A NEW ORLEANS TRIBUNE ANALYSIS
by Tribune Staff
By now, everyone likely knows that African Americans, who comprise only 32 percent of the state’s population, have made up 70 percent of Louisiana’s COVID-related deaths so far.
When Gov. John Bel Edwards made that statistic public during one of his daily press briefings earlier this month, he also said the “trend” was worthy of further study. Not surprisingly, Louisiana is not alone. Across the nation, the virus similarly impacts Black communities. For example, in Chicago, Blacks comprise 70 percent of COVID-19 deaths there as well, while making up only about 30 percent of the city’s population.
The reason is racism— historic, systemic and institutional racism, the good old-fashioned kind. With all due respect to Gov. Edwards, 400 years of racism is not a trend.
That we are 70 percent of the COVID-19 related deaths in the state should come as no surprise. Black Americans, including those of us who live in Louisiana, are more defenseless against every societal ill America has to offer. It starts the minute we enter the world—literally, from birth. In 1968, Black infants were about 1.9 times as likely to die as White infants. Today, the rate is 2.3 times higher for African Americans.
We already know the stats. We have repeated them incessantly in the pages of The New Orleans Tribune for 35 years to be exact. But we are always happy to remind.
African Americans are 2.5 times as likely to be in poverty as Whites. Even with the ACA (Obamacare) and the Medicaid expansion, we are still uninsured at higher rates than White Americans and more likely to work jobs where health insurance is not offered, while earning too much to qualify for Medicaid and not enough to afford private insurance. In 2017 the Black unemployment rate was 7.5 percent, up from 6.7 percent in 1968, but it is still roughly twice the White unemployment rate. The typical Black family had only $2,467 in wealth in 1963. And while today that figure is about six times larger ($17,409), wealth for White families dwarfs it. In 2016, the median African American family had only 10.2 percent of the wealth of the median White family ($17,409 versus $171,000).
All of those statistics and others point to the reason COVID-19 has hit our communities so hard. Yes, chronic illnesses that African Americans often suffer from at a disproportionate rate should and must be addressed by individuals and their doctors. But we simply cannot stop there, because structural racism is at the root of it all.
Glenn Ellis, a medical ethicist, researcher, lecturer and president of Strategies for Well-Being, a global consultancy that specializes in health equity and advocacy, says the fallout from COVID-19 and its disproportionate impact on Black people offers an opportunity to determine how we will prevent this from happening again.
“What this virus is doing is clearly demonstrating how institutional racism has affected Black lives in America,” Ellis told The New Orleans Tribune. “And it is singling out the healthcare system to show how we are at a disadvantage. We can start with the method used to tell people to seek diagnosis and testing for COVID-19. They said to contact your primary care physician. Don’t go to the hospital. Don’t go to the emergency room. Many Black people don’t have primary care physicians. Even with Medicaid and Obamacare, they go to community clinics or community medical centers, where they see rotating physicians.”
The fact that African Americans are less likely to visit primary care physicians as their source of healthcare is not an obscure bit of information. According to a 2016 study published in a National Institute of Health study—whether the reason is mistrust, lack of access or socio-economic status/ability—Black Americans go to private physicians office for care at only two-thirds the rate of White Americans. Now if the National Institute of Health already knows this, someone somewhere had to have known that directing Americans to call their primary care physicians if they were experiencing COVID-19 symptoms would leave many Black Americans with no one to call.
As Ellis contends, the very fact that this reality was not considered when crafting and delivering the message that primary care physicians were the frontline for COVID-19 care at the very least indicated a lack of understanding for what it means to be Black in America. At worst, it was a blatant disregard for Blacks in America and a sign of institutional racism.
Ellis continues, “So if you are telling people not to go to the hospital, not to go to the emergency room, but to call their primary care physician, who are you talking to? They are not even talking to me because they don’t understand the realities of my culture. And that allows a viral infection to continue to spread. We were allowed to go much longer without taking precautions. Without any way to deny it, you have to look at what racism does to the wellbeing of Blacks in America.”
To be sure, even the drive-thru method of testing employed earlier in Louisiana and across the nation was innately biased against the poor and disenfranchised. It presumed that anyone and everyone experiencing symptoms of the disease also had a personal vehicle. In New Orleans, about 20 percent of the population lacks access to a personal vehicle, more than twice the national average. A lack of reliable transportation was a primary reason many New Orleanians, especially poor, Black New Orleanians were unable to evacuate before Hurricane Katrina.
We’ve Been Here Before
It would be one thing if COVID-19 was the first time the impact of racism in America was exposed in such a raw and jarring manner. But it’s not.
Didn’t we learn this lesson nearly 15 years ago in the aftermath Hurricane Katrina? Didn’t the storm shine a light on how the deep socio-economic disparities fueled by systemic racism created two New Orleans—one that was overwhelmingly Black and unable to respond to the storm’s threat. Haven’t we been here before? Then, why do we find ourselves in this disgustingly familiar place? Better still, what are we going to do about it?”
Ellis has a thought.
“Now for the second time in recent years, this country has been given a chance to decide who it wants to be. We have a chance to say, ‘No, we don’t want to be a nation where an entire segment of our population is disenfranchised because of racism’. But if the nation won’t do it, as a whole, then Black folk need to get serious. We have to look at our consumption patterns,” he says, specifically referencing how and where Black Americans receive news and information.”
He continues, “We have to get strict and do it across the board in all areas—how we spend our money and how we vote. We really have to put more scrutiny on and demand more accountability from the people we vote for. Either we are going to do it together as a country or we have to come together as Black people and say ‘we’re not going to allow our communities and our people to die like this again’. We don’t have the luxury to be sitting around, waiting on somebody to save us.”
No Time for the Blame Game
There is probably no individual or organization that encourages personal responsibility and the need for those of us in the Black community to save ourselves more than we do here at The New Orleans Tribune. Our mantra: “We must come together to save ourselves because no one else will.”
Of course, Black Americans . . . all Americans for that matter, should watch what we eat. We should not smoke or drink too much. We should exercise more. We should take seriously and, with the help of healthcare professionals, better manage chronic illnesses. We should make regular doctor visits.
We must do better as individuals, families, and communities when it comes to taking care of our bodies. The disparate vulnerability of Black Louisianans to the coronavirus has made that clear. We comprise 70 percent of COVID-19 related deaths in a state where we are only a little more than 32 percent of the population. And with that fact, perhaps it is a natural inclination to look at the Black community, point a finger and say that we must be doing something wrong, something that makes us more susceptible to the disease. And it is true. There are things we have done (or have not done) that have resulted in this uneven impact. It’s okay to talk about those things, especially if everyone else, especially our leaders and policymakers, are ready to talk about the things that have been done to Black people in America over the last 400 years, how those things have undermined our community and left us vulnerable to COVID-19 and so much more.
More importantly, we need leaders to develop a plan to address the issues that harm our communities from a policy standpoint.
That is why it was disappointing to hear Gov. John Edwards (and others, including Black leaders, elected officials and influencers) go on and on about the lifestyle behaviors that contribute to Black folk being disproportionately impacted by COVID-19 without the proper context. The reason Black people are dying from coronavirus at a disproportionate rate does not begin and end with bad habits or existing chronic illnesses that afflict our community at higher rates than others. It begins with structural racism.
It is true, coronavirus does not see race or class. But our nation and its healthcare system do. And that is the problem we need our leaders addressing substantially more than we need to be lectured by any of them about the amount of salt someone shakes on their meal.
It is disrespectful to go on and on about how Black people need to do a better job of seeking care from primary care doctors without talking about the institutional racism that helps explain why they don’t.
According to studies, Black Americans seek their healthcare from primary care physicians at a rate of about two-thirds that of White Americans. And unless we are ready to talk about a lack of cultural competency among many healthcare professionals, the lack of access and resources that keeps many Black Americans from seeking the medical care they need, the understandable and inherent distrust many Black Americans have for the established medical system, or the fact that only four percent of the nation’s practicing physicians are Black, then we are wasting our time. The “Tuskegee Study of Untreated Syphilis in Black Males” went on for 40 years until as recently as 1972; and dark events like it, along with similar issues with this country’s medical establishment, are major reasons Black Americans don’t trust the established medical system. It’s true many Black people don’t go to the doctor as often as they should. Can you blame them? Better still, what can you do to change this reality?
Of course, we know there are things individuals must do to improve his or her own quality of life. But let’s put this thing in perspective. Historic and even current government-sanctioned policies that were and are racist at their core have shaped what it means to be Black in America in every way possible. So as our leaders try desperately to unpack the data, we believe too much energy has been spent pointing fingers at Black people for the decisions they make or don’t make while not nearly enough attention is given to circumstances that have driven those decisions for 400 years.
The way some folks talk about the disparate impact of the virus on the Black community, including U.S. Surgeon General Jerome Adams whose “do it for your Abuela . . . do it for Big Mama” plea to Black and brown Americans to not drink and to not smoke, is pejorative, superficial and utterly ignores the fact that 400 years of structural racism have manifested into every negative social determinant that impacts Black America. And if the nation’s surgeon general, who also happens to be a Black man, can’t dig any deeper than that to talk about not only habits that need to change, but government policies and healthcare industry practices that need to be transformed as well, then we are in trouble.
We were unnerved by Gov. Edwards, when, during his 1 p.m. address Friday (April 10), he
castigated the very community being hit hardest by this disease; then, almost as if it were an afterthought, he briefly mentioned something about “figuring out” the social determinants that play a role in the disparate impact COVID-19 is having on Black people in Louisiana and “see what we can do to address them.”
What is there to figure out?
Slavery. Domestic Terrorism. Jim Crow. Segregation. Redlining. Economic Exclusion. Historically Inequitable Treatment in the Education, Healthcare, Housing, and Criminal Justice systems. Are those enough social determinants for y’all?
And let’s be abundantly clear, we are not talking about ancient history. We are talking about a relatively young nation’s recent past that continues and current problems that exist because every one of this nation’s systems and institutions are built on a foundation of racism.
Yes, we must talk about poor diets, but let’s dare do that without mentioning that our city is littered with communities that are in fact food deserts forcing people to travel miles from home for fresh offerings or settle for the unhealthy options that are just up the block. How could anyone with even an ounce of decency talk about poor eating habits of a community and not talk about how areas in cities such as New Orleans and others like it across the country are void of healthy choices TODAY because of redlining policies that date back to the 40s, 50s, and 60s—an actual program created and sanctioned by the federal government to keep banks from backing loans to developers to build and sell homes in Black neighborhoods, which in turn kept Blacks from building wealth and kept business interests from opening groceries or other viable institutions to serve people they intentionally left trapped there. Today, groceries, banks, healthcare facilities, restaurants and the like won’t even consider many of these areas of our communities unless they are being gentrified.
Just look to New Orleans East for an example close to home. Large national grocery store and retail chains abandoned New Orleans East after African-Americans began to move there and white folks fled.
Stop victim-blaming and do something
Now as the state turns it’s attention to residents in the River Parishes, we have to talk about environmental racism. We hope that our leaders are not surprised because St. John, St. James and parishes that stretch along the Mississippi River, are getting hit hard now by coronavirus. As the number of cases in these areas grows, our leaders should not talk about the rate of diabetes or hypertension in these communities without mentioning the inequitable manner in which Black people in these communities suffer from cancer and respiratory illnesses because of the chemical plants that have been allowed to grow unchecked in their backyards.
We know it will be easier to talk about how residents along Cancer Alley need to exercise more. That way you don’t have to explain why the petrochemical plants are still allowed to flourish there despite their proximity to and detrimental impact on the communities of color. But we didn’t elect you to take the easy way out. Greed and environmental racism were already killing the people of these communities. COVID-19 is not helping. And neither will a brisk walk.
We could go on and on about every social determinant and point to historical or current policies and practices that directly impact the state of Black America today. We have been writing about this stuff for 35 years.
But right now, we just need y’all (including Black leaders) to stop it. Stop victim-blaming and do something.
For our part, we encourage our brothers and sisters to step up to the challenge and take as much control over their lives as they possibly can. We often dedicate the monthly “To Your Health” column of the this very newspaper to examining many of the illnesses that impact our community disparately, offering useful information and encouraging our readers to make healthier choices. Gov. Edwards is right about one thing—everyone needs to do his part. Everyone needs to do what they are supposed to do.
So, let us pray.
God grant us the courage to change the things we can and to accept personal responsibility for our individual lives.
Grant us the boldness to demand that our leaders fix the things they are supposed to fix, deliver services and create policies that close education, healthcare, housing, income and wealth gaps because that is what we elected them to do. And grant them the humility to either do their jobs or go home and be quiet.
Oh yeah, God, also grant them the wisdom not to blame the victims of 400 years of racism in America for not being able to handle this deadly virus as well as others who have enjoyed a 250-year head start in wealth, access, equity and opportunity in every way.