The poor, African Americans face worst of coronavirus

By Updated: April 16, 2020 11:40 AM CT | Published: April 15, 2020 8:25 PM CT

Beverly Robinson has serious issues with diabetes. In these strange times, she’s been in a two-bedroom apartment in Hickory Hill with eight family members, four of them young children, since the schools closed on March 13.

She worries about two adult children who’ve lost jobs in the wake of the coronavirus business shutdown and younger ones who’ve had no mental stimulation for weeks because of the shelter-at-home rule. They fight and cry and pound on the door to go out.


Race remains a factor, even in a pandemic


At night, Robinson lies in bed, in dread that she or another family member, such as her 79-year-old mother, could die in the pandemic, dealing another setback to a family that lives in substandard housing with no car and checks most boxes for what poverty looks like in Memphis.

“My sugar is up because I’m stuck in here, eating stuff I am not supposed to eat,” she said early Wednesday, panic in her voice. “But, that’s all we had.”

Wednesday, in Shelby County, 75% of people who have died from COVID-19 here were African American. 

In Chicago and other metropolitan areas, 70% of those who died with the disease are African American, revealing the large disparity in health and life expectancy for black citizens in the United States in 2020.

“It shocks me that people are surprised this is a problem,” said the Rev. Sonia Walker, associate pastor at First Congregational Church in Midtown. “People don’t think of racism and the patterns of it. It’s rooted in the belly of our birth as a country. It’s like a perennial garden. You don’t have to do anything. It’s just there.”

As the nation reels from the wallop of COVID-19 and its enormous economic impact, people with influence say the nation needs to invest in proven systems and research for mitigating poverty and the suffocating effects it has on the nation’s future workforce, including the under-educated people of color the nation is counting on to fund Social Security.


Questions about race and locations of COVID-19 outbreaks gain attention


“I believe the coronavirus is a call to action,” Dr. David Williams, professor of public health at the Harvard T.H. Chan School of Public Health, told reporters Wednesday in a forum on race and coronavirus presented by the Robert Wood Johnson Foundation.

“The striking disparities we have seen are not the fault of the individuals, families and communities that are experiencing them. Instead, they reflect longstanding social policies that created pervasive and economic inequities in the U.S.

“Most Americans are unaware that these disparities exist. The coronavirus has highlighted them to us and gives us a chance to make a commitment to do better than we have done in the past,” he said.

He suggests more investment in early-childhood education and neighborhoods, and more efforts to bring employment to low-income areas, noting that all three strategies improve health.

Last week in a COVID-19 symposium put on by the University of Tennessee health Science Center, Dr. Jon McCullers, assistant dean and pediatrician in chief at Le Bonheur Children’s Hospital, called for massive investment in public health.

“We have to redesign health care, and expand health coverage to everyone in Tennessee.”


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UTHSC’s executive dean, Dr. Scott Strome, said on Wednesday the pandemic is a call to “engage folks in the health care system. ... We have to make sure that every single person has a provider and health insurance. That is the only way,” he said.

For a century, health authorities have known that black people and Native Americans live shorter lives than the average American – in some cases, 10 years shorter.

There are multiple reasons for that difference, including poor diets, substandard housing and higher levels of stress, which includes the stress of discrimination, according to Harvard’s Williams.

<strong>Scott Strome</strong>

Scott Strome

“That has negative effects on physical and mental health. African Americans also receive poorer quality health care and have less access to care,” he said.

Collecting data on COVID-19 among racial minorities is critical for seeing patterns in how it was contracted and spread, he said.

“And we also need to address the pressing needs in housing, food and economic systems.”

COVID exacerbates poverty on several levels. For instance, people living in close quarters cannot effectively quarantine at home.

The average family in East Memphis that contracts the infection has insurance and likely can fairly easily quarantine at home, Strome says.

“If they get really sick, they can get care right away. Optimistically, they are going to get through this without having to go to the hospital.”

The same situation for an impoverished African American family in Memphis quickly becomes dangerous because it likely means a serious loss of income from perhaps the sole breadwinner and the possibility that everyone in the home will be infected.

“That mother and her children have a much greater risk of getting it but also of dying from the disease. That is what we are seeing throughout America,” Strome said.

“The fact that we don’t have effective care for all of our citizens is costing us more money than if we did,” Strome said.

For African Americans here and around the nation, economic and health status is magnified by exposure in the manual labor jobs they work in essential industries, including public transportation, groceries and health care.

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“I don’t see a white mail carrier very often,” Rev. Walker says. “There are a lot of first responders in our society. They are not just firefighters and EMTs. More of us are using the grocery store than the hospital,” she said.

She worries for the brown and black people she sees working those jobs now, knowing they have little choice and that the risk to their families is large.

From the beginning, the Shelby County Health Department has known that the earliest confirmed COVID-19 cases were people with insurance and a primary care physician who could refer them for testing.

They tended to live in the Poplar Corridor away from the urban ZIP Codes where the largest amounts of infection now show on the heat maps the Health Department issues each day.

“A lot of people I know don’t have insurance at all,” Beverly Robinson says.

In the early days of the epidemic, people who hadn’t traveled and didn’t have a primary care physician had little chance of being tested. 

Weeks later, testing is just beginning to fan out over the whole city. Frayser, for instance, will have its first public testing this weekend, partly because Charlie Caswell, executive director of Legacy of Legends Community Development Corp. in Frayser, wrote letters and pushed for help.

Cherokee Health has been providing tests in Frayser for several weeks but only to people who were its clients.

“Because of the speaking out and writing letters, Kroger is now going to help pay for the PPE (personal protection equipment) and some of the tests,” Caswell said.

One of the biggest issues with COVID-19 is the unknowns, Strome, at UTHSC, said.

“Part of the problem is not a lack of reporting, it is the limited number of testing facilities in our under-served communities.”

The disease there is still largely under-diagnosed, he said.

“I have taken pride in the fact that Shelby County has not risen to the level of cases as other places,” Rev. Walker said. “It’s a false pride. The only reason our numbers are low is because we are not testing enough.”

After conference calls with Memphis City Council members and other leaders on Wednesday, Caswell is pushing for a questionnaire that each tested person in Frayser would receive this weekend so the city can have data on where they live and how many people live in the home.

“When you are dealing with this pandemic in communities of poverty, with five to seven people in two-bedroom homes, if they test positive, where do they go? Resources need to be made available so we could have a place to send them for 14 days away from their families.

“If we just sent 100 people back home who tested positive, we will continue to lose the battle.”

The idea he and others in Frayser are floating is to petition the state to use the TANG (Temporary Assistance for Needy Families) reserve it has accumulated to cover the cost of hotel rooms. Caswell says it would be cheaper than continuing to let people get sick, spread it to their families and eventually require space and ventilators in ICU units.

Strome is one of the people in Caswell’s corner. In response last weekend to a letter Caswell wrote asking for help, Strome outlined steps UTHSC would take to intervene, including naming a three-person physician team to find primary care physicians for people who show up for testing.

“We must commit this crisis and the disproportionate numbers of people of color dying from this disease into our social consciousness – using it as fuel to promote changes in our public health system so that we can better combat this and similar problems in the future,” Strome wrote in his letter.

Robinson has not been tested and doesn’t know when she might be.

She is absorbed in a series of short-term battles, including getting children as young as 5 to sit in front of the family’s one laptop for school.

“They don’t like it. It’s boring,” she said.

She hopes her federal stimulus check comes this week. She expects it will go for groceries.

“There really ain’t much else you can do with it. That and buying small stuff that the kids need.”

While the federal government will deposit it in an online account, she will have to put it on a card to spend it.

“I don’t want to stand in line to do that,” she said. “You just don’t know what’s around you.”

Topics

Dr. Scott Strome Rev. Sonia Walker Charlie Caswell Robert Wood Johnson Foundation

Jane Roberts

Longtime journalist Jane Roberts is a Minnesotan by birth and a Memphian by choice. She's lived and reported in the city more than two decades. She covers healthcare and higher education for The Daily Memphian.


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