Bonnie Castillo, RN. Photo: Michael Gerometta

Bonnie Castillo, RN. Photo: Michael Gerometta

Nurses Call for More Data, Action on Racial Disparities and COVID-19

Bonnie Castillo, RN. Photo: Michael Gerometta
Bonnie Castillo, RN. Photo: Michael Gerometta

Following reports of a growing racial disparity in COVID-19 deaths, on April 8, 2020, National Nurses United called on the federal government and states to provide full reporting on the demographic breakdown of the effects of the pandemic and what actions are being taken to protect historically medically underserved communities.

News reports have raised alarms about a disproportionate death rate among African Americans in Chicago, Detroit, Milwaukee, and New Orleans. A recent Washington Post survey found that counties that are majority-African American have three times the rate of infections and almost six times the rate of deaths as counties where white residents are in the majority.

Similar concerns are emerging of a greater impact for Native American, Latino, and other medically underserved communities, noted NNU.

“These early reports indicate a widespread pattern and problem throughout the US, especially given the long, deplorable history of racial disparity in healthcare in access to medical services and treatment,” said NNU Executive Director Bonnie Castillo, RN.

“More reporting of who are the hardest hit communities is essential,” Castillo said. “And we must rapidly expand testing, and treatment, including elimination of all out of pocket costs, and prioritize placement of full healthcare services for those in African American, Latino, and Native American communities who are bearing an unequal burden and suffering in this national emergency.”

Among the reports to date:

Illinois – African Americans account for 68% of Chicago’s COVID-19 deaths, and more than half the confirmed cases, though comprising only 30% of the city population, according to the Chicago Department of Public Health. Other reporting has put the Chicago African American death and infection rate at 72%. For Illinois overall, African Americans are less than 15% of the state population, but 40% of the disease deaths.

Wisconsin – African Americans make up nearly half of the infection rate and 80% of the COVID-19 deaths, ProPublica reported, though the state has not yet released its data. In Milwaukee county, African Americans comprise 73% of the deaths three times their percentage of the population. The state’s decision to go ahead with its primary on April 7, with photos of long lines to in Milwaukee, where 27% of the population is black, has increased alarm.

Michigan – African Americans comprise 40% of the state’s deaths, according to state data, though just 14% of the state’s population. Predominantly African American Detroit has been especially hard it, accounting for more than one-fourth of the deaths.

California – In partial data just released Tuesday, Los Angeles County health officials reported that African Americans account for 57% of the county’s COVID-19 deaths despite being just 9% of the county’s population.

Louisiana – African Americans, are 70% of the deaths, more than double their percentage of the state population, according to Louisiana’s Department of Health. New Orleans is a major hot spot of those deaths.

Washington, DC – African Americans account for nearly 60% of the deaths in a city where they are 46% of the population, the Washington Post reported.

North Carolina – African Americans, with 21% of the population, comprise 38% of the deaths. Disproportionate rates of COVID-19 cases among African Americans have also been cited in Mississippi and rural counties in Georgia.

New Mexico – Gov. Michelle Lujan Grisham told President Trump this week about “incredible spikes” in COVID-19 cases among Navajo nation residents, warning that the virus could “wipe out” some tribal nations, said a news report. “We’re seeing a much higher hospital rate, a much younger hospital rate, a much quicker go-right-to-the-vent rate for this population. And we’re seeing doubling every day-and-a-half,” she said.

But many states, and the Centers for Disease Control and Prevention, are still not reporting demographic data on the death and infection rates.

Castillo said the lack of reporting from other states, such as Texas, may reveal similar high rates that many believe are occurring among Latinos and other vulnerable populations that also have faced high historic rates of racial health disparities.

Multiple factors likely contribute to the widespread racial disparities, said Castillo.

Those include higher levels of lack of insurance, fewer health care services and other resources, and higher levels of pre-existing health conditions that are major risk factors for COVID-19 deaths.

African Americans, Latinos, and Native Americans are disproportionately affected by all those barometers. The Louisiana data, for example, reported 66% of those who died had hypertension.

Additionally, due to discriminatory economic factors, African Americans and Latinos are disproportionately concentrated among many people who work in “essential” services such as low-wage grocery stores and restaurants, public transit, and many lower-wage healthcare workers. Those still working in these fields are more likely to face exposure to the virus and less likely to have access to the limited supply of testing kits. It has been reported, for example, that in Philadelphia upper-income residents have been tested for the virus by as much as 600% more than lower income residents.

To make matters worse, those in the hardest-hit communities are statistically less likely to wear face masks in public for their own protection, due to societal racism and fear of being racially profiled by police—again increasing their risk of infection.

“This pandemic brings into sharp focus the long, appalling history of racism in our healthcare system, and the need for fundamental overhaul with Medicare for All that would address, finally, the widespread disparity in access to care and ensure that medical care will no longer be based on ability to pay, race, ethnicity, prior health condition, or immigration status,” Castillo said.

“As a nation, we cannot be silent, and we must act,” Castillo said.

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