Across the country, the disproportionate impact of COVID-19 on people of color is making headlines. In early April, the U.S. Centers for Disease Control and Prevention released data showing that although Black people make up 13 percent of the population, they comprise 30 percent of COVID-19 cases. Black Chicagoans are dying at nearly six times the rate of White residents. In Wisconsin, Black residents make up half the deaths despite being only 6 percent of the population.
Communities of color are always among the most vulnerable in a crisis. With COVID-19 directing some national attention to this, filmmaker Crystal Emery sought to connect this crisis to its larger context and start conversations about what has to change. Emery, who is a AAAS IF/THEN Ambassador and founder of URU, The Right to Be, recently held a virtual screening and discussion of her documentary, “The Deadliest Disease in America.” The film originally aired in 2005 but has been updated to address the role of racism in COVID-19 outcomes. The film looks at the different facets of structural racism built into this country and its healthcare system.
Emery says, “As is always so with oppression, burden and blame somehow fall on the victims... History – and perhaps faith – leads us to believe we'll survive this crisis. But will the world and mankind change for the better? Will we learn anything from it? Will anything be done differently to better protect people in the future?”
Liz Crocker, AAAS program associate for the IF/THEN Ambassadors Program, finds the film very relevant today, “especially since some have blamed higher rates of COVID-19 mortality in the Black community on choices such as diet, or not taking social distancing seriously,” she said. “This film helps us understand the existing context of inequality going into the pandemic, which is necessary for addressing the inequality faced during the pandemic. It highlights that even when Black patients have access to the same resources as White patients, they are more likely to have their concerns dismissed and receive a lower quality of care. This film and the panel are important calls to action to address racism in our medical system and larger society.”
In 2002, Crystal Emery lost the use of her arms and legs, a result of Charcot-Marie-Tooth disease, a form of muscular dystrophy. Because of her health problems she became intimately familiar with the U.S. healthcare system. With her personal medical providers she had always felt cared for, but as she began having stints in the hospital with doctors who didn’t know her, she experienced “every kind of nightmare.”
The film shows viewers that it is not only the country’s history of racism and discriminatory housing practices, which confine communities of color to areas where environmental factors like air and water pollution are worse, and access to good quality healthcare, nutritious food, high quality education and employment is less, but also overt or unconscious bias in treatment that causes different outcomes. In many cases, people may go to the same doctor, but they will be treated differently because of the color of their skin.
These factors lead to rates of death and disease that are much higher. Black babies are twice as likely to die in their first year of life as White babies. As noted in Emery’s film, about the same number of Black women and White women get breast cancer, yet death rates are 40 percent higher among black women.
During the COVID-19 pandemic, people of color are more likely to work in jobs that have been deemed essential or require leaving the house. They are more likely to need that income to survive, to live in crowded apartments where they can’t distance themselves from others, and to have inadequate health insurance. The panel discussion after Emery’s film screening emphasized this point about health insurance: “We are unique as country that we find it acceptable to link employment to healthcare access,” said Thomas LaVeist, dean of the Tulane University School of Public Health and Tropical Medicine.
Shirley Malcom, senior advisor at AAAS, moderated the panel and reminded viewers that “freedom and responsibility go hand-in-hand.” She suggested people remember this as they make decisions about social distancing in the weeks and months ahead.
There are many factors exposing certain communities to greater risk, and both individuals and governments should consider these as the economy reopens. The panel discussed the need for good quality universal healthcare, childcare, a living wage, and mail-in ballots so people can safely vote in November -- something the AAAS Center for Scientific Evidence in Public Issues also has been advocating for as well.
Camara Jones, a family physician and epidemiologist and a 2019-2020 Evelyn Green Davis Fellow at the Radcliffe Institute for Advanced Study at Harvard University, also urged a public health response to the coronavirus that goes “beyond documenting it to altering its course,” through population-based random sampling rather than testing only those with symptoms, in order to assess the current rate of infection in the community.
As part of addressing implicit bias in healthcare, Marc Morial, president and CEO of the National Urban League, noted that the silence of people of good will is as dangerous as the voices of those of bad will – urging people to speak up when they see injustice, and to make a lifelong commitment to doing so.