Gates: Virus rates probably more about poverty

If COVID-19 surged in white Appalachia, it would probably wreak as much devastation as it has in Black communities, according to Dr. Zane Gates, co-founder of Empower3, a subscription-based direct primary care organization headquartered in Altoona.

The racial disparity in infection rates and outcomes for the coronavirus is not so much about race as about poverty, said Gates, who is Black.

People in low-income areas tend not to have good access to health care, depending as they often do on the community health center system, founded 50 years ago to serve impoverished areas — a system that is “overwhelmed and underfunded,” Gates said.

People in low-income areas also tend to have habits and illnesses that make them vulnerable to the coronavirus, including high rates of smoking and of Chronic Obstructive Pulmonary Disease, diabetes and high blood pressure, Gates said.

The stress of poverty, rather than the stress of racism, is also more important as a determinant for COVID-19 outcomes, according to Gates.

“All poor people are under a lot of stress,” Gates said. “No matter the color.”

He knows that first-hand, having grown up in the Evergreen Manors low-income housing development in Eldorado, son of a single mother, he said.

“We lived in the ‘Zoo,'” as people called it, Gates said.

It was half-black, half-white, and the white kids heard the same disparaging term about the project as the black kids did, he said.

He experienced no racism at Evergreen and none in the Catholic school system, where he was educated, he said.

Still, “it’s different in the inner city,” he said, stressing that he can’t speak for the experience of Black people there.

He experienced racism himself in other settings, however, including once when he was pulled over while driving in Pittsburgh, because he was a black man, and police were looking for a black suspect; and once when he was pulled over for exceeding the speed limit in Cresson.

When he explained that he was a doctor heading to Mainline Medical Associates nearby, the officer, not believing that a Black man could be a physician, said, “Let’s take a ride.”

They drove to the office, and the officer pulled his cruiser behind Gates’s car, preventing any possible “escape,” and they entered the building.

“Do I work here?” Gates asked the staff. One of his doctor colleagues denied it at first, to get a laugh, before making it clear that Gates was one of them.

The cop never apologized.

It would not have happened that way if he were white, Gates said.

“Racism is tough,” he said.

Still, it hasn’t been stressful for him, he said.

“(But) I can’t speak for the inner city,” he said again.

While stress as a factor in COVID-19 vulnerability is mainly a function of poverty, racism certainly adds stress — but mainly for those who are poor, he said.

That is because the poor are “powerless,” he said.

The wealthy Black person who hears a slur “can go back to his yacht,” Gates said.

But there is a possible genetic factor in Black people’s vulnerability to COVID-19, related to the way they came here from Africa, according to Gates.

They came in the holds of slave ships, and were almost certainly deprived of sufficient water, so a high percentage of the survivors were those who tended to retain salt and water in their bodies — those who could “endure a lot of dehydration,” he said.

In modern settings that predisposition makes them susceptible to high blood pressure, as studies have shown, he said.

Another potential genetic factor that may create health issues for Black people in America is the greater preponderance of meat in the American diet, compared to the diet of their African forebears — as contrasted with the smaller differences between the diets of white people here and those of their European forebears, he indicated.

For James Allen of Altoona, who is of mixed race, racism can sometimes be stressful, especially when he has to explain it to his children.

But mostly he finds a way to deal with it, with the help of a conciliatory approach.

He grew up in Trenton, N.J., and encountered some police officers who would presume that a Black person with nice clothes or shoes was a drug dealer.

“It made me stop getting name brands,” he said.

Such encounters were among the reasons he moved here, he said.

“Out here, the police don’t harass you,” he said. “I thought I was in heaven.”

A couple times in his life, people have called him the “N” word, but his grandmother told him not to respond in kind, because “you’re giving them what they want,” he said.

He’s dealt with reverse discrimination from black members of his own family for marrying a white woman, just as his white great-grandfather dealt with discrimination from his family for marrying out of his race, he said.

He wishes that race relations would have continued like they were for about a year after Sept. 11, when “everybody forgot about races,” he said.

“We need to (be respectful of one another) when things are not bad,” he said. “We’re all equal.”


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