Covid-19 pandemic is undoubtedly the most problematic health and economic calamity of the century and has been an extreme challenge for the entire human race since its first outbreak in China. Nations all over the world are striving tirelessly to control the spread and fight the catastrophic effects of the novel coronavirus. Even during these unprecedented times, racial and ethnic minority groups are being affected disproportionately by the health systems of the country. For communities of people with different colors, races, and backgrounds, Covid-19 has had an unjustifiable burden in the United States that cannot be overlooked anymore.
Injustice and Disparities During Covid-19
Inequalities in the social determinants of health include factors like social status, neighborhoods, education, and the effects these factors have on different ethnic groups are inevitable (“Coronavirus Disease 2019”, 2020). These effects include injustice and disparity due to discrimination, healthcare access, utilization, income and wealth gaps, and housing (“Coronavirus Disease 2019”, 2020). The first and foremost issue of injustice and disparity faced by people during the COVID-19 pandemic is racial discrimination. It is disquieting and disturbing that in the United States, racial discrimination exists even in the hospital systems that are meant to protect their citizens and are supposed to work only for their well-being. Statistics show that people from racial and ethnic minority groups are usually uninsured compared to White Americans. Health care access to these uninsured citizens can be limited as they face communication and language barriers as well (“Coronavirus Disease 2019”, 2020).
According to case reports in April 2020, Black Americans make up a total of 30% of the current number of Covid-19 cases, whereas Black Americans make up only 13% of the total population of the United States (U.S. Census Bureau, 2018). Similarly, Latino Communities make up a total of 18% of the population of the United States and account for only 17% of the current Covid-19 cases (U.S. Census Bureau, 2018). Moreover, recent reports on Covid-19 cases in the United States show that people of color are at a higher risk of stage four illness if they contract Covid-19 as a result of a higher rate of co-occurring diseases due to underlyingly health conditions such as asthma, diabetes, hypertension, obesity, and weak immune system (Kaiser Family Foundation, 2020; CDC, 2020; U.S. Census Bureau). In the United States, people of ethnic minority groups are usually employed in the services industries such as retail, restaurants, and hospitality are at particular risk of income deduction or even unemployment due to economic crises brought about by the Covid-19 pandemic. Furthermore, ethnic minorities are more likely to reside in public housings or even situations like multigenerational families that make it difficult for individuals to practice social distance and self-isolation if they contract Covid-19. The use of public transportation gives further rise to the risk of spreading Covid-19 (Kaiser Family Foundation, 2020; CDC, 2020; U.S. Census Bureau).
As history itself the only major evidence, it is not the first time that the world is facing a pandemic, which means that people of ethnic minority groups had faced racial discrimination and disparities in the past as well. The two main situations that will be discussed under the historical context in this section are: The 1918 Influenza Pandemic and the infamous fourteenth-century plague, also referred to as The Black Death. When compared with the current Covid-19 pandemic, the influenza pandemic seems to have some similarities. However, the black death plague was quite different. But injustice, racial discrimination, and disparities faced by people of color and ethnic minorities existed in all three eras with disturbing results (“Analyzing the Past in the Present: The Black Death, COVID-19, and the Ursinus Quest”, 2020).
The second pandemic of the bacteria Y. pestis that occurred in the eastern hemisphere, also known as Afro-Eurasia, is commonly called the Black Death. This plague first occurred during the mid-fourteenth century and therefore remained for centuries afterward with recurring outbreaks and is still known to be the largest pandemic in human history (“Analyzing the Past in the Present: The Black Death, COVID-19, and the Ursinus Quest”, 2020). Despite the catastrophic effects this pandemic had on the entire human race, according to Logan Mazullo, the disease was not a “great leveler” as people of colors, and ethnic minority groups were being burdened with disproportionate effects due to lack of resources and facilities (“Analyzing the Past in the Present: The Black Death, COVID-19, and the Ursinus Quest”, 2020). Many reports from the time of the Black Death show that people from the elite class, especially the rulers and royal families, were particularly safe from the plague. This apparent discrimination triggered social class tension and frustration in the entire society.
An estimate of 50 to 100 million people died due to the 1918 influenza pandemic all over the world. In the United States, 1 million people died, and the case-fatality rate was approximately 2.5%, which is relatively high (“Historical Insights on Coronavirus Disease 2019 (COVID-19), the 1918 Influenza Pandemic, and Racial Disparities: Illuminating a Path Forward”, 2020).
Even though the preceding pandemics and epidemics had a disproportionate toll on the Black American community and other minority groups, however, the results of the influenza pandemic were different. Studies that were conducted during the influenza pandemic to determine the racial discrimination showed that the Black Americans had lower influenza morbidity but higher case fatality rate as compared to White Americans (“Historical Insights on Coronavirus Disease 2019 (COVID-19), the 1918 Influenza Pandemic, and Racial Disparities: Illuminating a Path Forward”, 2020).
In the early 19th century, other than the Influenza pandemic and the Black Death plague, the smallpox epidemic also caused a higher rate of morbidity and fatality among Black American people. According to statistics recorded before the 1918 influenza pandemic, Black Americans accounted for an astounding number of 50,000 causalities in the 1862-1867 smallpox epidemic in the country (“Historical Insights on Coronavirus Disease 2019 (COVID-19), the 1918 Influenza Pandemic, and Racial Disparities: Illuminating a Path Forward”, 2020).
Most Affected Communities
To demonstrate which communities and races are being most affected by the injustice and disparities that exist during the Covid-19 pandemic in the United States, it is crucial to analyze the demographical and statistical data recorded by the researchers. According to such analyses, African American deaths due to Covid-19 are approximately two times more than expected based on their share of the population (Godoy, 2020). Similarly, Latin American deaths due to Covid-19 is more than their share of the population is around 42 states of America, including Washington D.C. (Godoy, 2020). As a result, the number of White American deaths due to Covid-19 is less than their share of the population is over 37 states, including Washington D.C. (Godoy, 2020). In Wisconsin, around 141 African Americans’ deaths count for 27% of the causalities due to Covid-19 when the population percentage of African Americans in the state is only 6% (Godoy, 2020).
These disparities of social determinants of health are observed in all age groups. However, it is particularly higher among young African Americans and Latin Americans. When statistics of cases in African Americans and Latin Americans are compared with that of White Americans, it is observed that those aged between 45-54 years of death rate are at least six times higher (Ford, Reber, and V. Reeves, 2020). White Americans age between 45-54 comprise 62% population of the United States, and among these age groups, 1,013 White Americans have died due to Covid-19, which only 22% of the total number of deaths all over the country (Ford, Reber, and V. Reeves, 2020). On the other hand, 1,448 African Americans and 1,698 Latin Americans between the age of 45-54 have died due to Covid-19 in the United States (Ford, Reber, and V. Reeves, 2020).
Is this Issue Systematic?
Many deep-rooted reasons contribute to racial discrimination and disparity while accessing healthcare during the Covid-19 pandemic in the United States. Covid-19 cases and their illness effects increase among African Americans and Latin Americans because of their jobs, education, residential situations, geography, and lack of healthcare facilities (Egede and Walker, 2020). These issues prevail because discrimination in one sector initiates a discrimination practice in another sector (Egede and Walker, 2020). These interconnected systematic issues affect hospital systems by social deprivation due to fewer job opportunities, lack of education, and better housing systems. Therefore, it can be safely said that the injustice and disparities faced by people of ethnic minority groups during Covid-19 are due to systematic problems that cannot be resolved overnight and require a change in strategies and policies by the government of the United States.
Legal and Public Health Solutions
Currently, the government of the United States is trying to make policies and legislation to implement both short-term and long-term solutions to deal with injustice and disparity faced by minorities and people from different races. Data related to Covid-19, including screening tests, hospitalization, ICU admission, and case-fatality rates, are collected disaggregated by race and ethnicity at both and national scale. The CARES Act provides financial support for small businesses and individuals (“Substance Abuse and Mental Health Services and Administration,” 2020). For instance, in California government is providing financial supports to the immigrants affected by the Covid-19 pandemic to compensate for low-wage workers as the pandemic has brought economic crises on people who work in the services industries (Yearby and Mohapatra, 2020). Similarly, in Arkansas, if someone is tested positive for Covid-19 in a facility, the employees were given an extra 125$-500$ a week by the governor (Yearby and Mohapatra, 2020). Moreover, 12 states, including the District of Columbia, have passed laws to increase the income for direct care workers during the Covid-19 pandemic (Yearby and Mohapatra, 2020). However, these are not the most effective strategies to deal with injustice and healthcare disparity faced by minorities. Therefore the government should bring about more strict and better legislation for the well-being of people from all races during these trying times. The government should address all major as well as minor issues that contribute to these racial discriminations, including better housing systems so that people can practice social distance and self-isolation at home, clean environment and water for a healthy lifestyle, and low cost or free expanded treatments for immigrants. Even though it is a fact that racial discrimination has existed previously as well, however, researches and recommendations based on the studies conducted during previous pandemics cannot be implied in the current situation as they are outdated and not suitable for these people of the modern generation. Therefore, the government of the United States has to address these issues today using smart and effective strategies and policies that are suitable for people of this era. These solutions might not sound simple and easy to be implemented, but they are necessary to minimize the catastrophic effects of the Covid-19 pandemic and, therefore, must be brought into action as soon as possible.
The inequities and disparities observed during the Covid-19 pandemic are unprecedented yet predictable at the same time. As historical data shows us the existence of racial discrimination during a pandemic, but the seriousness of the matter is unparalleled as the government of the United States has not yet succeeded to plan properly to protect the racial and ethnic minority population. Dr. Alicia Fernandez, a professor of medicine at the University of California San Francisco, researched healthcare disparities and says, “I think it’s incumbent on all of us to realize that the health of all of us depends on the health of each of us” (Godoy, 2020). This quote highlights the importance of the issues and how it cannot be neglected anymore as people are dying because other people are not inclined to help them just because of the difference in their background and color.
- “Coronavirus Disease 2019”. (2020). Centers of Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html
- “Analyzing the Past in the Present: The Black Death, COVID-19, and the Ursinus Quest”. (2020). Ursinus College. https://www.ursinus.edu/live/news/4682-analyzing-the-past-in-the-present-the-black-death
- “Historical Insights on Coronavirus Disease 2019 (COVID-19), the 1918 Influenza Pandemic, and Racial Disparities: Illuminating a Path Forward”. (2020). NCBI PMC. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298913/
- Godoy, M. (2020). What Do Coronavirus Racial Disparities Look Like State by State? NPR. https://www.npr.org/sections/health-shots/2020/05/30/865413079/what-do-coronavirus-racial-disparities-look-like-state-by-state
- Ford, T. Reber, S. Reeves, R. (2020). Race gaps in Covid-19 death are even bigger than they appear. Brookings. https://www.brookings.edu/blog/up-front/2020/06/16/race-gaps-in-covid-19-deaths-are-even-bigger-than-they-appear/
- Egede, L. and Walker, R. (2020). Structural Racism, Social Risk Factors, and Covid-19 — A Dangerous Convergence for Black Americans. The New England Journal of Medicine. https://www.nejm.org/doi/full/10.1056/NEJMp2023616
- “Substance Abuse and Mental Health Services and Administration”. (2020). SAMHSA. https://www.samhsa.gov/sites/default/files/covid19-behavioral-health-disparities-black-latino-communities.pdf
- Yearby, R. and Mohapatra, S. (2020). Law, structural racism, and the Covid-19 pandemic. Oxford Academic. https://academic.oup.com/jlb/article/7/1/lsaa036/5849058#206971940