The Need for Equitable Health Care Amid COVID-19

The pandemic is hitting African American communities hardest. Black mayors are taking the lead in narrowing racial disparities and working for policies that help protect everyone.

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SCOTT KEELER/Times
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It's been clear since early in the coronavirus pandemic that it was taking a disproportionate toll on black Americans. Over the past weeks, new data has revealed the grim extent of that reality.

In Mississippi, where 38 percent of the population is black, African Americans account for 52 percent of COVID-19 deaths. In Michigan, 40 percent of COVID-19 deaths are among blacks, even though they constitute only 14 percent of the population. Nationwide, by one estimate, the COVID-19 mortality rate for black Americans is 2.4 times higher than the rate for whites.

These disparities are not a coincidence. Widespread structural racism ensures that black communities always fare poorly, but particularly in times of crisis.

There are many reasons COVID-19 is devastating black communities. African Americans are disproportionately likely to work in essential service jobs — as health-care workers, bus drivers, postal workers and more — in which the risk of contracting the disease is highest. Only 20 percent of black workers, compared to 30 percent of white workers, have the option to work from home.

Blacks are also more likely to be uninsured or underinsured and have fewer financial resources and employment benefits such as paid sick leave to weather health crises. Systemic barriers in housing, income and education make African Americans more susceptible to long-term health issues, such as diabetes and obesity, that make them more likely to die from COVID-19. Yet, instead of looking at working conditions, the persistent racial wealth gap and health-access inequalities, particularly in testing, we often blame the most vulnerable.

Adding to all this, the Trump administration has threatened black Americans' access to needed medication. President Trump continues to tout hydroxychloroquine to treat COVID-19 and claims to take it himself. But there is little to no proof that the drug is effective against the disease, and it can cause heart abnormalities that can lead to death. Meanwhile, the hundreds of thousands of Americans with lupus, a disease the drug is proven to treat, fear a supply shortage. The disease is three times more common in African American women than in white women.

In sum, federal policymakers, and in too many cases their counterparts at the state level, are not doing enough to protect black communities. Black mayors are picking up the slack, developing solutions to improve the health of their residents.

In Chicago, for example, Mayor Lori Lightfoot has created a Racial Equity Rapid Response Team that includes health-care providers, clinicians and other community stakeholders. The team aims to bolster education, testing and treatment for black residents, and it has created communications material to guide essential workers and multigenerational households on how to stay healthy.

In Houston, Mayor Sylvester Turner is helping bring COVID-19 testing to underserved communities of color by establishing mobile testing sites in their neighborhoods. The city also established a task force to provide public health education, masks and other supplies to these communities.

In my city of Newport News, Va., I've supported outreach and mobile services for the homeless community, a majority of whom are people of color. Our team is providing services in the field, delivering food and essential supplies to these people. We've also established mobile showers and help with laundry services, and we're offering mobile testing for homeless people and folks in low-income neighborhoods.

As the new president of the African American Mayors Association, I'm also supporting efforts to collect and release racial and other demographic data on COVID-19 to ensure an equitable recovery and culturally competent data analysis for policymakers and city executives. Without the data, we can't begin to get communities of color the resources, testing and treatment they need. We're part of the We Must Count Coalition, and we recently sent a letter to President Trump and all governors calling for complete data. We also commend the COVID-19 response bill recently passed by the House, which includes $130 million to bolster data collection.

Black mayors provide local, tailored solutions. We will fight for black communities in this pandemic and beyond, and hope our work will spur more equitable state and federal policies that help to protect all Americans from the impact of COVID-19.

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

Mayor of Newport News, Va., and president of the African American Mayors Association
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