Shortly after the coronavirus pandemic began to spread widely in America, doctors and public health authorities noticed that hospitals were disproportionately treating black patients for the virus. As local officials began to track cases, a national trend emerged: not only were black Americans more likely to contract the virus, they were also more likely to die.
Black Americans are 2.4 times more likely to die from COVID-19 than white Americans, and 2.2 times more likely to die than Asians and Latinos, according to the latest data from the APM Research Lab.
A Bubbler Talk questioner wants to know whether that same disparity can be seen in Milwaukee, and how other American cities compare.
The APM Research Lab found that black Wisconsinites die at rates several times higher than black residents of other cities. If you’re black and you live in Wisconsin, it means you likely live in Milwaukee County, and likewise, you’re about 5.7 times more likely to die of COVID-19. Wisconsin is second only to Kansas and Washington D.C. for worse outcomes.
“It comes out to about one out of 2,000 black [Wisconsinites] has died, whereas the number for white [Wisconsinites] is one in 4,700,” says Andi Egbert, a demographer who headed the APM research. “If you spend a little bit of time, most of us can think of about 2,000 people we know in our lives, in our various social networks. It’s just tremendous to think about.”
While the data is alarming and the disparities are clear, they do little to suggest why Milwaukee is more deadly for black people than most of the country.
“That's something that a community needs to ask itself and its leaders need to reckon with … hopefully it should lead to action,” says Egbert.
Underlying health conditions among black Milwaukeeans
The team at Johns Hopkins University that’s tracking COVID-19 deaths says black people display higher rates of heart disease, lung disease, and diabetes. As many as 90% of people hospitalized with life-threatening cases of COVID-19 display at least one of those underlying conditions.
But all races can develop those conditions. Heart disease is the leading factor of death among white Americans too. There also doesn’t appear to be any meaningful disproportionality between Wisconsin and other states in the prevalence of heart disease, respiratory issues, and diabetes. Black residents are only somewhat more at risk of dying from those diseases than white residents — not many times more likely, which is the case with COVID-19.
“People often assume that that greater prevalence is being driven by some underlying genetic difference. In fact, there's really little to no evidence of that,” said Joseph Graves. He's a professor of biology at the Joint School for Nanoscience and Nanoengineering and author of The Race Myth: Why We Pretend Race Exists in America.
Graves says there's no such concept as a biological race. He criticizes the pervasive concept of “essentialism,” which posits that different cultural groups have innate biological differences that determine social and health outcomes. Graves and others say biological essentialism is rooted in racism since there is more genetic variance within a single racial group than there might be between people of different races.
“Biology as destiny is a simple explanation, and it's used to cover up the more fundamental dynamics of injustice,” says Graves, who still believes it’s important to study races as a cultural phenomenon.
Essentialism has become a powerful shorthand to explain disparities in black COVID-19 death. In April, NPR interviewed a doctor in one of America’s hardest-hit areas, New York, who claimed essential genetic differences are the likely culprit for excess black death.
“There has to be some genomic aspect that makes [black, Latino, and Native Americans] particularly susceptible to the virus,” said Dr. Wayne Riley, president of SUNY Downstate Health Sciences University, on The National Conversation.
Even though little is still known about this coronavirus, Graves said the fact that it’s a new virus means that no racial group was biologically predisposed.
“At the end of the day, no humans had any immunity to this virus. The social conditions that people live in played the biggest role in determining who was infected and who died,” he said.
Recent incidents of police brutality and profiling demonstrate that socially-determined racism exists all across America, but that still doesn’t explain why the disproportionality of black death is so pronounced in Wisconsin.
Mapping COVID-19 and segregation
In January, researchers from Wallet Hub ranked Wisconsin as the most segregated state in the country. They racked several markers of social mobility — like whether or not different racial groups complete high school at the same rates, how their health outcomes compare, whether they’re empowered to vote proportionally to other races, and whether they’re comparably employed.
“Racial segregation can be an accelerant for the prevalence of infectious disease in a given community,” says Graves.
WUWM compared Wallet Hub’s rankings of relative segregation by state with the APM Research Lab’s state data about racial disparities in COVID-19 deaths. There appears to be a linear correlation between a state’s relative racial integration (including those markers of social mobility) with a black person’s likelihood to die from COVID-19. Wisconsin is uniquely positioned at the intersection of being the most segregated state and the state with the second-highest racial disparity in coronavirus deaths.
While the highest total black coronavirus fatalities are happening in places with large black populations like New York, Michigan, Illinois, and Louisiana, their relatively higher integration appears to have spread the burden of this pandemic more equitably.
“Something like where you live, and your relationship to water, fresh air, or a pharmacy will determine whether you live or die if you get sick,” says Rashad Shabazz, an expert on segregation at Arizona State University and author of Spatializing Blackness.
“[Black Americans] tend to live in places that do not have the best access to fresh fruits and vegetables, they lack the resources of homeownership and wealth-building. When there are so few resources, coronavirus will impact them much more negatively and we will see higher rates of death as a result of it.”
That largely tracks with the trends in Milwaukee’s segregation, which the Washington D.C.-based Urban Institute reported has persisted for decades.
WUWM's Angelina Mosher Salazar compared Milwaukee’s ZIP codes by race, occupation, and median income using U.S. Census Bureau data. The ZIP codes that have more coronavirus cases are also those with high populations of black and Latino residents, low median household incomes, and areas where the occupation tends to be office and administrative work and production. The U.S. Bureau of Labor Statistics considers essential work such as receptionists, hotel clerks, postal workers, bank tellers, and insurance adjusters as “office and administrative” workers.
“If you live in crowded conditions ... and you have to go to work because you're in one of these essential industries like working at a grocery store, transportation, or health care, then you're more likely to come in contact with the virus,” said Graves.
Since powerful interests created this segregation, and therefore the radical disparities in health, Shabazz believes these inequities can be socially undone as well.
“Segregation says it’s not only OK for people to live apart, but it also says that the consequences of that organization are normal and natural ... It doesn't allow for an understanding of how this phenomenon is socially and politically maintained, and most importantly, it overrides our ability to even consider that this can be changed,” he says.
Milwaukee County officials say these outcomes can change. They’ve written to Gov. Tony Evers to request Wisconsin to release the entire $165 million earmarked for the county by the Federal CARES Act. County Executive David Crowley and County Board Chairwoman Marcelia Nicholson claim that the county received only $62 million from the state. They cite countering racial disparities in coronavirus care as the main reason Milwaukee needs the rest of the money.
“The rest of the state can’t see the centrality of Milwaukee, and its health to the health and stability of the rest of the state,” says Shabazz. “I think it's profoundly colored by race ... and it's going to undermine the stability of the entire state.”
The University of Wisconsin-Madison has announced a grant program totaling $2.7 million to community organizations and researchers to figure out ways of lessening the disparities of COVID-19. But for Shabazz, the key to preventing more disparities in future pandemics lies in a different kind of investment.
“Bus routes, trains, parks, and bike lanes are things that can be installed in communities of color today that would have a significant impact on the people who live there, as well as finding ways to address the historical exclusion of people of color from the housing market,” he said.
Editor's note: Special thanks to the APM Research Lab, which is sponsored by our partners at American Public Media. The Lab is regularly updating the statistics cited in this report in its project “The Color of Coronavirus.” WUWM reporter Angelina Mosher Salazar contributed to this story.
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