There’s an old saying that’s eerily appropriate in the wake of the novel coronavirus pandemic: “If white America sneezes, Black America catches the flu.” And as New York Times investigative journalist Nikole Hannah-Jones tells MTV News, “It's almost never been more literal than it is now.”
The most marginalized groups will always bear the brunt of a crisis. At the height of the Great Recession which started in 2008, the Black unemployment rate peaked near 16 percent, almost double the rate for white Americans. Black Americans were also disproportionately affected by the AIDS epidemic: Though they accounted for just 12 percent of the national population in 1986, the CDC reported that the infection rate was three times higher in Black communities than in white communities. And now, the coronavirus pandemic is the latest emergency to highlight the residual effects of structural and systemic racism in this country. COVID-19 mortality rates are almost six times higher in counties with predominantly Black residents than in counties with predominantly white residents.
The reason? Well, there’s no short answer. The causes are multi-layered, compounded by centuries-long inequitable policies that marginalized Black communities, often by design. Breaking it down requires an understanding of that traumatic history, which was chronicled in the New York Times’s 1619 Project. In a now-viral Twitter thread, the project’s creator, Hannah-Jones, contextualized the COVID-19 mortality rate disparities into three broad areas: chronic health problems in Black communities caused, in part, by discriminatory housing policies and environmental racism; inequities in the labor force, and disparities in access to health care.
And the issues that Black Americans must navigate in addition to COVID-19 often transcend class. As Hannah-Jones points out, even affluent Black Americans are more likely to live in areas with fewer grocery stores with healthy food options due to redlining, a system of racial discrimination in mortgage lending which relegated Black homeowners to certain neighborhoods. Researchers at Brown University found that “the average affluent black or Hispanic household lives in a poorer neighborhood than the average lower-income white resident.” No matter the income level, this often places more minority households in close proximity to toxic sites or heavily trafficked areas, exposing them to air pollution. The Union of Concerned Scientists found that minorities live with 66 percent more air pollution than their white counterparts. Consequently, Black people suffer from preexisting conditions like diabetes, hypertension, high blood pressure, and asthma at far higher rates than their counterparts.
In the labor force, Black Americans are more likely to work essential service jobs and commute to work on public transportation, making social distancing difficult. On top of that, disparities in access to health care for Black Americans create another roadblock to fighting illness, which is why Hannah-Jones believes supporting policies that make health care more accessible to all Americans is a good place to start in closing the gap.
During a recent Zoom interview, Hannah-Jones talked with MTV News about the structural disadvantages plaguing Black communities, the role they’ve played in COVID-19 mortality rates, and how people can lobby their representatives for meaningful action that would help vulnerable people.
MTV News: How is COVID-19 disproportionately affecting Black people in this country?
Nikole Hannah-Jones: So we are just now starting to get racial data on the number of infections, hospitalizations, and fatalities having to do with coronavirus. And what we're seeing is that it is having a particularly devastating effect on Black communities, specifically. They are being infected at much higher rates, they are being hospitalized at higher rates, and they are dying at much higher rates. And in some places, not just dying disproportionately, but making up the majority of deaths in communities where Black people are not the majority. We're seeing that in Milwaukee. We're seeing that in Chicago. We're seeing that in New Orleans. St. Louis has just released some preliminary data. And every person who has died of coronavirus in St. Louis is Black. So it is really having a particularly devastating impact on Black communities.
MTV News: 70 percent of the deaths in my hometown of Chicago are Black Americans, but we only make up about 30 percent of the population. What are some of the reasons we're seeing this?
Hannah-Jones: What we're seeing is kind of a tsunami of disadvantages that are all coming to bear on Black Americans who are contracting the virus. We know that this virus, when we've seen it overseas, is particularly deadly to people who already have preexisting conditions. They call them comorbidities. So, people who already are diabetic, who have hypertension, who have other kinds of heart or respiratory problems, are much more likely to succumb to the virus. Because of that, we presume that this was a disease that really killed older people.
When it came to the United States, we started seeing younger Americans dying. And that's because Black Americans not only disproportionately suffer from hypertension, diabetes, asthma, other heart issues, but we suffer from them at a much younger age. That means that the virus is deadlier for Black Americans at a younger age, and that really speaks to the chronic disadvantage and chronic health disparities that Black Americans face.
There's a reason why Black Americans get these diseases that normally only hit older Americans: Because Black people live in a much higher stress environment. We are the most segregated of all racial groups. We live in areas that have the highest amounts of pollutants and toxins. Living close to highways means we're much more likely to get asthma. It means we're much more likely to have other respiratory illnesses. It also means, when we look at the types of foods that are available in Black communities and the effects of stress on Black communities, that we tend to be having more hypertension. Stress is felt in the body and causes lots of these health conditions that we're seeing Black people suffering from from much younger ages.
MTV News: The 1619 Project goes into how the history of the transatlantic slave trade created this ripple effect throughout centuries, and we still feel those reverberations in our communities right now. Issues like environmental racism and redlining have led to some of the health disparities we see right now. Can you talk a bit about how environmental racism, segregation, and redlining has led to some of the conditions we see among Black folks?
Hannah-Jones: I think this is really important because what we're starting to see as we learn that Black people are disproportionately dying from this, is this blaming of Black communities. Saying that, “Well, that's just because Black people don't take care of themselves. Black people don't take care of their health.” The truth is that Black people are living in a constructed environment that is designed to actually produce exactly the disparities that we see. It is not accidental that Black people are the most likely to live near toxic sites, the most likely to live in polluted neighborhoods, the most likely to live in areas where there is a lot of highway and freeway traffic. And so what that means is Black people have been intentionally placed in the most vulnerable positions.
All of this has the effect of having severe health declines. I mean, the rates of asthma in Black children is, in some communities, 20 to 30 times that of white children. And that's simply because of the communities that Black people are forced to live in. When powerful people decide that they want to put a polluting factory or a waste dump, they put it into the places that are the most vulnerable and that have the least power to resist. Those are low income Black communities. It should not be surprising that Black people are suffering from these things. But it's important to understand, Black people are not suffering from these things simply because we are making poor life decisions. We have a country that was built around not valuing Black communities, and not valuing Black people, and forcing us to live in conditions that are unhealthy for us.
MTV News: In Michigan, Black people comprise 43 percent of COVID-19 deaths, and only make up 14 percent of the population. I couldn't help but think about Flint when it comes to environmental racism, as well as labor force and employment disparities.
Hannah-Jones: Black people are the most likely to work in positions of service, and front-facing positions of service more specifically. The cashier, the person at the airport who's taking your order, the bus drivers, the postal workers... We are disproportionately represented in those jobs, which means we are disproportionately represented in jobs where you're going to come in contact with a lot of strangers and not be able to shelter at home. If you are delivering mail, or you're working at Popeyes, or you are driving the transit, you can't shelter at home. You actually have to work. That meant that Black people were getting this infection much more than other people.
We're also the least likely to own our own homes, which means we're much more likely to live in apartments or in more dense housing. We literally could not isolate in the ways that many white and Asian Americans could. So we're getting infected at higher rates, but also have the least access to quality health care.
MTV News: Yeah, let's talk about that access, and implicit bias in the health care system. Black American women have higher mortality rates when it comes to giving birth than their counterparts, largely because of implicit bias. You also tweeted a study about how bias factors into how someone’s care plays out.
Hannah-Jones: Not only are Black Americans disadvantaged in terms of income, in terms of the types of jobs that we work, in terms of where we live, but we also face systemic disadvantages throughout the entire spectrum of health care. We often live in places where we have the lowest percentage of doctors serving us, where we don't have hospitals that we can go to. We are the least likely to be insured in the first place. And then, when we enter those facilities, study after study shows that we face bias in those facilities.
Doctors don't believe that Black people feel pain the same. They are less likely to order follow-up procedures on Black people who are presenting with the exact same issues as white Americans. And that means our diseases go untreated. That means that we were already going to be more vulnerable to this virus. And now we don't know what type of treatment Black people are experiencing once they enter into these hospitals, because we know that that bias exists.
MTV News: What policies would you suggest supporting for people who want to help? How can they weigh in?
Hannah-Jones: We're dealing with the results of deeply, deeply entrenched societal issues. But there is something that could be changed almost overnight that would have a massive impact on that. And that's universal health care.
If we could allow the millions of Americans who cannot access a test, who cannot go to the hospital when they're feeling ill, because they don't have insurance, then that would deal a lot with the disparities that we're seeing in the region. There is no overnight fix for housing segregation and toxic waste sites. But we could very quickly choose to insure all Americans in this country and ensure that health care treatment is a basic human right in the United States.
This interview has been edited for length.