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'A stone of hope': Communities of color hot spots for more than COVID-19

June 19, 2020
Dr. Mark Cucuzzella and George Rutherford - The Re-evolution of Running , Shepherdstown Chronicle

African-Americans represent four percent of the population in West Virginia and yet make up over seven percent of the cases. The death rates show five percent of the deaths being African American, according to the West Virginia Department of Health and Human Resources.

Despite late testing and often incomplete racial data, this is likely an accurate picture. However, we often do not have full demographic data of those tested, because this data is only acquired when local health departments investigate positive cases. Cases might be under-reported, as there is often limited access and resistance to enter healthcare facilities in communities of color.

West Virginia is one of the best states gathering racial data, but holes still exist. Nationally, almost half of cases and nine percent of deaths still have no race tied to them.

Article Photos

Etched on Martin Luther King, Jr.'s memorial are his words, 'Out of a mountain of despair, a stone of hope.' Courtesy photo

According to current data, African-American deaths from COVID-19 are nearly two times greater nationwide than would be expected, based on their share of the population. In four states, the rate is three or more times greater. West Virginia has been fortunate in the pandemic, reporting just over 2,000 cases and only 88 deaths, with over two million cases and 100,000 deaths reported nationally, according to the COVID Tracking Project.

Our country is volatile now. Etched on Martin Luther King, Jr.'s memorial are his words, "Out of a mountain of despair, a stone of hope." The memorial's sculptor, Lei Yixin, depicted this quote by creating a granite statue of King emerging as a "stone of hope" from a symbolic "mountain of despair." The rough edges depict the difficult journey, while the entrance conjures the openness of democracy.

I (George) have been leading local action, and one result was a commitment from state leaders to increase testing and outreach to African American communities throughout the state. Last month, the state finally started increasing testing after receiving pressure from the state's NAACP chapters. We have tested over 1,000 people in our minority communities over the last month, which is a start to help us see the picture. The NAACP negotiated for a portion of the $1.5 billion federal dollars allocated to West Virginia's fight against the coronavirus to be directed to communities of color.

Locally, I (George) have found people more polite and kinder that usual, such as making and distributing free masks, keeping the six feet distance between each other in stores and still striking up a conversation, increasing food donations for the needy and showing concern for their neighbors and the elderly by calling them on the phone. Maybe it takes a pandemic to make the world more loving.

Are Communities of Color Disease Hot Spots?

The coronavirus is exposing deep inequities in our society. The COVID-19 hot spots of disease burden and mortality also reflect different types of hot spots. Even though it is clear that viruses do not discriminate, data from across the U.S. and United Kingdom demonstrate that neighborhoods of color are impacted differently by COVID-19. Almost daily the news and medical journals report the disparities in test positivity, hospital admissions, ICU cases and death.

Something unusual is happening on both sides of the Atlantic, where the U.S. has the world's highest number of fatalities and the U.K. has now topped 30,000 deaths, the most in Europe. A recent U.K. Office of National Statistics report found black people are over four times more likely to die with COVID-19 than white. The most recent U.S. CDC report revealed that over 30 percent of COVID-19 patients are African American, even though they make up only 13 percent of the population.

More recently, the Henry J. Kaiser Family Foundation's prepublication database from a team of epidemiologists and clinicians at four universities show counties with higher black populations account for more than half of all COVID-19 cases and almost 60 percent of deaths.

But what about New Orleans, where minorities are overrepresented in the hospitals, in ICUs and in mortality? Can we blame the Mardi Gras celebrations in late February? Similar stories are playing out in the neighborhoods and hospitals in Detroit, Chicago and New York. The New York Times shared a map reflecting the mortality by neighborhood, showing that African American communities to have the highest COVID-19 mortality rate.

Why are so many dying? Certainly Louisiana was at high risk for becoming a hot spot, with a nearly 40 percent obesity rate and high numbers of people with diabetes, cardiovascular disease, hypertension and kidney disease. The same is true for the hardest hit neighborhoods in the other cities. Many of the victims suffer from more than one of these conditions. Vitamin D deficiency is also being connected to poor outcomes and tied closely to people of color.

Beyond The Medical Model -- The Structural Social Hot Spots

Back in April, U.S. Surgeon General Dr. Jerome Adams stated on CBS that "Blacks are more likely to have diabetes, heart disease, lung disease and many black Americans are at higher risk for COVID-19."

On a later CNN podcast, Adams then said, "My recommendation is to all of America that we're really doing this [social distancing] to protect not just ourselves but each other. Every single person who stays at home is a person who is not spreading COVID-19."

But the social distancing rules can't apply equally to communities of color, where structural inequities exist. Living spaces are overcrowded, making distancing all but impossible. Working and schooling from home is often not an option. Essential jobs in the service sector are overrepresented by minorities, creating more chances for exposure -- jobs such as home health aides, grocery work, delivery and services.

We are aware of the importance of optimal nutrition on metabolic and immune function. Many minority neighborhoods are food deserts, with limited access to affordable, nutritious foods and the necessary support systems to make leading a healthy lifestyle possible.

It's not all negative. Bright spots in education are happening in communities of color, with improved home computer and internet access. States are enacting task forces to address disparities. The U.S. Air Force just became the first branch of the Armed Forces to select an African American chief of staff in General Charles Q. Brown -- he was voted in unanimously, 98-0.

We can build back stronger communities. Knowledge leads to public policy change and public health preparedness to address the disparity hot spots as we learn to live with COVID-19. We can engage in peaceful demonstrations for justice.

We may not get to the mountaintop, but together we can try.

George Rutherford first demonstrated for civil rights and equality for African Americans in 1962 and is president of the Jefferson County National Association for the Advancement of Colored People.

Dr. Mark Cucuzzella is a professor at WVU School of Medicine and retired from the U.S. Air Force. He practices at Jefferson Medical Center and in Martinsburg at the Center of Diabetes and Metabolic Health.

 
 
 

 

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