The COVID-19 pandemic has disproportionately impacted communities of color in America. Racial and ethnic disparities in health care are known factors contributing to the higher morbidity and mortality among people of color, as compared to white Americans. These disparities have a dual impact – not only are they resulting in differences in the actual care and treatment that COVID-19 patients receive, but they also put people in BIPOC communities at higher risk of contracting COVID-19 in the first place:
Implicit bias refers to unconscious attitudes or stereotypes that affect our understanding, actions, and decisions. While we all have biases, the impact of those on others depends on our social and professional roles in society. Biases held by health care workers when treating COVID-19 patients can determine things like who gets admitted into the hospital versus getting sent home to rest, who gets rushed into testing versus sitting around in the waiting room, and who is put on the next available ventilator. Reports show that even when controlling for insurance status, income, age, and condition severity, people of color tend to receive lower-quality healthcare than white people do[i].
Prior Health Conditions
A key risk factor in getting severely ill from COVID-19 is having a(n) underlying health condition(s). Black, indigenous, and people of color are 1.5 to 2.0 times more likely than white people to develop many of the major chronic health conditions[ii]. Diabetes, lung diseases, and serious heart conditions have been particularly relevant to COVID-19 risk.
Stress & Immunity
Stress has a physiological impact on the body’s immune system. It’s common to come down with a physical illness when you have a lot on your plate, but communities of color in America live with heightened levels of stress every day. Things like income inequality, discrimination, violence, and systemic racism contribute to chronic stress that can weaken immunity[iii], making these populations more vulnerable to diseases like COVID-19 (and the underlying health conditions that increase the risk of COVID-19).
Essential Work & Service Jobs
While many of us have been quarantining and social distancing to help minimize the spread of COVID-19, our essential workers don’t have that option. A disproportionately high number of Black and Latinx workers are unable to work remotely[iv]. This disparity is even more pronounced in the health care field – Black workers are 50 percent more likely to be in the healthcare and social assistance industries and 40 percent more likely to work in hospitals than white workers[v]. And since workers of color are overrepresented in the service industry[vi], they’re seeing higher unemployment rates, as businesses like restaurants and retail stores shut down or went out of business[vii].
- Black people make up 13-15 percent of the United States population, but about 27 percent of COVID-19 cases in the US. This doesn’t account for the 14+ percent of cases among people who identified themselves as “multiple” or “other”[viii].
- Black Americans are dying from COVID-19 at nearly 2.5 times the rate of white people (61.6 deaths compared to 26.2 deaths per 100,000 people). This is the highest mortality rate of any racial/ethnic group and, since data started being reported, has consistently been over twice as high as any other group[ix].
- About 11.9 percent of employees in the US are Black, but they make up 17 percent of “front-line” (essential) workers, further increasing the disproportionately high rates of COVID-19 infection and death[x].
- Black Americans who are not essential workers are more likely to have lost their jobs because of COVID-19 than white people and other racial minorities. Economists call this a “first fired, last hired” phenomenon – Black people tend to lose work early on, and their unemployment rate continues to rise despite the employment market recovering for white workers[xi].
- Nearly half (49 percent) of the Latinx population say they or someone in their household had to take a pay cut or lost their job (or both) due to COVID-19, compared to 33 percent of all US adults[xii].
- The Latinx demographic in the US largely works in essential and service jobs; due to COVID-19, these industries either crashed (like the hotel/travel industry) leading to lost jobs or required employees to be on the front lines and risk infection (workplaces like hospitals and grocery stores)[xiii].
- When adjusted for age (as COVID-19 deaths rise with age), the mortality rate for Latinx people is 2.5 times higher than white people[xiv].
Native American and Indigenous Communities
- The Navajo Nation has the highest infection rate of COVID-19 per capita in the U.S. when compared with any individual state[xv].
- Indian Health Service hospitals only have 625 beds across the country, with six ICU beds and 10 ventilators to care for over 2.5 million Native Americans from 574 tribes. Some tribes have additional health services in their communities, but these only add another 772 beds, totaling 1,397[xvi].
- The Centers for Disease Control and Prevention has turned down a series of requests from tribal epidemiology centers for COVID-19 data – the same data that is freely available to states. Without this data, tribal authorities can’t initiate contact tracing on their lands or impose informed lockdowns or other restrictions[xvii].
- Even though data shows that COVID-19 is hitting indigenous communities hard, it’s likely that the numbers are worse than we know. Many state health departments categorize Native American and indigenous people as “other”, suggesting the severity of COVID-19 on these communities is being underreported[xviii].
Asian & Pacific Islander Communities
- Racist physical and verbal attacks on Asian and Pacific Islander people have spiked worldwide since the start of COVID-19 outbreaks[xix].
- The increased racism and xenophobia alone are enough to cause accumulated trauma, which can have a devastating psychological impact now and well into the future for anyone with Asian heritage. This is only exacerbated for those who have been physically and/or psychologically attacked[xx].
- Asian American businesses across the US began to report decreased business as early as January 2020; many owners attribute this to misplaced fear about the origins of COVID-19[xxi].
[i] Bridges, K.M. (2018, August). Implicit Bias and Racial Disparities in Health Care. Human Rights Magazine. Retrieved from https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/
[ii] Price, J.H., Khubchandani, J., McKinney, M., & Braun, R. (2013). Racial/ethnic disparities in chronic diseases of youths and access to health care in the United States. BioMed Research International, 787616. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3794652/#
[iii] Johns Hopkins Medicine. (2020, April 20). Coronavirus in African Americans and other people of color. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid19-racial-disparities
[iv] Cerullo, M. (2020, March 23). Black and Hispanic workers less able to work from home. CBS News. https://www.cbsnews.com/news/work-from-home-black-hispanic-workers/
[v] Hawkins, D. (2020, April 16). The coronavirus burden is falling heavily on Black Americans. Why? The Guardian. https://www.theguardian.com/commentisfree/2020/apr/16/black-workers-coronavirus-covid-19
[vi] Maxwell, C., & Solomon, D. (2020, April 14). The economic fallout of the coronavirus for people of color. Center for American Progress. https://www.americanprogress.org/issues/race/news/2020/04/14/483125/economic-fallout-coronavirus-people-color/
[vii] Kochhar, R. (2020, June 11). Unemployment rose higher in three months of COVID-19 than it did in two years of the Great Recession. Pew Research Center. https://www.pewresearch.org/fact-tank/2020/06/11/unemployment-rose-higher-in-three-months-of-covid-19-than-it-did-in-two-years-of-the-great-recession/
[viii] Cohut, M. (2020, May 18). COVID-19: The mental health impact on people of color and minority groups. Medical News Today. https://www.medicalnewstoday.com/articles/covid-19-mental-health-impact-on-people-of-color-and-minority-groups
[ix] APM Research Lab. (2020, June 10). The color of coronavirus: COVID-19 deaths by race and ethnicity in the U.S. https://www.apmresearchlab.org/covid/deaths-by-race
[x] Smialek, J. & Tankersley, J. (2020, June 2). Black workers, already lagging, face big economic risks. New York Times. https://www.nytimes.com/2020/06/01/business/economy/black-workers-inequality-economic-risks.html
[xi] Smialek, J. & Tankersley, J. (2020, June 2). Black workers, already lagging, face big economic risks. New York Times. https://www.nytimes.com/2020/06/01/business/economy/black-workers-inequality-economic-risks.html
[xii] Krogstad, J.M., Gonzalez-Barrera, A., Noe-Bustamante, L. (2020, April 3). U.S. Latinos among hardest hit by pay cuts, job losses due to coronavirus. Pew Research Center. https://www.pewresearch.org/fact-tank/2020/04/03/u-s-latinos-among-hardest-hit-by-pay-cuts-job-losses-due-to-coronavirus/
[xiii] Morales, E. (2020, May 18). Understanding why Latinos are so hard hit by COVID-19. CNN. https://www.cnn.com/2020/05/18/opinions/latinos-covid-19-impact-morales/index.html
[xiv] Owens, C. (2020, June 17). Coronavirus racial disparities are worse than we thought. Axios. https://www.axios.com/coronavirus-racial-disparities-age-ea4730ce-52aa-4a17-a02c-5817da4245c5.html
[xvi] Carlson, K. (2020, March 25). Tribal leaders face great need and don’t have enough resources to respond to the coronavirus pandemic. The Conversation. https://theconversation.com/tribal-leaders-face-great-need-and-dont-have-enough-resources-to-respond-to-the-coronavirus-pandemic-134372
[xvii] Tahir, D. & Cancryn, A. (2020, June 11). American Indian tribes thwarted in efforts to get coronavirus data. Politico. https://www.politico.com/news/2020/06/11/native-american-coronavirus-data-314527
[xviii] Akee, R. (2020, May 13). How COVID-19 is impacting indigenous peoples in the U.S. PBS News Hour. https://www.pbs.org/newshour/nation/how-covid-19-is-impacting-indigenous-peoples-in-the-u-s
[xix] Human Rights Watch. (2020, May 12). COVID-19 fueling anti-Asian racism and xenophobia worldwide. https://www.hrw.org/news/2020/05/12/covid-19-fueling-anti-asian-racism-and-xenophobia-worldwide
[xx] Johnson, A.L. (2020, April 27). The psychosocial impact of COVID-19 on Asian Americans: Counselor interventions and considerations. Counseling Today, American Counseling Association. Retrieved from https://ct.counseling.org/2020/04/the-psychosocial-impact-of-covid-19-on-asian-americans-counselor-interventions-and-considerations/
[xxi] Thorbecke, C. & Zaru, D. (2020, May 20). Asian Americans face coronavirus ‘double whammy’: Skyrocketing unemployment and discrimination. ABC News. https://abcnews.go.com/Business/asian-americans-face-coronavirus-double-whammy-skyrocketing-unemployment/story?id=70654426