African Americans struggle with disproportionate COVID death toll

Creating a toxic storm of death and illness, the pandemic is devastating black communities across the United States and revealing the deadly legacy of inequality.

A woman and child wait at the Rockaway Avenue transit stop in Brooklyn, New York’s Brownsville neighborhood. Under New York City’s Essential Service Plan, the Metropolitan Transit Authority has slashed subway service by 25 percent. Many subway lines run in 20 to 30 minute intervals.
Photograph by Laylah Amatullah Barrayn

Coronavirus is ravaging every part of Warren Bell’s life in New Orleans. His 81-year-old cousin was hospitalized with COVID-19. His youngest daughter is furloughed from her culinary job at a major hotel because of the pandemic. His oldest daughter, a nurse, is doing 12-hour shifts at New Orleans East Hospital “where COVID-19 patients started dying weeks ago.”

“One of the nursing staff died over a week ago and her supervisor was on quarantine. So naturally, I worry every day about her,” says Bell, a former TV news anchor and radio host. A football coach at the school where his wife works, and a long-time friend, jazz patriarch Ellis Marsalis, recently died from the disease. “This is scary stuff,” he says.

In urban centers large and small across the U.S., the novel coronavirus is devastating African American communities. The environments where most live, the jobs they have, the prevalence of health conditions such as high blood pressure and diabetes, and how they are treated by the medical establishment have created a toxic storm of severe illness and death. (These common, underlying conditions make coronavirus more severe.)

In cities, counties, and states that are reporting racial data, the impact of coronavirus on the black community has been extraordinary and disproportionate. Almost one-third of infections nationwide have affected black Americans, according to data from the Centers for Disease Control, though blacks represent only 13 percent of the U.S. population. Likewise, nearly one-third of those who have died across the country are black, according to an analysis of available state and local data by the Associated Press.

In some places, African-American deaths have been even higher. Thirty-six percent of coronavirus deaths recorded in Wisconsin have been among blacks, though they comprise just 6.7 percent of the state’s population. Seventy-one percent of fatalities in Shelby County, Tennessee, which includes Memphis, are Africans Americans, who make up half the population.

The Lawyers’ Committee for Civil Rights Under Law, an organization that targets the inequities confronting African Americans and other racial and ethnic minorities, teamed up with hundreds of medical professionals on April 6 to demand that the U.S. Department of Health and Human Services and the CDC release daily racial and ethnic data on COVID-19 tests and outcomes. With no response yet from the CDC, the group sent a second letter now that two more weeks of data indicate worsening numbers.

“People are either in shock or kind of numb,” said Demetrius Young, a city commissioner in Albany, Georgia, where a whopping 90 percent of those who’ve died have been African Americans. “They are very scared waiting to hear the next news of who has died. People will get a little tingle and immediately get frightened. Someone called me and broke down in tears because a friend who had been to her house tested positive. She had an anxiety attack.”

Why is the impact so outsized on African Americans?

“Look in our community: You see food deserts, transportation deserts, and education deserts,” said Dr. Celia J. Maxwell, an infectious disease physician and associate dean at Howard University College of Medicine in Washington, D.C. “All the social determinants of health that you would look to [in order to] keep the community in good health are missing from our communities of color.”

“With persons of color, and African Americans specifically, there are so many issues they are dealing with—health, socio-economic, poverty, education and systematic racism,” Maxwell added. “With all those things together, it doesn’t surprise me that these patients would be more vulnerable to something like COVID-19. It’s the healthcare disparity that’s driving the epidemic.

Other contributing factors, health disparities experts say, are the close-knit nature of family, friends and church in the black community. Added to that is overcrowding in urban areas and homes where multiple generations might share space.

COVID-19 has torn through gatherings attended by African Americans, including a celebration of sheriff’s deputies and the tight-knit ballroom dance scene in Detroit; a funeral and a birthday party in Chicago; an annual African-American ski trip to Idaho that brought together 600 skiers from across the nation and as far away as London; and Mardi Gras in New Orleans.

While many of the health issues prevalent among African Americans make them more susceptible, some—such as the skiers—were relatively healthy, athletic, and higher wage earners.

Dr. Ebony Hilton, associate professor of anesthesiology and critical care medicine at the University of Virginia, said African Americans suffer higher rates of eight of the top 13 top causes of death in the U.S. – heart disease, stroke, cancer, influenza and pneumonia, diabetes, HIV disease, kidney failure and homicide.

“I knew that the coronavirus would leave a higher rate of death in the African-American community,” she said. “I knew we would be in an uphill battle. I could see the storm coming.”

Dr. Keith Ferdinand, professor of medicine at Tulane University School of Medicine in New Orleans, said numerous variables are making African Americans more vulnerable to COVID-19. They include working in service industries or “essential jobs” that require them to expose themselves to others who may be infected; using public transportation to get to work; lack of access to early testing; and a historical distrust of the health-care system because of previous bias. This leads to “a mixture of the many difficulties faced by African Americans which may compound or even extend the burden for the coronavirus risk factors,” Ferdinand said.

Moreover, many African Americans are concentrated in hourly wage jobs that don’t have health benefits, said Maya Rockeymoore Cummings, a former chairwoman of the Democratic Party of Maryland and candidate for the U.S. House of Representatives from Baltimore. They are either among the first wave of layoffs who are now unemployed and uninsured, or, they were deemed “essential workers” and are being exposed to the virus, she said. (See pictures of essential workers serving on the frontlines around the world.)

“Go to the store or look out the window when your garbage is collected,” said Rockeymoore Cummings, who is also the widow of U.S. Rep. Elijah Cummings. “We have disproportionately exposed people who don’t have the benefits to protect themselves.”

From the cities, counties, and states that have collected COVID-19 data, here are a few of the findings.

Albany, Georgia

In this city of 75,000 people 150 miles south of Atlanta, 90 percent of the COVID-19 deaths have been African Americans in a town that’s 72.5 percent black. Authorities said they believe two funerals and possibly the annual Snickers Marathon in the first week of March, which hosted 1,000 runners, contributed to the spread.

“We’re still very much in the crisis stage,” Young said. “We’ve had 50 deaths. I have two lifelong friends who passed away. I have a lot of acquaintances through the faith community who are affected.”

Albany’s African American community is very close-knit, he said, and a 30 percent poverty rate has exacerbated the situation. “A lot of people in the demographic are already suffering from poor access to health care. And we have a large elderly population, which is not very healthy,” he said.

One person who served on a jury of a high-profile murder trial seems to have unwittingly “passed the virus on to a lot of others in the courtroom, including our chief judge, who is fighting for his life. Another judge has since passed away,” Young said.

The Rev. Jarod Pierce, pastor of The Real Church in Albany, said he only leaves home when it is absolutely necessary. One of the reasons it hit so hard was people didn’t take it seriously “until it hit close to home,” he said. “Someone called me last week. Their mom, grandmother and uncle were all fighting for their lives.”

Despite pushback from mayors across the state and warnings from public health leaders to move forward cautiously, Georgia Gov. Brian Kemp on Friday relaxed some social distancing measures and opened some non-essential businesses including hair and nail salons, barber shops and bowling alleys.

Washington, D.C.

In the nation’s capital, 81 percent of the fatalities have been African American, according the mayor’s website, in a city whose population is 46 percent African American. Many of the deaths are in the city’s poorest and predominantly African American neighborhoods.

Sandy Henderson, a retired conference manager, was among 600 African American skiers across the U.S. and as far away as London, who traveled to Ketchum, Idaho, for the annual get-together of the National Brotherhood of Skiers in early March. Henderson, president of the Washington, D.C., affiliate Black Ski Inc., and her companion came home sick.

“I felt so chilled, all I could do was get up the stairs and cover up,” said Henderson, 69. Their physicians prescribed them both the antibiotic Zithromax, used for common bacterial infections, and sent them home. Later in the week, Henderson fainted on her bathroom floor.

Several days later, when they still felt awful, they knew something was very wrong. At the nearest emergency room, they were tested for flu, strep throat, and COVID-19, and three days later, both were found positive for COVID-19. After both were deemed out of danger, the hospital sent them home.

Meanwhile, as many as 100 people from their ski trip had fallen sick and at least four had died, Henderson said. She and her companion are fortunate not to suffer from the underlying health issues that make the disease so deadly for others.

Chicago

Fifty-six percent of the city’s deaths have been African American, though they make up just 30 percent of the city’s population. Mayor Lori E. Lightfoot said the numbers are “troubling“ and “a stark reminder of the deep-seated issues which have long created disparate health impacts in communities across Chicago.”

The impact is personal for the Rev. Marshall Hatch, pastor of historic New Mount Pilgrim Missionary Baptist Church. “My sister passed with corona-related illnesses seven days ago. My best friend passed a couple of days before that.”

The church is doing virtual services, streaming live with “one singer, one minister, a musician,” and producers offsite, he said. “Naturally our [streaming] numbers are up ten-fold. Because of anxiety, fear, sense of isolation, these services are a spiritual lifeline to people.”

Hatch’s church is one of the largest on Chicago’s West Side, one of the city’s poorest communities, which is plagued with violence, joblessness and has the second-lowest life expectancy out of 77 Chicago neighborhoods, he said. “This epidemic has magnified the kind of inequities that people experience every day.”

It’s “a tale of two cities,” Hatch said. “The wide disparity in life expectancy between our community and other communities is stark and immoral. We have Illness based on stress, food deserts, and the violence that comes from neighborhoods in despair.”

Milwaukee

The novel coronavirus also hit U.S. Rep. Gwen Moore (D-WI) close to home. Her 4th congressional district includes the city of Milwaukee, where 72 percent of the COVID-19 related deaths have been African Americans, in a city that is only 39 percent African American.

Moore has been in quarantine twice in the last month after being exposed separately to two different individuals who later tested positive for COVID-19. Her daughter, a nursing assistant on the frontlines, and a cousin, who is a nurse, are awaiting COVID-19 test results.

She also is concerned about a nephew who lives in a homeless shelter.

“When you have four men living in a room, social distancing is not practical, and people have different standards of sanitation,” Moore said.

Several of her friends and colleagues are recovering from the virus, including a 33-year-old state representative, a county commissioner and a candidate for city attorney. A retired police lieutenant colonel she knows succumbed to the virus.

“It’s everywhere I go,” Moore said. “I’m one of the vulnerable people. I’m on cancer treatment. I have been ordering my groceries. Every time I don’t have to wait in line at a grocery store is one less time of exposing myself.”

Milwaukee Health Commissioner Jeanette Kowalik said she feels that early on, the Centers for Disease Control and Prevention (CDC) overemphasized travel as a key risk factor. Many people “didn’t feel they needed to worry about it because they didn’t travel and didn’t know anybody who did.”

Kowalik said she knows three people who contracted COVID-19 without having traveled overseas, and have since recovered – all African-American men. A friend and mentor of hers, an African American educator, died from disease.

“Earlier there were myths that black people couldn’t get COVID-19,” Kowalik said. “Then there were the conspiracy theories. We put a lot of energy into that instead of energy into prevention.”

Moore, meanwhile, worries that some young African Americans still aren’t taking the outbreak seriously. A young black man told her he could survive coronavirus because his immunities were strong. “It had never occurred to him” that he could infect and kill others such as herself.

New Orleans

Nearly 57 percent of COVID-19 deaths the state have been African Americans, though they make up only on third of the state’s population.

Rev. Fred Luter, pastor of the 5,000-member Franklin Avenue Baptist Church in New Orleans, presided over six funerals in two weeks. With only immediate family permitted to attend, the services are livestreamed and abbreviated.

Members of his congregation ranging in age from their 40s to 80s have died from COVID-19 in recent weeks, and others have been infected and quarantined. “You see more people wearing masks and staying home. It’s like a wakeup call that this getting is more serious than we thought it was.”

One of the most heartbreaking stories, Luter said, is that of the Rev. Dr. Gilbert L. Barnes, who had been senior pastor of Rock of Ages Church in Marrero, Louisiana, outside of New Orleans, for 25 years. He and his wife, Janie, celebrated their 60th anniversary this past September. Barnes, 77, died of complications to COVID-19 on April 5. His wife, Janie Barnes, 76, who also tested positive, died just hours before him.

“People are losing husbands, wives, and children,” Luter said. “You would love to embrace them and give them a hug, but we just can’t do it. Everybody understands, but it doesn't ease the pain of not being able to share that physical touch.”

Meanwhile in New Orleans, Warren Bell finally got one spot of bright news. After more than two weeks in the hospital, his cousin is recovering and will be released to a rehabilitation facility or to the home of his son, a popular local priest. His cousin still needs oxygen, but “he’s definitely kicking corona’s butt.”

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