Social determinants, racism, and COVID-19

By Austin Frakt

At an April 11 press conference, Surgeon General Jerome Adams acknowledged that people of color are disproportionately affected by COVID-19. For example, African Americans comprise 25% of the population of Milwaukee County, Wisconsin but nearly half of confirmed cases and three-quarters of the deaths. Latinos represent one-third of the population of New York City but a majority of deaths. Similar patterns are found elsewhere. Though Adams voiced some of the factors that contribute to the outsized burden shouldered by people of color, he is facing criticism for some of what he said and some of what he didn’t say.

The Surgeon General said,

We do not think people of color are biologically or genetically predisposed to get COVID-19. There is nothing inherently wrong with you. But they are socially predisposed to coronavirus … exposure and to have a higher incidence of the very diseases that put you at risk for severe complications of coronavirus.

He acknowledged that there are structural factors that contribute to this predisposition, including aspects of jobs and hosing. About those structural factors, Zeeshan Aleem at Vox wrote,

[H]e didn’t get into why they exist and how much of it doesn’t come down to individual behavior. Instead, his talk of personal responsibility — a familiar trope that’s often used to blame communities of color for their suffering — obscured the fact that a lot of these issues stem from a history of institutional racism.

I should also note, as have others, that the rapid spread of the virus in prisons and jails also disproportionately affects people of color, and for reasons traceable back to racist policies and practices. Another racial element to the pandemic is the unjustified scapegoating and harassment of people of Asian descent.

For Mother Jones, Edwin Rios spoke with family physician and epidemiologist Camara Jones who agreed that the consequences of the pandemic reveal structural racism.

[T]his disease is not an equal-opportunity disease, and it’s manifesting itself more severely in people of color who’ve been historically oppressed and disinvested.

She offered as a first step to

un-invisiblize structural racism and say this structural racism and the historical federal partitioning of our cities into racially segregated neighborhoods, the disproportionate placement of toxic dump sites, that stuff which is giving us more asthma, more lung disease, or the HIV epidemic—these are the old aspects of racism showing up during this pandemic.

There’s much more by her at the link. It’s worth reading in full.