COVID-19 and racial bias of the healthcare system

Four months after COVID-19 brought the nation to a standstill, Americans are waking up to an inescapable reality: an uncontrolled virus is steamrolling the nation leaving death and devastation — with no end in sight. Ranking the world’s highest coronavirus death toll, chaos and confusion reign in every state of the Union. Politicians offer misleading advice and protesters challenge lockdown directives while medical experts continually warn bewildered citizens to maintain infection-mitigating behaviors.

And as the nation celebrated its Declaration of Independence, it became clear that, in the eyes of COVID-19, the proclamation “…that all men are created equal,” falls short. A July 5 New York Times article revealed, “Latino and African-American residents of the United States have been three times as likely to become infected as their white neighbors,” according to new data released by the CDC.

Across states like Florida and Arizona, communities of color are already struggling just to get tested, as the chain pharmacies and urgent care clinics selected as testing sites are often located too far away. Sometimes clinics require evidence of insurance that many do not have. Are we going to see a replication of New York's minority communities where the virus spread rampantly? Nonprofits and foundations have had to step in to provide testing facilities, but it’s not enough. Free testing widely, without evidence of insurance, is needed right now. 

While the CDC has acknowledged gaps in data, there is hope for a more comprehensive picture as race and ethnicity data become a required part of testing as of August 1. Solid demographic information can help determine the geographical areas where racial/ethnic challenges are contributing to the spread of the virus. Demographic data can also help to further assess any racial/ethnic disparities in the healthcare system for constructive development and assist in healthcare investment considerations.

The testing data will only be as good as the action that follows.

When the White House Task Force on coronavirus announced statistics showing COVID-19 is killing African Americans at higher rates than any other ethnic population, the rush to open the country accelerated. Once that demographic became known, coincidently politicians’ narrative shifted from “public health emergency” to “Black people dying is not an emergency.” The demand to reopen businesses, churches, and, now even schools have prevailed. While all lives matter, Black lives matter less.

The coronavirus pandemic stripped away the façade of “We’re all in this together” and exposed the ugliness of racism at work. Racism was evident when armed citizens stormed the Capitol building in Lansing, Michigan, to protest Governor Gretchen Whitmer’s executive order extending a statewide lockdown. The demonstrators brought nooses, Confederate flags, Swastikas, and other symbols of white power. Lives of ethnic minorities do not matter. Their demand to Whitmer: Open the state. We don’t want to lose our jobs and we’re not the ones dying. Whitmer called them “racist” and misogynistic.”

Greater susceptibility to disease among people of color is not surprising; it is a reflection of the legacy of privilege, race, and power in America — historic, systemic racism. On a page dedicated to COVID-19 in racial and ethnic minority groups, the CDC website admits, “Long-standing systemic health and social inequities have put some members of racial and ethnic minority groups at increased risk of getting COVID-19 or experiencing severe illness, regardless of age.”

It is clear that COVID-19 is highlighting the overwhelming racial bias of the healthcare system. It ranges from doctors making assumptions about their patients instead of taking the time to ask respectful questions and listen, to pharmacies assuming a morphine prescription is fraudulent because certainly a black person must be looking for drugs. Black women’s health is less researched across all conditions. This is especially alarming when it comes to conditions that could require surgery such as fibroids, which are far more likely to develop than in white women. And yet black women are often told the only option is a hysterectomy rather than a noninvasive approach. Black women are also two to three more times likely to die from pregnancy-related causes.

What appears to be a simple, everyday act of going to the doctor because of sickness is riddled with concern for women of color. Many feel they have to dress up in order to be respected, if they even decide to go. Public transportation is a barrier to reach a health care facility and often a luxury of time many don’t have. The systemic discrimination and bias felt toward black communities is insurmountable and unimaginable.  

The national agenda must, therefore, address more than physical and mental health; it must also address systemic racism and its abysmal legacy across all healthcare. For COVID-19, prevention and treatment initiatives such as sustained quarantine periods, social distancing, widespread testing, contact tracing, and protective equipment must be uniformly and consistently applied. The agenda going forward must go beyond mere expressions of “We’ll get through this,” and “In these uncertain times...”

With solid data showing which ethnicities are most vulnerable, it will be easy to identify actions and decisions influenced by the presence of racism. More research is needed on COVID-19 and for all of health care. I call on politicians to demonstrate their commitment to human equality by using new demographic information as a proactive mechanism to address the disparities. Far too long the data collected has not served this purpose well. It’s time we change this with research and a strong response.