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Government’s Role in Addressing the Pandemic’s Grim Racial Reality

COVID-19 is hitting African Americans the hardest. Public officials could do far more about the social determinants of health that underlie the coronavirus's disparate impact.

Coronavirus screening in Alabama, a state that hasn't expanded Medicaid. (Joe Songer |
Recently, I wrote about the potentially harsh realities of the coronavirus for those who live at the margins of society, particularly racial minorities. Earlier this month, the Centers for Disease Control and Prevention published data showing that African Americans have been contracting and dying from COVID-19 in numbers far out of proportion to their share of the population. And because so little testing has been completed, experts predict that the impact might be much greater than the CDC's numbers suggest.

The underlying reasons for this disparity are not hard to understand, but doing something about them will be hard and require public officials to act courageously and creatively.

The numbers from the CDC and state and local governments portray a troubling narrative of the deadly impact of racism in America and the failure of health-care systems to focus on our most vulnerable in responding to the pandemic. Much has been written in the wake of the CDC report about the negative effects of COVID-19 on the black community, but few, if any, solutions have been offered. We need more than descriptions of the problem; we need results.

More than ever, we need to rise to the level of the crisis and focus on racial justice to address social determinants of health that include lack of access to health services, income inequality, low employment and poor working conditions, the digital divide, insufficient educational opportunities, and inferior physical environments.

Public officials alone cannot do all that is needed to transform society, but there are important roles they could play. For one, they can improve governmental hiring and purchasing policies and practices to make them less racially biased. To counteract racial profiling in public safety, they can spend more on community policing strategies. Local officials also should stop approving incentives for developers to overbuild high-cost housing for affluent residents while ignoring the need for affordable housing for middle- and low-income residents. Diseases like COVID-19 disproportionately impact those housed in close quarters, as well as the homeless.

There is much to do at the state level as well, starting with making sure that all Americans have access to health care. Fourteen states, mostly in the South, have refused to expand Medicaid eligibility under the Affordable Care Act. It is inhumane not to do so when thousands are suffering and dying from COVID-19 and are without coverage.

Another important step would be to consolidate more local governments so there can be more and fairer funding to help ameliorate health disparities. My state of Georgia, for example, has 159 counties, the second most in the nation, and 535 incorporated cities. Some of the newer cities were established to inoculate white residents from minority-led city and county administrations. It is time to cut the waste occasioned by the duplications of government services.

Further, public leaders can ensure that health-care professionals become integrated into all areas of government, not just in times of pandemics. Chief health officials should be part of executive cabinets. Their point of view and active participation are needed for short- and long-term planning, development of annual budgets, and onboarding of community and other public health-related facilities.

Finally, state and local governments should strengthen their partnerships with colleges and universities to provide education and training that will help eradicate some of the social determinants of health. Among other things, states and cities together can advocate that more minorities be trained as nurses, doctors, EMTs, and in other health-care professions. Not only would that help address the staffing shortages that exist in those professions, but an added bonus would be that many minorities might be willing to work in communities where the needs and shortages are greatest.

For too long, government officials have known that racism and other social determinants of health have disadvantaged large numbers of American citizens but have accepted this reality as a given and done nothing about it. Now public officials must act courageously. Facing the existential threat of COVID-19, it is time that we all heed the words of scripture: "Do justice, love mercy, and walk humbly."

Governing's opinion columns reflect the views of their authors and not necessarily those of Governing's editors or management.

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