The onset of COVID-19 has reopened our collective imagination about the relationship between disease and racial disparity. This imagination also reflects a reality of real pain that inspires both resilience and trauma. Pain caused by an intergenerational wound that has never been able to heal. COVID-19 enters this wound at a time when echoes of “Black Lives Matter” are drowned out by a pandemic that impacts “all lives.” However, this pandemic begs to question, what is it about Black lives that causes us to lose them at higher rates than their white counterparts? In 1993, Bruce McEwen and Eliot Stellar coined the term allostasis to describe the way “physiologic systems within the body fluctuate to meet the demands from external forces” (McEwen and Stellar 1993). The stress of racism deteriorates the way the body functions over time (Geonimus et. al. 2006). This weathering of the body, ultimately, describes how racism impacts health. Racism is, therefore, an underlying health condition that causes Black people to die at higher rates, this includes COVID-19.
COVID-19 is a reminder that the impact of disease and disparity are a reflection of human experience. In the case of the Black community, that experience is deeply entrenched in contemporary racism. It has been over two months since the release of a vaccine to the public, which also signals an end to this pandemic. However, what does that end look like for the Black community and what have we learned from this pandemic? Anthony Fauci, on April 7, 2020, told the White House Press that “health disparities have always existed for the African American community” in response to the realization that the COVID-19 death rate was a symptom of a greater disease.
According to the CDC, the current non-White fatality rate is anywhere between 1.1 (Asian) to 2.8 (Black and LatinX); with Natives dying 2.6 times more than Whites. However, this disparity is not due to already existing disparities, or underlying conditions, it reflects a historical experience with racism. As is the case with anything that negatively impacts the whole of America, Black America just happens to be one of the most accurate barometers to all things related to health. Anthony Fauci, citing the Black Surgeon General of California, Dr. Nadine Burke Harris, acknowledged that underlying conditions like hypertension and asthma are causing the Black community a higher death rate.The question remains, why are Black people so vulnerable?
Dr. Burke Harris answered this in saying, “science makes clear how powerfully our experiences and environments shape our biology.” Hypertension and asthma are clear examples of how living in food deserts with high concentrations of air particulates shape health outcomes for the Black community. According to the National Research Council (2009), Blacks are 50% more likely to live in a food desert. Those same neighborhoods are also more likely to contain air pollution that increases likelihood of asthma (EPA, 2019). This is no accident. Racism is the underlying condition that continues to take lives and subtract lifespans. During this Black History Month, let us be inspired to change the future’s history in our present.
National Research Council (US). The Public Health Effects of Food Deserts: Workshop Summary. Washington (DC): National Academies Press (US); 2009. 2, Determining the Extent of Food Deserts. Available from: https://www.ncbi.nlm.nih.gov/books/NBK208011/
McEwen BS, Stellar E. Stress and the Individual: Mechanisms Leading to Disease. Arch Intern Med. 1993;153(18):2093–2101. doi:10.1001/archinte.1993.00410180039004 Geronimus, A. T., Hicken, M., Keene, D., & Bound, J. (2006). "Weathering" and age patterns of allostatic load scores among blacks and whites in the United States. American journal of public health, 96(5), 826–833. https://doi.org/10.2105/AJPH.2004.060749