Richard Bernstein: Covid-19 and structural racism

Editor’s note: This commentary is by Richard Bernstein, M.D., a retired physician, who is a trustee of the Rokeby Museum and National Historic Site in Ferrisburgh.

The Covid-19 pandemic has exposed fault lines that separate people of color and whites, and it continues to shine a light on the terrible effect that white supremacy and structural racism have had historically in America.

The Covid-19 pandemic hit the news early in February. Several weeks later, on March 27, five U.S. lawmakers (Sens. Harris, Brooker, Warren, Pressley, and Rep. Kelly) pressed the agency of Health and Human Services to release racial data on infection and death rates. The data showed that 30% of Covid-19 cases occurred among African Americans, who make up about 13% of the population. In some places the incidence was even higher: In Louisiana, 70% of victims were African Americans; in Alabama, 44%; in Milwaukee, 39%.

The reasons for the racial disparity in the Covid-19 pandemic have been studied and published. On average, African Americans are poorer more likely to use public transportation. They make up a large percentage of “essential workers” that include bus drivers, health care attendants, grocery clerks, and sanitation workers. Fewer black workers have been able to work from home. Low-wage jobs come with no sick leave, forcing many to come to work even when symptomatic. Lack of adequate health insurance impedes access to medical care.

Housing affects exposure to Covid-19: 44% of Blacks own their own homes, whereas 74% of whites do. Rental housing is often cramped, with several generations living together in one unit. Much of the rental housing in poor neighborhoods is substandard and difficult to sanitize. Social distancing is nearly impossible to accomplish.

Those suffering from chronic diseases such as asthma, hypertension, and heart disease are more vulnerable to Covid-19. Often linked to obesity, diabetes strikes 30% of blacks overall, but only 18% of whites. A larger percentage of African Americans than white Americans are obese (47% vs. 36%). 

These statistics have led to the first dangerous counternarrative in the Covid-19 crisis — that Covid-19 infection and death are largely a result of behavioral failings, and that if African Americans would only eat less, exercise more, and adopt healthier lifestyles, their infection rates would decrease.

But the basis for the higher incidence of Covid-19 infections and death is the awful persistence, if not increasing emergence, of racism and structural racism in this country. 

Racism, according to Merriam Webster, is an individual belief that race is the primary determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race. Structural racism, however, is enshrined in policy at all levels of government. It is the public policies and institutional practices that perpetuate racial group inequity in ways that have allowed privileges associated with “whiteness” and disadvantages associated with “color.”

As soon as it became clear that Covid-19 spread among people in the African American community, the federal government, rather than  protecting the vulnerable, began to steer a new course. According to Linda Villarosa (New York Times Magazine), “… like clockwork, after cities with sizable populations of black people began to report large numbers of Covid-19 infections (and deaths) a counternarrative began. … The national, state and municipal shutdowns were too draconian; the coronavirus pandemic was not as much of a threat — at least, not to all Americans — as had been argued.” 

Sunjayta Gupta writes in Science News, “African Americans’ risk of higher exposure to Covid-19 has historical roots — including legal segregation in schools and housing, discrimination in the labor market, and redlining, the practice of denying home loans to those living in predominantly African American neighborhoods. Those forces have contributed to a persistent racial wealth gap, with African Americans continuing to struggle to move into neighborhoods with the sorts of socioeconomic opportunities that allow white families to better avoid exposure to Covid-19.”  

Continued exposure to racism and prejudice produces what Dr. Arlene Geronimus calls “chronic and toxic stress (New York Times). She contends that this leads to “weathering” or accelerated aging and plays a role in chronic diseases such as diabetes, hypertension, and heart disease. 

Racism and prejudice can take many forms. Currently, the three counties in Georgia with the highest incidence of Covid-1 are Early (49.6% African American) Randolph, and Terrell counties (both 62% African American). 

Georgia refused Medicaid expansion under the Affordable Care Act. The high infection rates include many of the poor whites in Early County, and Ta-Nehisi Coates argues that racism is so deeply ingrained in some areas of the country that whites avoid measures that would help the community as a whole because they would also help blacks (MSNBC).

How can you join the struggle for social justice?  As a staunch to despair, here are some links to explore:

1. What white people can do: This website offers a list of political actions and organizations.

2. Join an organization fighting racism and promoting social justice:

           — Black Lives Matter

         — NAACP

           — Southern Poverty Law Center

3. For those moved to action, Showing Up for Racial Justice has chapters in Middlebury and other parts of Vermont.  


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