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PSU prof: Minorities harder hit by COVID-19

As of mid-June, Black people in the U.S. who have tested positive for COVID-19 have been hospitalized at five times the rate of white people, according to the CDC, and the reasons go far beyond the coronavirus, said a Penn State School of Public Policy professor who spoke this week as part of the school’s virtual “Policy and the Pandemic” series.

“It’s very much about social interaction” related to housing and employment, about longstanding health care issues specific to Black people and about poverty, according to Niki vonLockette, associate professor of public policy and African American studies.

It also may relate to the sheer stress “of being Black in this country,” as studies have shown that there is a residual and persistent health deficit for Black people, vonLockette said.

The issues are interrelated: being Black helps determine what kind of neighborhood and what kind of housing you grow up in, and that helps determine what kind of education, and what kind of employment you find later in life, which helps determine whether you live in poverty and whether you have adequate health insurance, which in turn helps determine how healthy you are.

More research is required to “fully understand the complex interplay between the various biological, social and cultural factors underlying these early findings (of racial disparities connected with COVID-19),” states an April 20 article in the British Medical Journal titled “Is ethnicity linked to incidence or outcomes of COVID-19?”

With housing, it’s a matter of “proximity to people,” because of the higher number of residents in the average home and the higher number of units per the average structure, vonLockette suggested.

“For many people from racial and ethnic minority groups, living conditions can contribute to health conditions and make it harder to follow steps to prevent getting sick with COVID-19 or to seek care if they do get sick,” the Centers for Disease Control and Prevention states on its website.

Members of minority groups often live in densely populated areas where it can be hard to practice social distancing, the CDC stated.

Often, such neighborhoods are far from grocery stores and medical facilities, making it hard to stock up on supplies. That makes it harder to stay home and receive care when sick, and often the residents of those neighborhoods must rely on public transportation, subjecting them to infection risk, the CDC says.

Members of minority groups also often live in multi-generational households, which can make it hard to protect vulnerable older people, according to the CDC.

“Some racial and ethnic minority groups are over-represented in jails, prisons, homeless shelters and detention centers, where people live, work, eat, study and recreate within congregate environments,” adding to the infection risk, the CDC stated.

There’s also a greater concentration of Black people in the northeastern cities where the pandemic first surged in the U.S., increasing their vulnerability,

vonLockette said.

With employment, there is a lower percentage of Black people who have had the “luxury” of sheltering in place at home, vonLockette said.

Those without that luxury include “essential workers” in health care settings and grocery stores, according to vonLockette.

Also with employment, there’s a higher percentage of Black workers who don’t feel economically secure enough to stay home for their own safety, especially when their employers expect them to continue working, according to

vonLockette.

“These workers must be at the job site despite outbreaks in their communities,” the CDC states.

Many such workers don’t get sick leave, making them more likely to keep going in when they’re sick, according to the CDC.

There is also probably a higher percentage of Black people in jobs where “worker protections” against COVID-19 aren’t up to par, vonLockette suggested.

Those include people in health care who have worked without adequate protective equipment and bus drivers in cities who worked without masks,

vonLockette said, speaking of governmental “fumbling” at the pandemic’s beginning.

“Racial housing segregation is linked to health conditions, such as asthma and other underlying medical conditions, that put people at increased risk of getting severely ill or dying from COVID-19,” the CDC states.

Lack of health insurance, health care costs — including the cost of missing work — and distrust of the health care system are among other problems that contribute to health inequities for members of minority groups, according to the CDC.

“Concomitant comorbidities,” including “hypertension, diabetes, obesity and the higher prevalence of cardiovascular disease among Black persons” are likely drivers of the racial differences in COVID-19 outcomes, according to Dr. Clyde Yancy in an April 15 story on the Journal of the American Medical Association network titled “COVID-19 and African Americans.”

Regarding poverty, Black service members, at least initially after World War II, didn’t benefit from the GI Bill to attend college like white people did, largely because the federal government gave states the responsibility for distributing the money, and southern states didn’t let much of that money go to Black people, vonLockette said — although her grandfather lived in a state that didn’t follow the discriminatory practice, and so he was able to earn a graduate degree.

But many Black families headed by service members didn’t get the opportunity for advancement that white service members enjoyed, according to vonLockette. That inequity helped contribute to the lower socio-economic status of blacks, she indicated.

“On average, racial and ethnic minorities earn less than non-Hispanic whites, have less accumulated wealth, have lower levels of educational attainment and have higher rates of joblessness,” the CDC states. “These factors can each affect the quality of the social and physical conditions in which people live, learn, work and play, and can have an impact on health outcomes.”

“Low socioeconomic status alone is a risk factor for total mortality independent of any other risk factors,” Yancy wrote.

Yet even after controlling for variables like housing, employment, poverty and health status, there is a “persistent racial disparity” that further erodes the health of African Americans, according to vonLockette.

“There’s something about being Black in this country,” she said.

The theory is that there’s “a health tax for being Black,” she added.

The existence of that “health tax” is suggested in the childbirth problems of tennis player Serena Williams and entertainer Beyonce, both of whom are wealthy enough to insulate themselves from the problems typical with the Black community, vonLockette said.

Its existence is also suggested in the results of a study that showed that the gap in infant mortality rates between white people and Black people today is about the same as it was in 1850 — although those rates are much improved for both groups, she said.

It seems to be a kind of “racial stress,” she said.

The whole country got a taste of that stress in viewing the video of George Floyd’s death in Minneapolis, and the video of the interaction in New York City between a Black bird watcher and a white woman who called police, claiming falsely that he was threatening her life, vonLockette said.

“It happens every day,” she said of such racial stressors.

By the numbers

New/total county cases: Blair 6/99 (1 death); Bedford 1/92 (4 deaths); Cambria 10/123 (3 deaths); Centre 4/239 (8 deaths); Clearfield 3/85; Huntingdon 2/256 (4 deaths, although SCI-Huntingdon has reported 5)

Area new/total cases: 26*/894

New/total cases statewide: 1,009** (up 40 percent) / 93,876 (77 percent recovered), 635 positive serology tests

New/total deaths statewide: 32/6880

*Most new cases for area since May 10, when there were 67 reported, largely because of an outbreak at SCI-Huntingdon

**Most new cases for state since May 10, when there were 1,295 reported

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