Racial inequalities in COVID-19 - the effect on black communities
07 June, 2020
In this Special Feature, we look at the racialized impact that COVID-19 is wearing black communities in america, using expert opinions and rounding up the available evidence.
The issue of how race-related health inequalities are affecting several disadvantaged groups, and black communities in particular, in the U.S. is quite complex and has wide ramifications. COVID-19 has only served to unmask inequities that contain existed for hundreds of years.
The existing climate of social unrest in the U.S. and the thousands of individuals protesting against systemic racism and to get the Black Lives Matter movement is bringing these inequities into even sharper focus, adding more political and emotional weight to a longstanding issue.
A few articles on the problem can only get started to scratch the surface - however the complexity of an issue shouldn't deter us from tackling it.
A week or two ago, Medical News Today dove into some ways that COVID-19 is affecting persons of color and minority groups. We also interviewed Prof. Tiffany Green about how racial inequities play into the disparities observed through the pandemic.
In this Special Feature, we follow up by looking at the available scientific evidence of the uneven and racialized impacts of the pandemic, together with what other experts have to say about racial disparities during COVID-19 and in healthcare more broadly.
As the pandemic persists and more data become available, MNT will continue steadily to address the broader issue and give attention to the impact that COVID-19 is having on specific racial and ethnic groups.
For now, a lot of the data points to a disproportionate effect on black Americans, therefore the rest of the article will give attention to this group.
Making sense of incomplete data
As the COVID-19 pandemic unfolds, more data are becoming available regarding infection rates, mortality rates, and testing, shedding light on the ways that the crisis has effects on different sociodemographic groups.
However, in some countries - and perhaps especially in the U.S., considering its high amounts of cases and deaths - the info is becoming available in dribs and drabs, as the relevant specialists have been reluctant to assemble and reveal data organized by specific sociodemographic factors.
For instance, sex-disaggregated data had not been publicly obtainable in the U.S. in mid-April 2020, when the country had the highest number of COVID-19 cases on the globe.
Similarly, it took the government 3 months to get started on tracking COVID-19 deaths and infections in assisted living facilities, and even then your efforts were incomplete, despite outcry from researchers and public health experts.
Race- and ethnicity-related data have already been no exception. In mid-April, almost 3 months after the start of the pandemic in the U.S., the Centers for Disease Control and Prevention (CDC) were breaking down only 35% of their data according to race and ethnicity.
At that time, according for some studies, the race or ethnicity of folks acquiring 78% of the diagnoses on a national level was “unknown,” and only half of the states were reporting COVID-19 mortality by race and ethnicity.
Researchers have remarked that while, “1 in 5 counties, nationally, is disproportionately black and only represent 35% of the U.S. population […] these counties accounted for nearly half of COVID-19 cases and 58% of COVID-19 deaths.”
Inaccurate or incomplete reports of data can paint a misleading picture - one which can misinform public health policies.
A study that has yet to be peer-reviewed - led by researchers at Yale University, in New Haven, CT - noted in mid-May that “The CDC data shows that white patients represent an increased proportion of COVID-19 diagnoses than their representation in the general population.”
“Yet data produced from specific regions that report race and ethnicity of COVID-19 decedents show that black patients are dying at a higher rate than their population share.”
In the lack of a clear picture at a federal level, scientists, nonpartisan research groups, and advocacy groups have stepped in to gather as much data as possible in a systematic way.
Reports from disparate U.S. states, in conjunction with emerging studies, are all painting a worrying picture: Black Americans are being hit the hardest by the pandemic, along with Latinx communities, while Indigenous populations and other minority communities are also taking the brunt of COVID-19 in some states.
Black Americans up to three times much more likely to die of COVID-19
The analysis led by Yale researchers, which appeared as a preprint in mid-May, used newer data, assessed its quality, and adjusted for age in their analysis.
Lead study author Dr. Cary Gross and colleagues discovered that black Americans are 3.5 times much more likely to die of COVID-19 than white Americans. In addition, the team discovered that Latinx people are almost twice as more likely to die of the condition, weighed against white people.
“We also discovered that the magnitude of the COVID-19 disparities varied substantially across states. Although some states do not have demonstrable disparities, [black and Latinx populations] in other states face 5- or 10-fold or more threat of death than their white counterparts,” say the authors.
Dr. Marcela Nunez-Smith, a professor of internal medicine at Yale and senior writer of the analysis, comments, “We need high-quality data and a consensus on the metrics we use to direct resources and tackle staggering health inequities.”
It really is worth noting that the CDC are actually showing national averages by race, data that had not been obvious on its website a couple weeks ago. However, it remains unclear if they are employing data from all 50 states and Washington, D.C. to reach these averages.
A report issued by the nonpartisan American Public Media (AMP) Research Lab towards the end of May found similar results.
“The most recent overall COVID-19 mortality rate for black Americans is 2.4 times as high as the rate for whites and 2.2 times as high as the rate for Asians and Latinos.”
The AMP report calculated these rates predicated on the full total number of deaths up to May 19, of which point the scientists had details about the races and ethnicities of 89% of the people who had died of COVID-19. The info originated from 40 of the 50 states and from the District of Columbia.
“While we have an incomplete picture of the toll of COVID-19,” the authors write, “the prevailing data reveals deep inequities by race, most drastically for black Americans.”
Death rate for black Americans doubles their population share
For black persons in the U.S., the death rate of COVID-19 is staggeringly high, weighed against the population share.
As the AMP report notes, collectively, black Americans make up 13% of the population in all U.S. areas that released COVID-19 mortality data, nevertheless they take into account 25% of the deaths.
“Basically, they are dying of the virus for a price of roughly double their population share, among all American deaths where race and ethnicity is well known.”
By comparison, “Across all 41 reporting jurisdictions combined, whites are considerably less likely to die from COVID-19 than expected, given their share of the populace. They represent 61.7% of the combined population, but have observed 49.7% of deaths in the us where race and ethnicity is well known.”
Echoing the Yale study, the AMP report found huge disparities in individual states. These disparities are much broader than the 2.4-times higher level of mortality among black Americans, compared with white Americans.
For example, “In Kansas, black residents are 7 times much more likely to have died than white residents, while in Washington, D.C., the rate among blacks is 6 times as high since it is for whites. In Missouri and Wisconsin, it is 5 times greater.”
The authors of the AMP report also deplored the mishandling of the crisis by the U.S. federal government, regarding the gathering and disseminating of data on race.
Andi Egbert, a senior researcher at APM Research Lab, said, “I won’t speculate about motive, but I can’t believe in a modern economy that we don’t have a mandated, uniform method of reporting the data across states.”
“We are amid this tremendous crisis, and data is the foremost way of knowing who is suffering and how.”
- Andi Egbert
Dr. Uché Blackstock, CEO of Advancing Health Equity, also criticized the U.S. federal a reaction to race-related disparities.
“The disparities are continuing to be reflected in the data, yet we still have a complete insufficient guidance from the government about how to mitigate these divisions. There is absolutely no real plan how exactly to manage it.”
Source: www.medicalnewstoday.com
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