astounding” that the CDC has not collected more complete demographic data. “The department of Health and Human Services has not offered a concrete plan about how it intends to tackle the problem in front of us,” Clarke told reporters. “The fact [is] they do not have race information tied to all of their data. We know that our communities are being ravaged by COVID and the federal government has a role to play.”
Although there is limited data on the disease’s impact by race in the U.S., we do have some information that reinforces evidence that African Americans have an increased risk of both getting COVID-19 and not surviving.
Data from Michigan shows that while African Americans make up 14 percent of the state’s population, they represent 40 percent of the coronavirus deaths in the state.
At the time of this writing, African Americans represent 39 percent of those that have died in Illinois where the black community represents 14.6 percent of the population. Preliminary data from North Carolina, Georgia and Kansas confirm similar ratios.
In early April, Delegate Nick Mosby led a group of state legislators in an effort to urge Governor Hogan to instruct the Maryland Department of Health (MDH) to release racial and geographical grouping data. By April 9, MDH released a report disclosing that black residents make up 52 percent of coronavirus-related deaths, although black residents comprise 31% of our state’s population. Gov. Hogan requested that the department continue to publish all data available on racial and ethnic breakdowns of COVID-19 cases.
Dr. Lisa Cooper, a medical expert and social epidemiologist with the Johns Hopkins Bloomberg School of Public Health, noted that broader social disadvantage is the reason black people are worse hit. She stated, “As a group, African Americans in the U.S. have higher rates of poverty, housing and food insecurity, unemployment or underemployment, and chronic medical conditions, and disabilities.”
Despite the missing data, many of us already acknowledge the health inequities resulting from economic, social, political and economic forces (also known as the social determinants of health). The coronavirus experience has simply magnified the systemic disparities that exist as a result of where we live, what we earn, how we are educated and how we access health care.
Unless we champion public health as an essential public good, we fail to preserve the American ideals of fairness, justice, and compassion for all. For those that do not share these values, or interpret them differently, they extend the risk to a national recovery. Constructing an expanded definition of public health, and addressing the non-medical variables that impact 80 percent of health outcomes, are not only the right things to do but also imperatives if we want to flatten the curve of COVID-19 in a sustainable manner.