Far more African American and Hispanic individuals are being infected with COVID-19 and dying from it. While African Americans make up about 15% of the population of Illinois, they account for 42% of deaths from COVID-19. In Chicago, 30% of the population is African American, but they account for 60% of the COVID-19 fatalities.
Susan Rogers, MD, president-elect of Physicians for a National Health Program explained how COVID-19’s disproportionate effect on black and brown communities is a reflection of institutional policies that leave people of color with fewer options to improve their lives. At the May 30 virtual Briefing, Dr. Rogers suggested ways of addressing COVID-19 among people of color, including a shift from private health care insurance coverage to a national single-payer health care system.
The proportions of African Americans and other minorities who are infected with COVID and die from it are more than double those of white Americans. Yet even those numbers don’t provide the full picture of the problem. Statistics regarding the incidence of and mortality from COVID-19 are not precise. The overall total number of cases is not fully known because of the lack of consistent and universal testing. The number of cases in minority communities is more widely underestimated because many individuals do not have a car or other access to testing sites. Other inequities affect the ability to be tested and treated for COVID-19 in minority communities: overall lack of access to health care facilities and providers.
The Affordable Care Act was intended to make it just as likely for African Americans and whites to have access to the usual sources of health care—clinics, private doctors’ offices, and community health centers—instead of the emergency room. Unfortunately, Medicaid was not expanded in all states, so it has not been available to about half of black adults of working age.
The inability to practice social distancing makes COVID-19 transmission more likely in minority communities because of decades of housing discrimination and lack of investment. ”It’s not that streets are full of people. It’s that the homes are. In immigrant and other minority communities, houses are often crowded. The virus tends to spread where people can’t socially isolate themselves,” she said. When multigenerational families are living together, a younger person may infect an older person who is at higher risk of infection and dying.
The Coronavirus Aid, Relief, and Economic Security (CARES) Act included the Payment Protection Program to provide resources to small businesses so they could maintain payroll, eventually rehire employees, and cover overhead. However, this was on a first come, first served basis and ran out of money within two weeks. Small businesses in minority communities were at a disadvantage from the outset because they are less likely to have attorneys or staff to navigate the system and jump through the loopholes, and they often don’t have relationships with banks. “This was another policy that was supposed to help the economy rebuild, but still disenfranchised poor people and people of color. There was little connection between who really needed the money and who was actually getting it,” said Dr. Rogers.
Dr. Rogers suggested a number of steps that should be taken immediately:
Protect patients from medical costs due to infection with and treatment of COVID-19.
Restore public health infrastructure. “Listen to the health experts, rather than a politician who is worried about being reelected.”
Protect the incarcerated. “Incarceration is a petri dish for infectious diseases like this. We need to protect especially those who are in because they can’t afford a $50 dollar bond….They’re not endangering society; they’re just poor.”
Protect immigrants. “Immigrants often work under false Social Security numbers, and they provide more money into Medicare than they take out; they’re keeping Medicare afloat.”
Stabilize hospital finances so the richest don’t get fatter and the poorest get leaner and eventually close. “It’s not that one hospital is necessarily better than the others. Often some are better because they have more money. We need them to be equitable.”
Free vaccines for all. “What is affordable for one is not affordable for another.”
Global cooperation. “This is a pandemic, a global health problem. It’s not in a state or county or neighborhood. It’s everywhere.”
Single Payer Health System
A single payer health care system will not address all the inequities in health care, but, in Dr. Rogers' opinion, it should make things better. In a single payer system, people pay a tax and businesses pay payroll taxes. Payroll taxes are based on income and are progressive. The money is sent to the government, and the government funds the health plan. The health plan then reimburses the doctors and offices and hospitals where the care is delivered in a much more streamlined system.
“Nothing is perfect,” said Dr. Rogers, “but covering everyone for health care has to be one of the things we should insist on if we want to make everyone healthier. You want the person who’s cooking your food to be healthy. You want the person who’s putting your silverware on your table to be healthy. You want the person bagging up your groceries to be healthy. We have to look at the whole community.”
Physicians for a National Health Program has more than 20,000 members across the country who are advocating for a universal, comprehensive single-payer national health system to address inequities in health care delivery.
Chicago Targets COVID in Minority Communities
Mayor Lori E. Lightfoot and the City’s Racial Equity Rapid Response Team (RERRT) announced in April that rapid steps are being taken to address the disproportionate impact of the coronavirus pandemic on African-American communities. Three communities have been identified for initial engagement, based on local COVID-19 data that indicated a need for action – Austin, Auburn Gresham, and South Shore.
RERRT is led by Candace Moore, the City’s first Chief Equity Officer, and Dr. Sybil Madison, the City’s Deputy Mayor for Education and Human Services, and West Side United. RERRT is partnering with three anchor community organizations—Greater Auburn Gresham Development Corporation, Austin Coming Together, and South Shore Works—to slow the spread of COVID-19 and improve health outcomes among communities that have been most heavily impacted.
Steering committees and working groups are targeting education, disease prevention, testing and treatment, and supportive services. They are engaging directly with residents in the impacted communities to identify gaps and solve problems in emergency response, provide education about protecting loved ones, help health care providers reach patients with underlying conditions that increase the risk of contracting COVID-19, and distribute masks and other protective equipment.