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Dr. Anto-Ocrah comments on health disparities during Covid-19 pandemic

Friday, April 10, 2020

By Sujata Gupta

COVID-19 was called the great equalizer. Nobody was immune; anybody could succumb. But the virus’ spread across the United States is exposing racial fault lines, with early data showing that African-Americans are more likely to die from the disease than white Americans.

The data are still piecemeal, with only some states and counties breaking down COVID-19 cases and outcomes by race. But even without nationwide data, the numbers are stark. Where race data are known — for only 3,300 of 13,000 COVID-19 deaths — African-Americans account for 42 percent of the deaths, the Associated Press reported April 9. Those data also suggest the disparity could be highest in the South. For instance, in both Louisiana and Mississippi, African-Americans account for over 65 percent of known COVID-19 deaths.

Other regions are seeing disparities as well. For instance, in Illinois, where the bulk of infections are in the Chicago area, 28 percent of the 16,422 confirmed cases as of April 9 were African-Americans, but African-Americans accounted for nearly 43 percent of the state’s 528 deaths. 

Other data find similar trends. A study published online April 8 in the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report looked at hospitalizations for COVID-19 across 14 states from March 1 to 30. Race data, which were available for 580 of 1,482 patients, revealed that African-Americans accounted for 33 percent of the hospitalizations, but only 18 percent of the total population surveyed.

Here are three reasons why African-Americans may be especially vulnerable to the new coronavirus.

1. African-Americans are more likely to be exposed to COVID-19.

SARS-CoV-2, the coronavirus that causes COVID-19, is highly contagious, even before symptoms appear (SN: 3/13/20). So to curb the virus’ spread and limit person-to-person transmission, states have been issuing stay-at-home orders. But many individuals are considered part of the critical workforce by the U.S. Department of Homeland Security and must continue to work. That includes caregivers, cashiers, sanitation workers, farm workers and public transit employees, jobs often filled by African-Americans.

For instance, almost 30 percent of employed African-Americans work in the education and health services industry and 10 percent in retail, according to 2019 data from the U.S. Bureau of Labor Statistics. African-Americans are less likely than employed people in general to work in professional and business services — the sorts of jobs more amenable to telecommuting. 

Driving solo to those jobs isn’t always an option. Among urban residents, about 34 percent of African-Americans use public transit regularly compared with 14 percent of white people, according to a 2016 report from the Pew Research Center, a nonpartisan think tank in Washington, D.C. Continued use of public transit during the pandemic may bring African-Americans into greater contact with infected people.

Additionally, a disproportionately high percentage of African-Americans may live in places that could increase their risk of exposure. Census data from January 2020 show that only 44 percent of African-Americans own their own home compared with almost 74 percent of white people. Consider a family living in a crowded inner-city apartment, says epidemiologist Martina Anto-Ocrah of the University of Rochester Medical Center in New York. “Can you possibly take an elevator alone? No.”  

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