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COVID-19 may not discriminate based on race — but U.S. health care does

Health officials have stressed that novel coronavirus doesn’t discriminate based on race or ethnicity. But disparities long present in the U.S. medical system are now driving what some call a crisis within a crisis: black and brown communities across the country are being hit harder, and with fewer resources to save them. Amna Nawaz talks to Dr. Uché Blackstock of Advancing Health Equity.

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  • Judy Woodruff:

    COVID-19 is forcing all of us to live in new ways.

    But, as Amna Nawaz reports, it is also exposing longstanding rifts in American society.

    This story is part of our ongoing series Race Matters.

  • Amna Nawaz:

    Officials have said over and over again the virus doesn't discriminate.

    But the disparities that have long been part of our medical system in America are now leading to what some call a crisis within a crisis, black and brown communities across the country being hit harder, in greater numbers, and with fewer resources to save them.

    For more on this , I'm joined by Dr. Uché Blackstock. She was an associate professor of emergency medicine at New York University. She now runs a consultancy called Health Advancing Equity, and practices in urgent care clinics in Brooklyn, New York.

    Dr. Blackstock, welcome to the "NewsHour."

    Start by just telling us about the patients you're seeing right now. What are they telling you? What are their symptoms? How sick are they?

  • Uché Blackstock:

    So, currently, I work out of an urgent care clinic in Central Brooklyn, where the population is largely black and brown.

    And we have really been seeing patients over the last one to — one to two weeks come in progressively sicker, a lot with fever, cough, worsening shortness of breath, some even sick enough to warrant emergency department visits.

  • Amna Nawaz:

    And are you seeing any kind of trend in their symptoms? Do you know that these are coronavirus cases?

  • Uché Blackstock:

    They're absolutely textbook COVID-19 cases, I mean, down to the type of symptoms, the course of the symptoms, the onset of worsening of symptoms, every patient after the next coming in with the exact same story. It's almost uncanny.

  • Amna Nawaz:

    You know, Dr. Blackstock, you had told me that, before the pandemic even hit, you were worried that those same patients you serve in your community were going to be hit harder. Why is that?

  • Uché Blackstock:

    For multiple reasons.

    I mean, even thinking about the testing criteria that was initially being used to determine whether or not someone had exposure to COVID-19. It included a person needed to have traveled abroad to one of the countries where COVID-19 was endemic, like Italy or China.

    It also required is someone having to know someone who had tested positive.

    And what we knew very early on was that, you know, there were communities that didn't have access to testing. We had heard of celebrities and politicians having very easy access to testing and quick turnarounds.

    And these are communities that already carry very high chronic disease burdens, like diabetes, high blood pressure, asthma. There are also high rates of obesity. And you know, these have all been tied into a racial health disparities linked to structural racism.

    So it's already kind of made of these patients and these communities more vulnerable to COVID-19, as we're seeing that these patients are at increased risk for developing very serious complications.

  • Amna Nawaz:

    You know, it has been studied and documented, as you just mentioned, the racial bias in our medical system, not just in access to care, right, but in how black and brown people are treated once they're in care.

    As the cases spread further, as people get sicker, how are you worried — or what are you worried will happen as a result of all of those institutional biases and how it'll affect your patients?

  • Uché Blackstock:

    Right.

    What we already know, as you alluded to, is that, when black and brown people interface with the health care system, they often encounter provider bias. So, we know, and it's well-documented, that their pain is undertreated or their complaints are minimized.

    So, my concern is that, when these patients present to emergency departments and hospitals in their areas with COVID-19 symptoms, that their symptoms may be downplayed or they may not be taken seriously.

    And we do already have the data to support that trend continuing to happen.

  • Amna Nawaz:

    You know, we're talking before the peak in New York has even arrived. What do you think your community is going to look like, those communities in which your patients live, a week from now, or two weeks from now, or three weeks from now?

  • Uché Blackstock:

    I am scared. I am. I'm scared that these communities are going to be absolutely ravaged and devastated by COVID-19.

    I mean, when I think about how, each day last week, I just saw sicker and sicker patients, it was — it was significant, and it was also terrifying. And so I do worry.

    And we already actually have some of the preliminary data out today in The New York Times that our poorer areas of the city, which are mostly black and brown, have the heaviest number of patients that have been affected with coronavirus.

  • Amna Nawaz:

    Dr. Blackstock, you, of course, have a family at home, too.

  • Uché Blackstock:

    Yes.

  • Amna Nawaz:

    You have a husband. You have two young kids.

    I wonder if you can tell me how you're processing this right now, whether you're scared for your own safety or theirs.

  • Uché Blackstock:

    Thank you for asking.

    I will readily admit that I am — I am scared. I'm scared about being infected myself. I'm scared about bring disease home to my husband and my two small children.

    I have had to have very difficult conversations with my family recently, including one with my husband the other night, where, once I realized things were really shifting here in New York City, I said to him, you know, there is a chance that I may not make it out of this, working on the front line. And, you know, I want you to know that I love you. I love our children very much. And just please make sure that they always know that their mama loved them.

    And so these are conversations that not just I'm having, but my — many of my colleagues are having with their families as well.

  • Amna Nawaz:

    Thank you for sharing that with us, and thank you for the work that you do.

    That's Dr. Uché Blackstock joining us tonight from New York.

  • Uché Blackstock:

    Thank you for having me.

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