Here we go again: In or Out?

One thing about this COVID 19 crisis is that it is uncovering some things that were hiding in plain sight. For instance, African – Americans are being infected by and dying at a greater rate than white Americans. Is anyone surprised anymore when a health problem disproportionately affects black Americans?
I tried to find the origin of the phrase, “When America catches a cold, black people catch pneumonia” but I gave up. Suffice it to say this observation has been around a long time, and it has long been true.

If anyone was surprised that may be due to the fact that the disease seemed to attack so few African-Americans, at first – probably because we don’t travel in international circles as much as white Americans and largely were not involved in bringing it back from China or Europe. At first, the ridiculous rumor was spreading that black people were immune to the virus. I cannot imagine many people believed that, but it turned out to be a fake with the left fist followed by a jab with the right.

Complete, comprehensive data is not yet available but what is available makes it clear that the disease’s impact has not been even. According to the Centers for Disease Control, African Americans make up 14 percent of the nation’s population but 33 percent of hospitalizations for COVID. In the hardest hit state, New York, for fatalities in which racial data is available, the death rate among black people (92.3 deaths per 100,000 population) was more than twice as high as among whites (45.2).

To its credit, the Trump Administration has paid attention to this disparity. U.S. Surgeon General Jerome Adams addressed the issue from the White House press room on April 10, and he noted that black Americans are at a higher risk than white Americans because we are more likely to have preexisting conditions and lack of access to health care. He also noted that black Americans need to avoid alcohol, tobacco and drugs, which is true even though Adams took heat for the condescending way he said it. (“Do it for your big momma, do it for your pop-pop.” Really?)

But here is the surprising/unsurprising thing COVID has revealed – the racial disparity is due, in part, to relative distrust black Americans have for doctors. I have seen anecdotal evidence that that is true – e.g. black people being interviewed on the news expressing doubt about all the “shelter in place” guidelines. But there is also empirical evidence of this distrust. For instance, a comprehensive study by the National Center for Biotechnology Information in 2007 found that many black Americans did not trust doctors due to “the growth of managed care and for-profit health care, disclosures of prior episodes of unethical medical research, growing public access to medical information, and publicity surrounding medical errors, malpractice, and fraud and abuse within the medical system.”

A 2018 study by the National Bureau of Economic Research found that black patients trust black doctors more. The study found that black men “are much more likely to select every preventive service, particularly invasive services, once meeting with a racially concordant doctor.” The study found that black doctors could reduce the black-white male gap in cardiovascular mortality by 19 percent.

So, add this to the list of “surprises” revealed by COVID: We need more black doctors. Only about 5 percent of doctors in the United States are black, according to the Association of American Medical Colleges.
It is one more reminder of the importance of diversity in every area of American society.

Picture of Dan Holly
Dan Holly
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