The Disproportionate Impact of Coronavirus on Black Communities
The coronavirus has killed more than 400,000 people and infected more than seven million worldwide. The U.S. has surpassed 110,000 deaths and has two million cases. Here in Canada, nearly eight thousand have people have died as the country inches closer to 100,000 cases.
But among those numbers, Black people are being disproportionality affected.
The Colour of Coronavirus
Figures compiled by the APM Research Lab titled “Color of Coronavirus” found Black Americans are dying of COVID-19 at three times the rate of white people. To date, more than 20,000 Black Americans have died from the disease. That’s 50.3 per 100,000 people, which works out to about one in 2,000 of the entire black population in the U.S. Compare that with 20.7 per 100,000 for whites, 22.9 for Latinos, and 22.7 for Asian Americans.
Meantime, the death rates vary for each state and city. For example, in Washington, D.C., Black Americans die from coronavirus at six times the rate of white people. It’s five times the rate in Michigan and Missouri. It’s three times the rate in New York, Illinois, and Louisiana. In Chicago, Black Americans account for more than 60% of the city’s COVID-19 deaths, but only 30% of the population.
A summary by The Centers for Disease Control and Prevention titled “An Epidemic of Inequities: Structural Racism and COVID-19 in the Black Community” found that despite Black Americans comprising only 13% of the national population in the U.S., they account for 30% of confirmed cases of COVID-19. The widest disparities in death rates are in states with the most segregated cities in the nation.
To make matters worse, there’s also disparity in testing. One study out of Massachusetts found Black people who went to hospitals with coronavirus symptoms in February and March were less likely to get tested or treated than white patients.
The Impact of Systemic Racism
The healthcare system — especially in the U.S. — has failed Black Americans. And it’s well documented.
Recent research looking at racial bias in pain assessment found that over 50% of medical students and medical residents think Black people feel less pain because they believe myths like “Black people have thicker skin or less sensitive nerve endings than white people”.
These beliefs, which originated in the 1800’s, are held by many medical students as recently as 2016. And they directly impact how Black people are treated for pain, including during child birth.
In one study from 2012, researchers found a correlation between paediatricians’ implicit racial biases and how they treated pain in a simulated surgery. During the simulated surgery with white patients, they consistently prescribed the appropriate pain medication. But during the simulated surgery with black patients, the likelihood of prescribing the correct pain medication decreased.
A Congressional report on racial and ethnic disparities in healthcare found that race is also a factor when it comes to healthcare quality.
In Canada, while national race-based data on COVID-19 hasn’t been collected yet, demographic data from Toronto shows the hardest hit communities are Black neighbourhoods. And Black Canadians have historically faced similar obstacles when it comes to disparity in healthcare. The federal government even omitted minorities from their list of coronavirus-vulnerable populations.
In January, the Black Experiences in Healthcare Symposium Planning Committee wrote a letter to Ontario’s provincial government calling for race-based data collection for COVID-19. They cited data from the U.S. and U.K. on Black populations disproportionately suffering from COVID-19 at a higher rate, and provided a report titled “Black Experiences in Health Care Symposium: Bringing Together Community and Health Systems for Improved Health Outcomes” highlighting key recommendations from this year’s symposium aimed at creating a more equitable health system.
But it’s more than just poor healthcare.
The CDC summary highlights systemic racism at large as the reason the Black Community is at a higher rate of COVID-19 death and infection. When it comes to infection rates, factors like employment and occupational standards (including Canada), housing, mass incarceration, and barriers to physical distancing all play a role. Meantime, mortality risk factors also include hyper-segregation, poverty, environmental contaminants and pollution, and pre-existing health conditions.
Diet and Lifestyle
Without addressing the root problem, the Trump Administration blamed the higher rates of COVID-19 deaths among Black Americans on underlying health conditions like diabetes, hypertension, and obesity. These conditions are common comorbidities among COVID-19 patients. Several studies (including one out of Wuhan, China, a Meta-Analysis, a New York City study, and a larger one out of London) have shown COVID-19 patients with these conditions are at a higher risk of severe symptoms and death.
And Black Americans are at a significantly higher risk for these comorbidities including coronary heart disease, hypertension, diabetes, and obesity.
These conditions can all be improved — or worsened — through diet and lifestyle. But, here lies another obstacle for Black Americans: diet-related disparities.
Food insecurity and race are associated with poor diet quality. Studies show “food deserts” — areas where it’s difficult for residents to find affordable, healthy food — are more abundant in Black communities and other minority neighbourhoods. Black people are also more likely than white people to participate in SNAP.
Instead of healthy food options and fresh produce, Black Americans are more likely to live in neighbourhoods with fast food franchises. And these franchises, with the help of the U.S. Government, have disproportionately targeted Black communities since the 1960’s.
A U.S. Department of Agriculture report showed from 2013 to 2014, Black Americans got 20% of their calories from fast food compared to 15% for whites. Fast foods and animal-based foods contain saturated fat and cholesterol which are known to increase the risk of developing heart disease, diabetes, and obesity — all comorbidities for COVID-19.
Meantime, a more Mediterranean influenced diet high in fruits, vegetables, whole grains, nuts, seeds, and legumes has been shown to prevent and often ameliorate COVID-19 comorbidities like heart disease, hypertension, and diabetes. The 2015 USDA Dietary Guideline Advisory Committee wrote, “…a dietary pattern that is higher in plant-based foods and lower in animal-based foods is more health promoting and is associated with lesser environmental impact than is the current average U.S. diet.”
And while it didn’t consider current COVID-19 data, a paper examining the potential impact of nutrition on coronavirus susceptibility suggested that the consumption of diets high in saturated fats and processed foods could place some minority populations at an increased risk for coronavirus. The researchers recommend focusing instead on “…fiber, whole grains, unsaturated fats, and antioxidants to boost immune function…”.
However, it’s of extreme importance to note that making a dietary change will not prevent someone from contracting an infectious disease — or spreading it. That’s not how infectious diseases work. Dietary patterns can lead to lifestyle diseases like heart disease, diabetes, and obesity that become underlying risk-factors for SARS-CoV-2. So, tackling these factors could potentially lead to less-severe COVID-19 symptoms if contracted in the future.
How to Help
In terms of changing this disparity, the CDC has issued short and long-term recommendations. Short-term changes include updating COVID-19 case and mortality counts to account for race and ethnicity, prioritizing racial equality in coronavirus testing facilities, allowing SNAP beneficiaries to buy groceries online, and expanding access to Medicaid for people who’ve lost employer-based health insurance.
Long-term changes include reinvesting in Black communities, public health infrastructure (including addressing implicit bias), fighting for environmental justice and an end to environmental racism, ending mass incarceration, and stamping out the racial wealth gap.
And when it comes to nutrition, there are several organizations and initiatives working to provide healthy meals to communities at risk. Might Be Vegan started a program called Food Love that helps Black and low-incomes families in need access fresh plant-based food. Ten Thousand Black Vegan Women, a movement started by public health nutritionist Tracye McQuirter, highlights the health benefits of a vegan lifestyle by helping Black women shift to a plant-based diet. McQuirter also co-authored the African American Vegan Starter Guide with Farm Sanctuary and co-founded BlackVegetarians.com, the first vegan website by and for Black Americans.
Other sources include Support + Feed, which works with plant-based restaurants in Los Angeles to help those in need during the COVID-19 crisis; Chilis on Wheels, which helps make vegan food accessible to low-income communities throughout the U.S.; Food Not Bombs, an all-volunteer global movement that serves free vegan food and vegetarians meals to the less-fortunate in more than 1,000 cities in 65 countries; Empowerment Food Project, a group of activists who encourage healthy food choices that also benefit the environment; and Food for Life Global, one of the largest plant-based food relief programs in the world.
