Lily Kiamanesh, Class of 2024
As the United States enters the third wave and ninth month of its COVID-19 outbreak, many have stopped to examine how the virus has affected this nation. The US reports the largest number of cases worldwide with these numbers increasing at rapid rates. As of now, over 16 million Americans have contracted the virus and close to 300,000 have died from it (1). Although this appears to be a national problem that affects everyone equally, the battle has not been the same for every American. It is well known that people who are older or who have preexisting health conditions are more vulnerable to contracting and dying from the virus; however, COVID-19 affects other demographics in a similar manner. Depending on their race and socioeconomic status, Americans have very different chances of becoming infected and dying from COVID-19.
Recent research has shown that COVID-19 affects Black and Native American populations at higher rates. Across America, Black people disproportionately account for COVID-19 deaths relative to their percentage of the local population. In Milwaukee, African Americans account for 26% of the population; however, they make up 73% of the deaths (2). The same issue is present in other cities and states such as Chicago, North Carolina, and Louisiana. The death rate for predominantly African American counties is approximately six times higher than other counties.
Although these disparities are frequently attributed to chronic medical comorbidities (such as diabetes, heart disease, obesity, and chronic respiratory disease), other socioeconomic factors also heavily contribute to the COVID-19 fatality rates in African American communities. For example, African Americans comprise a large portion of “essential” industries such as healthcare, transportation, government, and food supply (3). While approximately one third of Caucasian and Asian American workers have the flexibility to work from home, fewer than one fifth of African American workers share the same privilege, making their chances of exposure much higher. Similarly, structural challenges such as high housing density, poverty, environmental hazards, and decreased access to healthcare may also factor into these disproportionate rates.
For Native Americans, COVID-19 has had especially drastic effects. In May, the Navajo Nation was a hotspot for the virus, with per capita rates surpassing those of New York and New Jersey (4). Now cases are on the rebound once again, causing the region to enter another “shelter-in-place” order early December. The 7-day average positive test rate was 14.5%, where the World Health Organization recommends a rate of 10% or less for two consecutive weeks (5).
The severe effects of COVID-19 on Native American populations may be accounted for by various health and socioeconomic factors. It was found that Native Americans are more likely to have diabetes, heart disease, and other conditions, exacerbating the effects of the virus and increasing the risk of complications (6). Native American homes are more than twice as likely to be overcrowded compared to other Americans’ homes (7). Social distancing between the young and the old is also difficult to implement due to the intergenerational nature of many households, which may cause the elderly to become more exposed to the virus compared to other communities (8). Approximately 48% of homes in tribal communities do not have access to safe water, and 19% of homes in the Navajo Nation lack complete plumbing facilities, making handwashing and other methods of necessary sanitation difficult (9). Furthermore, with a lack of government funds as well as the shut-down of casinos, which are the primary source of income for many tribes, tribal governments do not have sufficient resources to maintain health clinics and other important facilities during this time (6).
Along with race, socioeconomic status may also be a determining factor in rates of infection and death from COVID-19. Increased rates of poverty have often been associated with higher rates of disease and death and COVID-19 appears to be the same. A research study conducted by Johns Hopkins assessed numerous US states such as Illinois and Maryland. They found that neighborhoods in Illinois and Maryland that are more economically disadvantaged have more incidents of infection and death than more advantaged communities (10). Although low levels of testing within these communities may hide the increased rates of contraction, studies show that impoverished regions do bear a higher burden of disease.
Many socioeconomic factors that may contribute specifically to COVID-19’s drastic effects on African American and Native American populations also affect socioeconomically disadvantaged communities as a whole. One of these factors is occupation. The ability to work from home and accept a furlough from work is often not an option for people living in poorer communities (11). Because of this, those who work in person are exposed to the virus more than those who can remain socially distanced at home. Low income may affect living conditions by making cramped or overcrowded housing the only options for some (12). Additionally, many people who are socioeconomically disadvantaged may not have adequate access to healthcare due to a lack of insurance or the costs of doctor and nurse visits.
While the COVID-19 vaccine appears to be approaching soon, the detrimental effects of the pandemic on the United States will never be forgotten. Although almost all Americans are suffering in one way or another from the pandemic, the virus has had more severe effects on members of minority groups and socioeconomically disadvantaged communities. While many search for cures and treatments, others search for solutions to these discrepancies and demand equal opportunities for all Americans during this difficult time, but especially for those who are suffering the most.
References:
Mortality Analyses. Johns Hopkins Coronavirus Resource Center. [accessed 2020 Dec 14]. https://coronavirus.jhu.edu/data/mortality
Thebault R, Tran AB, Williams V. 2020 Apr 7. The coronavirus is infecting and killing black Americans at an alarmingly high rate. The Washington Post. [accessed 2020 Dec 8]. https://www.washingtonpost.com/nation/2020/04/07/coronavirus-is-infecting-killing-black-americans-an-alarmingly-high-rate-post-analysis-shows/?arc404=true
Li AY, Hannah TC, Durbin JR, Dreher N, McAuley FM, Marayati NF, Spiera Z, Ali M, Gometz A, Kostman JT, et al. 2020 Jun 20. Multivariate Analysis of Black Race and Environmental Temperature on COVID-19 in the US. The American Journal of the Medical Sciences. [accessed 2020 Dec 8]. https://www.sciencedirect.com/science/article/pii/S0002962920302573
Toropin K. 2020 Nov 11. Navajo Nation says it has 34 communities with 'uncontrolled spread' of Covid-19. CNN. [accessed 2020 Dec 8]. https://www.cnn.com/2020/11/11/us/navajo-nation-covid-19-spread/index.html
In numbers: COVID-19 Across the Navajo Nation. 2020 Dec 11. Navajo Times. [accessed 2020 Dec 8]. https://navajotimes.com/coronavirus-updates/covid-19-across-the-navajo-nation/
Mineo L. 2020 May 11. The impact of COVID-19 on Native American communities. Harvard Gazette. [accessed 2020 Dec 8]. https://news.harvard.edu/gazette/story/2020/05/the-impact-of-covid-19-on-native-american-communities/
Crepelle A, Murtazashvili I. 2020 Jul 21. COVID-19, Indian Reservations, and Self-Determination. [accessed 2020 Dec 8]. https://www.mercatus.org/publications/covid-19-economic-recovery/covid-19-indian-reservations-and-self-determination
Kakol M, Upson D, Sood A. 2020 Apr 18. Susceptibility of Southwestern American Indian Tribes to Coronavirus Disease 2019 (COVID-19). The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association. [accessed 2020 Dec 8]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264672/
Schmidt CW. 2020 Jun 29. Lack of Handwashing Access: A Widespread Deficiency in the Age of COVID-19. National Institute of Environmental Health Sciences. [accessed 2020 Dec 8]. https://ehp.niehs.nih.gov/doi/full/10.1289/EHP7493
Hatef MD, Chang H-Y, Kitchen C, Weiner JP, Kharrazi H. 2020 Aug 19. Assessing the Impact of Neighborhood Socioeconomic Characteristics on COVID-19 Prevalence Across Seven States in the United States. Frontiers. [accessed 2020 Dec 8]. https://www.frontiersin.org/articles/10.3389/fpubh.2020.571808/full
Yancy CW. 2020 May 19. COVID-19, African Americans, and Health Disparities. JAMA. [accessed 2020 Dec 8]. https://jamanetwork.com/journals/jama/fullarticle/2764789
Khalatbari-Soltani S, Cumming RC, Delpierre C, Kelly-Irving M. 2020 Aug 1. Importance of collecting data on socioeconomic determinants from the early stage of the COVID-19 outbreak onwards. Journal of Epidemiology & Community Health. [accessed 2020 Dec 8]. https://jech.bmj.com/content/74/8/620.abstract
Image:
Steinberg P. 2020 Sep 3. Free COVID-19 Illustrations. Innovative Genomics Institute (IGI). [accessed 2020 Dec 14]. https://innovativegenomics.org/free-covid-19-illustrations/
Recent research has shown that COVID-19 affects Black and Native American populations at higher rates. Across America, Black people disproportionately account for COVID-19 deaths relative to their percentage of the local population. In Milwaukee, African Americans account for 26% of the population; however, they make up 73% of the deaths (2). The same issue is present in other cities and states such as Chicago, North Carolina, and Louisiana. The death rate for predominantly African American counties is approximately six times higher than other counties.
Although these disparities are frequently attributed to chronic medical comorbidities (such as diabetes, heart disease, obesity, and chronic respiratory disease), other socioeconomic factors also heavily contribute to the COVID-19 fatality rates in African American communities. For example, African Americans comprise a large portion of “essential” industries such as healthcare, transportation, government, and food supply (3). While approximately one third of Caucasian and Asian American workers have the flexibility to work from home, fewer than one fifth of African American workers share the same privilege, making their chances of exposure much higher. Similarly, structural challenges such as high housing density, poverty, environmental hazards, and decreased access to healthcare may also factor into these disproportionate rates.
For Native Americans, COVID-19 has had especially drastic effects. In May, the Navajo Nation was a hotspot for the virus, with per capita rates surpassing those of New York and New Jersey (4). Now cases are on the rebound once again, causing the region to enter another “shelter-in-place” order early December. The 7-day average positive test rate was 14.5%, where the World Health Organization recommends a rate of 10% or less for two consecutive weeks (5).
The severe effects of COVID-19 on Native American populations may be accounted for by various health and socioeconomic factors. It was found that Native Americans are more likely to have diabetes, heart disease, and other conditions, exacerbating the effects of the virus and increasing the risk of complications (6). Native American homes are more than twice as likely to be overcrowded compared to other Americans’ homes (7). Social distancing between the young and the old is also difficult to implement due to the intergenerational nature of many households, which may cause the elderly to become more exposed to the virus compared to other communities (8). Approximately 48% of homes in tribal communities do not have access to safe water, and 19% of homes in the Navajo Nation lack complete plumbing facilities, making handwashing and other methods of necessary sanitation difficult (9). Furthermore, with a lack of government funds as well as the shut-down of casinos, which are the primary source of income for many tribes, tribal governments do not have sufficient resources to maintain health clinics and other important facilities during this time (6).
Along with race, socioeconomic status may also be a determining factor in rates of infection and death from COVID-19. Increased rates of poverty have often been associated with higher rates of disease and death and COVID-19 appears to be the same. A research study conducted by Johns Hopkins assessed numerous US states such as Illinois and Maryland. They found that neighborhoods in Illinois and Maryland that are more economically disadvantaged have more incidents of infection and death than more advantaged communities (10). Although low levels of testing within these communities may hide the increased rates of contraction, studies show that impoverished regions do bear a higher burden of disease.
Many socioeconomic factors that may contribute specifically to COVID-19’s drastic effects on African American and Native American populations also affect socioeconomically disadvantaged communities as a whole. One of these factors is occupation. The ability to work from home and accept a furlough from work is often not an option for people living in poorer communities (11). Because of this, those who work in person are exposed to the virus more than those who can remain socially distanced at home. Low income may affect living conditions by making cramped or overcrowded housing the only options for some (12). Additionally, many people who are socioeconomically disadvantaged may not have adequate access to healthcare due to a lack of insurance or the costs of doctor and nurse visits.
While the COVID-19 vaccine appears to be approaching soon, the detrimental effects of the pandemic on the United States will never be forgotten. Although almost all Americans are suffering in one way or another from the pandemic, the virus has had more severe effects on members of minority groups and socioeconomically disadvantaged communities. While many search for cures and treatments, others search for solutions to these discrepancies and demand equal opportunities for all Americans during this difficult time, but especially for those who are suffering the most.
References:
Mortality Analyses. Johns Hopkins Coronavirus Resource Center. [accessed 2020 Dec 14]. https://coronavirus.jhu.edu/data/mortality
Thebault R, Tran AB, Williams V. 2020 Apr 7. The coronavirus is infecting and killing black Americans at an alarmingly high rate. The Washington Post. [accessed 2020 Dec 8]. https://www.washingtonpost.com/nation/2020/04/07/coronavirus-is-infecting-killing-black-americans-an-alarmingly-high-rate-post-analysis-shows/?arc404=true
Li AY, Hannah TC, Durbin JR, Dreher N, McAuley FM, Marayati NF, Spiera Z, Ali M, Gometz A, Kostman JT, et al. 2020 Jun 20. Multivariate Analysis of Black Race and Environmental Temperature on COVID-19 in the US. The American Journal of the Medical Sciences. [accessed 2020 Dec 8]. https://www.sciencedirect.com/science/article/pii/S0002962920302573
Toropin K. 2020 Nov 11. Navajo Nation says it has 34 communities with 'uncontrolled spread' of Covid-19. CNN. [accessed 2020 Dec 8]. https://www.cnn.com/2020/11/11/us/navajo-nation-covid-19-spread/index.html
In numbers: COVID-19 Across the Navajo Nation. 2020 Dec 11. Navajo Times. [accessed 2020 Dec 8]. https://navajotimes.com/coronavirus-updates/covid-19-across-the-navajo-nation/
Mineo L. 2020 May 11. The impact of COVID-19 on Native American communities. Harvard Gazette. [accessed 2020 Dec 8]. https://news.harvard.edu/gazette/story/2020/05/the-impact-of-covid-19-on-native-american-communities/
Crepelle A, Murtazashvili I. 2020 Jul 21. COVID-19, Indian Reservations, and Self-Determination. [accessed 2020 Dec 8]. https://www.mercatus.org/publications/covid-19-economic-recovery/covid-19-indian-reservations-and-self-determination
Kakol M, Upson D, Sood A. 2020 Apr 18. Susceptibility of Southwestern American Indian Tribes to Coronavirus Disease 2019 (COVID-19). The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association. [accessed 2020 Dec 8]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264672/
Schmidt CW. 2020 Jun 29. Lack of Handwashing Access: A Widespread Deficiency in the Age of COVID-19. National Institute of Environmental Health Sciences. [accessed 2020 Dec 8]. https://ehp.niehs.nih.gov/doi/full/10.1289/EHP7493
Hatef MD, Chang H-Y, Kitchen C, Weiner JP, Kharrazi H. 2020 Aug 19. Assessing the Impact of Neighborhood Socioeconomic Characteristics on COVID-19 Prevalence Across Seven States in the United States. Frontiers. [accessed 2020 Dec 8]. https://www.frontiersin.org/articles/10.3389/fpubh.2020.571808/full
Yancy CW. 2020 May 19. COVID-19, African Americans, and Health Disparities. JAMA. [accessed 2020 Dec 8]. https://jamanetwork.com/journals/jama/fullarticle/2764789
Khalatbari-Soltani S, Cumming RC, Delpierre C, Kelly-Irving M. 2020 Aug 1. Importance of collecting data on socioeconomic determinants from the early stage of the COVID-19 outbreak onwards. Journal of Epidemiology & Community Health. [accessed 2020 Dec 8]. https://jech.bmj.com/content/74/8/620.abstract
Image:
Steinberg P. 2020 Sep 3. Free COVID-19 Illustrations. Innovative Genomics Institute (IGI). [accessed 2020 Dec 14]. https://innovativegenomics.org/free-covid-19-illustrations/
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