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With more than 600,000 cases and 26,000 deaths, the United States is leading the world on COVID-19. But not every American is experiencing it equally.
Key points:
- A recent survey found African-Americans were almost twice as likely to know someone who'd been hospitalised or died due to COVID-19
- The minority group appears disproportionately in US coronavirus statistics
- One Harvard expert says it's what he would expect
A recent survey from the Pew Research Centre revealed a quarter of black Americans knew someone who'd been hospitalised or died as a result of having coronavirus — almost double that of white Americans.
More than 70 per cent of COVID-19 deaths in the state of Louisiana were African-Americans, despite accounting for just a third of the general population. In New York City it's 17 per cent of deaths, for a 9 per cent share of residents.
One expert in the field says it's sadly not surprising.
David Williams, from the Harvard School of Public Health, has been studying the racial disparities in health for decades. He's an expert on how race and socioeconomic status affects physical health.
He spoke with The Drum's Julia Baird — you can find that full interview here.
Why are experts so worried?
Professor Williams says he is not shocked by what we're seeing — in fact, it is what he would have predicted.
"What we've known for a long time, black people in the United States and other people of colour have chronic disease at younger ages and are more likely to have more than one condition," he said.
"So, they are just physiologically more compromised and therefore more vulnerable to the pandemic."
What has got him particularly concerned is a 'perfect storm' of conditions playing out in this community: where years of social inequalities are leaving people more at risk.
So what are these social conditions leaving African-Americans disadvantaged?
Well, money, for one.
"In national data for the US, black people earned 59 cents for every dollar of income white people earned," he told The Drum.
According to the Economic Policy Institute, poverty rates are the highest for black Americans, at 20 per cent.
Professor Williams warns the economic impact of COVID-19 is hurting the African-American community in profound ways — and the very means of keeping this group afloat financially is actually risking their health even more.
"They work in jobs that aren't salaried, they're working on the hour, if they don't show up for work, they don't get paid, they don't have other benefits," he said.
He also cites generally lower living situations and life stress. When you live in these tough conditions for many years — as Professor Williams' research suggests much of the community does — it affects your physical health. He calls it "weathering".
"Imagine a drop of water falling from the rooftop of the building onto the concrete sidewalk below. If the water drips one day it's not a big deal, but if there's a constant day in and day out, drip, drip, drip of water, the sidewalk below would become weathered because of the constant exposure to adversity."
From his research, this is what Professor Williams believes is happening in the African-American and other minority communities.
Long-term poorer socio-economic conditions are essentially 'eroding' good health.
"This all adds up and leaves them much more vulnerable to a broad range of diseases."
Your questions on coronavirus answered:
How does the US health system fit into this?
Professor Williams says there are two primary ways the US health system fits into this COVID-19 experience equation. Neither are particularly positive.
The first is that access to care remains a barrier, particularly for those in the African-American community.
In the US, healthcare is linked to having health insurance. A 2016 survey found this was something black Americans were more unlikely to have — 11.7 per cent were uninsured, compared to 7.5 per cent of white Americans.
"[Even if] they have insurance that can get them into care, the out of pocket expenses they have to pay — we call them co-pays and deductibles — are high, so there is a financial cost at the point of care."
The second problem, he warns, is even more troubling.
"I say this with care — there are so many people putting their life on the line in working to save lives and do their best on the one hand, and I acknowledge that to be true," he said.
"But at the same time, we have a mountain of scientific evidence that indicates that when black people and other persons of colour enter health care contexts in the US, they receive poorer quality care than whites do."
A 2003 report from the US National Academy of Medicine appears to back this up.
"Across virtually every therapeutic intervention from the most simple medical procedures to the most complex, blacks and other minorities received poorer quality care and less intensive care than whites," Professor Williams said.
He says studies in the years since support this, though he's careful to emphasise that he believes it's not a deliberate discrimination, but implicit bias, or "unconscious discrimination".
"What the research shows, if you hold a negative stereotype about a group of people and you meet someone from that group, the process is automatic, the process is unconscious, you will treat that person differently," he said.
"This is not about American doctors, this is about human beings and how we all process information."
Professor Williams says these experiences — which he notes there's a long history of — add to the general mistrust of the government in the African-American community.
This may discourage people from approaching healthcare services. It's one piece of the puzzle, alongside the trends of poorer socio-economic conditions.
Could coronavirus be a turning point in healthcare for minority communities?
For a man who has spent most of his career studying and raising awareness of the effects of race and disadvantage on health, Professor Williams is hopeful COVID-19 could finally prompt some real government action.
"It's shining a bright light on an issue that was hidden to many," he told The Drum.
He wants political leaders to make a commitment and work together to find and implement new policies that would make a difference.
"I am hopeful that this could be a watershed moment where as a nation we say we can do better."
The Drum airs weeknights on ABC and News Channel.
What you need to know about coronavirus:
Topics: covid-19, diseases-and-disorders, health, race-relations, community-and-society