Two years since it was first reported, the COVID-19 pandemic continues to rake havoc in many parts of the world. Almost every community in the globe has experienced the devastating effects of the disease. However, in the United States, there is a disturbing trend where people of color, specifically African Americans, experience more severe illness and fatality rates as compared to their white counterparts. During the early months of 2020, there were glaring disproportionate rates of illnesses and fatalities among the black community in the US.
In Chicago for instance, the population of African Americans is about a third. However, by March 2020, 50% of all the COVID-19 infection cases were among the black community. Further, close to 75% of all COVID-19 related deaths involved African Americans (Health Equity Considerations and Racial and Ethnic Minority Groups, 2021). The same case is replicated in Milwaukee County in Wisconsin where 70% of all the coronavirus fatalities were from black Americans even though they only comprise 26% of the population (The color of Coronavirus, 2021). Similar trends have always been observed among other minority populations such as the Native Americans and the Hispanics.
Notably, these minority communities share some common economic and social conditions that act as risk factors for the disease. First, they live in crowded residential conditions, which makes it difficult to practice social or physical distancing. The preexisting redlining policies and historical racial housing segregation contribute to enhancing the spread of the disease among African Americans. Averagely, up to ten people share a three-bedroom apartment in black-dominated residential areas. Other than congested housing, a sizeable number of blacks work in essential fields such as food services, health care, transportation, and environmental services. According to the CDC, 30% of licensed vocational and licensed practical nurses are African Americans (Health Equity Considerations and Racial and Ethnic Minority Groups, 2021). This implies that their professions cannot allow them to work from home, which is one of the most highlighted measures of curbing the spread of the virus. Besides, the majority of them rely on public modes of transport to go to work (Tai et al., 2021). This further puts them in close contact with others, which enhances their exposure to the virus.
Many black Americans and other minority groups are either underinsured or lack health insurance. Thus, they suffer from inconsistent access to health care services. One of the most significant measures of lowering the spread of COVID-19 is seeking frequent medications and managing chronic diseases. However, these are expensive medical undertakings especially if one does not have medical insurance. For instance, an asthmatic patient or one suffering from diabetes requires consistent medical checkups and treatment. Without this, such a patient is more predisposed to the effects of the deadly COVID-19. Therefore, lack of health insurance is a significant barrier to accessing quality health care, a key factor in the acquisition and spread of the disease among the population.
Furthermore, African Americans have a higher chronic health conditions burden. There are higher rates of heart disease, lung disease, and diabetes among people of color in the U.S. These form the underlying health conditions that heighten the chances of suffering and dying from coronavirus. Indeed, the Centers for Disease Control and Prevention (CDC) revealed that about 90% of the COVID-19 hospitalized patients are those with preexisting health conditions. Since many black Americans fall in this group, they are more likely to suffer from the burden of the pandemic than their white counterparts for instance.
The ability of the body to fight diseases including COVID-19 is influenced by, among other things, one’s psychological wellbeing. However, African Americans are some of the most stressed Americans. They live in conditions of discrimination, institutional racism, income inequality, violence, poor housing, joblessness, and poor health care. All these contribute to chronic stress conditions among them. The net effect is that their body immunities are worn down, further predisposing them to infectious diseases such as COVID-19. Indeed, the stress that people of color encounter in dealing with racial discrimination often take a toll on their bodies, causing them to age faster (Xiong et al., 2020). The CDC links this as one of the underlying conditions of COVID-19. People under this category experience more severe symptoms of the disease.
All the factors highlighted above-congested living environments, employment in essential service industries, underlying medical conditions, and increased stress levels have severe effects of COVID-19 among African American populations in the U.S. However, these are not new issues; they are long-standing and often characterized the community. It must be noted that public health emergencies such as the recent tropical storm Ida and Hurricane Katrina often occur in black neighborhoods (Sandoiu, 2020). This means that people of color are often more affected by such misfortunes, which further worsen their already pathetic health situations.
The ABC model of crisis intervention makes use of three steps. It begins with establishing the existing relationship, then understanding the problem at hand before finally taking appropriate action. From the above discussions, the relationship has already been established and the problem understood. The existing crisis is the more dire effects of the COVID-19 pandemic among the African American and other minority populations in the United States. It has emerged that crowded living conditions, employment in essential service industries, underlying medical conditions, and increased stress levels have direct links to the spread of COVID-19 among people of color (Kanel, 2014). These risk factors that predispose African Americans to the virus are the existing problems. It is, therefore, appropriate to take appropriate measures to address the problem.
According to the ABC method, taking an appropriate method to address the crisis involves pursuing a working intervention strategy. The most appropriate intervention strategy is to fight racial disparity that defines the pandemic. People of color will greatly benefit if fair housing policies are instituted and their employment opportunities improved. All efforts must be made to mitigate the economic inequalities that characterize the black lives in the U.S. Although these measures will have long-term effects and cushion African Americans against the severity of any future health emergency, the most urgent thing is to reduce their sickness and fatality rates now.
One of the most effective ways of mitigating these racial disparities in health care is to operationalize distributive justice. This can be achieved through the collection of relevant racial data on COVID-19. It had been reported by the CDC that there are no sufficient state-level data on testing and death cases of COVID-19. This hampers efforts to better track the disease burden among various minority communities across the U.S. for just allocation of essential resources and infrastructure. Another intervention measure would be to use both place-based and risk-based strategies to reduce exposure to the disease. Due to the increased risks of exposure that essential workers have to the diseases, it is crucial that they be equipped with personal protective equipment.
The prison systems are some of the most crowded places in the United States. Coincidentally, a significant proportion of African Americans are serving in these facilities. Therefore, these areas act as fertile grounds for the spread of the disease. It would, thus, be necessary to release minor and low-risk offenders from prison to decongest the prisons and curb the prevention of the disease further.
With the existence of several COVID-19 vaccines, it is significant that members of this population are encouraged to take up the doses. Although there have been some misgivings and myths about the vaccines, particularly among the black populations, the same can be reversed through targeted messaging. There should be novel approaches that are aimed at encouraging people to take up the vaccines even as they maintain physical and social distancing, wearing masks, and washing hands frequently. This is a critical public health intervention approach that must be aimed at rescuing a vulnerable population. One such approach would be to step up social media campaigns.
Testing of COVID-19 should also be stepped up especially among people of color. Studies have shown that when the virus is detected early, appropriate medical intervention measures could be done before it inflames the lungs. Interestingly, most vulnerable populations do not show COVID-19 symptoms like their white counterparts. This contributes to the late detection of the disease, which also greatly contributes to increased fatalities among members of the group. Therefore, testing should be made available in every black neighborhood, especially considering the fact that this population mostly lacks primary care doctors around them.
References
Health equity considerations and racial and ethnic minority groups. (2021). Centers for Disease Control and Prevention.
Kanel, K. (2014). A Guide to crisis intervention. Cengage Learning.
Sandoiu, A. (2020). Racial inequities in COVID-19 — the impact on black communities. Medical News Today.
Tai , D. B., Shah, A., Doubeni, C. A., Sia , I. G., & Wieland, M. L. (2021). The disproportionate impact of COVID-19 on racial and ethnic minorities in the United States. Clinical Infectitious Diseases, 72(4), 703-706. doi: 10.1093/cid/ciaa815.
The color of coronavirus: COVID-19 deaths by race and ethnicity in the U.S. (2021). APM Research Lab.
Xiong, J., Lipsitz, O., Nasri, F., Lui, L. M., Gill, H., Phan, L.,… McIntyre, R. S. (2020). Impact of COVID-19 pandemic on mental health in the general population: A systematic review. Journal of Affective Disorders, 277, 55-64.