Health Disparities and the Black Community

I remember when my grandmother got so sick that it was beyond what love could manage and my father made the difficult decision to put her into a nursing home. I heard a lot of conversation around which home to put her in. The nicer, predominantly white nursing homes weren’t in the city limits and were so expensive, they weren’t really contenders. But there were many others in the inner city; ones that had not so great reviews and that smelled of cheap disinfectant and despair. This is my earliest memory of understanding the types of health disparities that exist between whites and Blacks. This year’s pandemic reminds me that those inequities still exist, and in times of crisis, they are exacerbated.

When the pandemic hit, families that were struggling to make ends meet found themselves being forced to do so with fewer resources, and fewer opportunities to provide for themselves. Workers that found themselves sick with COVID-19, but lacking paid leave, faced the difficult decision of staying home to heal or keeping their jobs. Many were forced to go to work ill in order to ensure they’d have a roof over their heads. Some were fired by their employers when they asked for time to recuperate. But Black and Brown workers and their families were hit the hardest, many already underemployed in food service, temporary or gig jobs. What the pandemic has exposed is that the health disparities Black people were already living with only get worse when times get hard––and for some, those disparities mean life or death.

African Americans are at a much higher risk of contracting COVID-19 than the rest of the population, and they are much more likely than white people to die from the virus. Black people are also more likely to have underlying health conditions that increase the risk of severe illness with COVID-19. 

But underlying health issues are not the only reason that Black communities are faring worse than other communities. The CDC identified five additional societal factors that also put African Americans at greater risk:

— Healthcare access and utilization: People of color are more likely to be uninsured than non-Hispanic whites. Many African-Americans also hesitate to seek care given the history of outright mistreatment by healthcare practitioners and researchers in this country –  including forcing Black males with syphilis in Tuskegee to go untreated for “research” purposes and sterilizing thousands of Black women without their knowledge or consent. 

— Healthcare access and utilization: People of color are more likely to be uninsured than non-Hispanic whites. Many African-Americans also hesitate to seek care given the history of outright mistreatment by healthcare practitioners and researchers in this country –  including forcing Black males with syphilis in Tuskegee to go untreated for “research” purposes and sterilizing thousands of Black women without their knowledge or consent. 

— Occupation: Many essential workers are people of color, working in industries like healthcare, food service, and factories. That typically requires working in close contact with others, with no work-from-home options and no paid sick days.

— Educational, income, and wealth gaps: A history of segregation and unequal facilities means living in a community with lack of access to affordable, high-quality child care and education. As a result, young Black people have lower high school graduation rates, which makes it harder to get into college and earn degrees that would open doors to higher-paying jobs. When your job pays less, it is difficult to save money and almost impossible to miss any work without losing your position. All that takes a toll on the ability to save and have a cushion for hard times.

— Housing: In many communities of color, it is not uncommon to have multi-generational families living together. Sometimes this is by choice, but it’s also a way to deal with persistent discrimination in housing and mortgage lending that keep communities of color from acquiring real estate. Living in such close quarters makes it difficult to follow isolation and quarantine recommendations. In addition, high unemployment rates in communities of color, especially during this pandemic, result in greater risk of eviction and homelessness.

— Discrimination: Living under the weight of racism and other types of discrimination cause stress that impacts the immune system and adds to the risk for COVID-19.

My hope is that as we celebrate Black History Month and the contributions of Black people, we also highlight African Americans’ unequal living conditions in this country. To truly honor Black communities’ contributions to this nation we must start with acknowledging the persistent mistreatment, marginalization, and discrimination against Black people; breaking down the systems that continue to oppress African American communities; and establishing new systems founded on an infrastructure of care, equity, and respect. 

One way we do this is by winning a permanent, national paid leave program with an inclusive family definition to cover all workers––no matter where they live or where they work. Join us in supporting this effort by reaching out to your Members of Congress and imploring them to vote to keep paid time to care front and center as we Build Back Better.

By Safiya Simmons

Where does it start?
Well past slavery.
Laws that say, get out, you can’t live here.
So you move where you can and try for the American dream.
But the banks laid down a thick red line.
No loans for you.
The factory with its good-paying union jobs
Manufactures excuses and
Ships the work overseas.
Developers run the new highway
Right through your block.
The state cuts funds for the schools your kids go to.
New jobs are out in the boonies.
No bus lines go there.
Family members double up.
You sizzle potatoes or box packages.
You clean, you take orders,
You care for the elderly,
Or some other job they say is essential but
Pays peanuts and fires you for being sick.
Mass incarceration robs your community.
The dirtiest factories set up shop down the street,
Destroy your air.
Lead lines your walls.
Asthma, diabetes, take root in your limbs.
Health care is beyond your reach.
And then, hello coronavirus.

Poem by Ellen Bravo