Flatten whose curve? COVID-19 response overlooks built-in racial inequities

The focus on individual behaviors, lack of health services and inadequate data reveal a public health infrastructure designed to protect wealthier and whiter communities while leaving the most vulnerable behind.

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File photo by Marc Monaghan

Mayor Lori Lightfoot announced a Racial Equity Rapid Response Team to address disparities in the COVID-19 crisis on April 6, 2020, weeks into the pandemic.

Reports from across the country show that Black and Latinx Americans are testing positive and dying of coronavirus at higher rates than whites. In Illinois, Black residents make up 30% of confirmed coronavirus cases and 37% percent of coronavirus-related deaths, but they only make up 14% of the state.

While efforts have been made to “flatten the curve” of infection, these stark racial inequalities reveal a public health infrastructure designed to protect wealthier and whiter communities while leaving the most vulnerable behind. While the scientific community has organized to fight COVID-19, we need to equally organize the scientific and policy community to fight the inequities built into our public health system that are largely responsible for the racial disparities arising today.  

Wash your hands. Work from home. Avoid congregating with others. Wear a facemask. The hyper-individualistic guidelines rolled out to halt COVID-19 and flatten the curve precisely represent the inequities built into our public health system. By focusing exclusively on the behaviors of individuals, policymakers overlook how the employment circumstances of Black and Latinx people force them to choose between social distancing or paying their rent. Only 19.7% of Black workers and 16.2% of Latinx workers work from home compared to 29.9% of White workers and 37% of Asian workers, according to an analysis by the Economic Policy Institute. Those with limited financial resources and access to transportation also cannot stock up food for weeks at a time.

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Black people across Illinois are dying from COVID-19 at 3.4 times the rate of the white population

 

The last two weeks have revealed more inequities built into the public health care system that are exacerbating racial disparities and eroding trust in government at a time when trust is sorely needed. City officials inexplicably permitted the demolition of a smokestack at the Crawford Coal Plant facility which blanketed the predominantly Mexican neighborhood of Little Village with dust particles. It has taken weeks to set-up COVID 19 testing sites in Chicago’s underserved West Side while testing had been available at numerous North Side and suburban locations. And although our leaders knew that Black and Latinx communities would be hardest hit by the pandemic and stay-at-home orders, state and local race task forces were only organized weeks after the pandemic started and largely in reaction to the news of racial inequalities, rather than proactively when the pandemic began. We agree with Gov. Pritzker and Mayor Lori Lightfoot that racial disparities have existed long before COVID-19, and that testing kits were in short supply. However, it’s clear who is given priority when the going gets tough and supplies are low: White and affluent Chicagoans.

These structural inequities have not stopped many policymakers or journalists from continuing to scrutinize the social distancing behaviors of Black and Latinx Americans when they literally can’t breathe in their own communities. Many blamed Black communities for spreading conspiracy theories about their susceptibility to COVID-19 and not taking the virus seriously, although the evidence shows that’s far from true.

Instead of asking Black and Latinx Americans to step up, we are calling for our leaders and healthcare systems to step up.

First, both public and private healthcare facilities need to continue ramping up testing sites and establish accessible testing facilities in disadvantaged communities that are being hardest hit. When a vaccine becomes available, we would argue that healthcare workers, delivery workers, and members of highly vulnerable communities get first access to the vaccine.

Second, the city and state should tap and mobilize the vast network of nonprofit service organizations to provide essential services and support to those most vulnerable to COVID-19.  We urge the state and local racial inequities task forces to partner with established organizations that are already best poised to effectively meet the needs of communities of color, rather than taking a top-down approach.

Finally, we have an incomplete picture of COVID-19 in Black and Latinx communities because of limited data. The Cook County Medical Examiner’s office should team with the Cook County Department of Public Health in order to accurately and rapidly record the death toll from COVID-19 in communities of color. Only then will we understand the full scope of the virus and where resources are needed most. 

In addition to these public health strategies, we should consider other policy levers to mitigate the effects of the pandemic and economic downturn for communities of color such as providing rent and mortgage relief, ensuring landlords adhere to the suspension of evictions, releasing detained individuals from prisons, jails, and immigration detention centers, and providing emergency funds for impoverished residents, like Los Angeles.

We applaud the healthcare workers, epidemiologists, and leaders working on the frontlines to treat patients and better understand this disease. At the same time, these crucial steps need to be taken to ensure the health and lives of Black and Latinx Illinoians through structural interventions in addition to individual interventions.