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The coronavirus pandemic has shed new light on racial disparities in American health outcomes. Economic disadvantage is one reason Black people in the United States are on average less healthy than white people -- but there are other causes, including the ongoing stress of systemic racism. Paul Solman reports in the second of a two-part Race Matters series.
Now the second of a two-part Race Matters report from Paul Solman on how past and present inequalities have sapped the wealth and health of Black Americans.
Last night, Paul focused on economic matters. Tonight, he looks at health outcomes, all magnified in the time of COVID.
His report is part of our ongoing series Making Sense.
Within 48 hours, Desmond Tolbert lost both mother and father to COVID-19.
Both your parents at the same time, it's hard.
Back in April, Black rural Georgia, where the Tolberts live, had some of America's highest pandemic death rates, foreshadowing today's stunning statistic, that Black Americans are at least twice as likely to die of COVID-19 than whites, almost four times more likely when you control for the fact that the Black population is younger.
I have never dealt with so much death in my life in such a short period of time as this.
Longtime Detroit civil rights activist Rev. Horace Sheffield, 65, had COVID-19 himself in March. He recovered. But his congregation has been decimated.
We all experience death in urban settings, people who are killed before their time in violence and all that, but nothing like this at all, ever.
Prison guard David Felton is one of Sheffield's parishioners.
I was in the hospital for five days, off work for 30 days, after contracting COVID.
I also had a relative that passed from COVID-19.
Fellow congregant K.C. Wilbourn-Snapp.
He was 51 years old.
Shafina Che Wiggens:
I lost my husband to the virus. I also had it myself. So it's been pretty tough.
Shafina Che's husband, Dajuan Wiggens, was 47.
He died March the 31st.
Why, if he's only 47?
Well, he did have high blood pressure.
And thus the puzzle that prompted this story: Why are African Americans dying at a much higher rate than whites?
Factor one would be essential worker employment.
Economics explains a lot, says Professor Trevon Logan.
A second factor would be density of living arrangements and higher rates of public transportation use.
As Marcus Thorpe put it of his 90-minute New York bus commute:
If you don't have a car, you got to get on something. You know what I'm saying?
And there are a number of other problems that threaten the health of Black Americans broadly, like the food desert, which is L'Tanya Holley's D.C. neighborhood.
There's not a grocery store in this area. The urban farm up the street was closed down. So what are the people supposed to do? They have to eat.
Where I grew up on the East Side, it's not uncommon to see Coney Island McDonald's, whatever, the fast-food restaurant.
That's Mainza Snapp of Detroit.
And then you see the liquor stores everywhere promoting cigarettes, alcohol, every single thing that you wouldn't see in a white neighborhood.
We do know that socioeconomic status has a huge impact on a whole host of health outcomes.
Public health physician Lisa Cooper is professor of medicine at Johns Hopkins.
African Americans are at greater risk for developing chronic diseases like diabetes, high blood pressure, heart disease.
All contribute, says Dr. Cooper, to a health condition among Blacks sometimes called weathering, which has been linked to cumulative stress.
The body responds as if it's, you know, trying to defend itself. And so there are elevated levels of stress hormones.
Which everyone knows are no good for you.
Also leads to premature aging. And so it would explain a lot of the phenomena that we see among African Americans.
There is another study that looked at telomeres.
Telomeres are the protective caps at the end of chromosomes that get shorter with age, explains sociologist Rashawn Ray.
And what this research found is that Black teenagers who are living in neighborhoods that are underserved, that have high levels of crime, their telomeres are the same length as elderly men, suggesting the ways in which weathering and chronic stress has impacted them.
But let's be clear. For Black Americans, economic stressors are just part of the story.
America has recently awakened to a steady drumbeat of unarmed Black men being shot by the police.
A TED Talk by sociologist David Williams.
What is even a bigger story is that, every seven minutes, a Black person dies prematurely in the United States.
Research has found that higher levels of discrimination are associated with the elevated risk of a broad range of diseases and even premature mortality.
And that's separate from the effects of economic disadvantage.
Racism has an independent effect on health. You can have African Americans who are upper middle-class who are experiencing much higher rates of disease than you would see among white Americans at the same level of socioeconomic status.
We feel it is a very important cause.
In 1968, psychiatrists William Grier and Price Cobbs co-authored a book called "Black Rage."
All Black people are angry, not just a few militants whom one may see on television. Black people in this country have had it.
By 2020, says economist Sam Myers:
It just builds up. It builds up. And, at some point, you just explode.
Let's stop shooting our young men.
Myers, born deaf, hardly needs to lip read to understand a not untypical encounter with police in Minneapolis, where he's been a professor for decades.
Put your hands up on the dashboard. I mean, I learned very quickly that it is dangerous to reach into your pocket to get your wallet, that the police officer instinctively believes that you're reaching for your weapon.
Outrageous, arguably. Enraging, for sure.
And so what we have done is that we have kind of moved our anger internally, because we believe that we have a job to do with respect to proving that we are worthy, that we are capable, that we are productive citizens. But that's what happens when that builds up.
I have been pulled over by the police more than 10 times in my own life.
Again, economist Trevon Logan.
I think it's impossible for anyone who's lived as an African American in this country to say that they haven't experienced racially specific stress. And that stress will have physiological consequences.
Which may explain why, by age 55, more than 75 percent of Black Americans have hypertension, blood pressure higher than 130 over 80, compared with less than 50 percent of whites.
You have high blood pressure?
That's why this COVID-19 has been such a harassing menace in our community, because people already were unhealthy.
And less access to health care makes matters worse, says Rashawn Ray.
Black men are less likely to utilize health care because of discrimination that's embedded within the health care system.
There's a recent study, really important for COVID-19, showing that Blacks were six times more likely to be turned away from testing once they even went to the hospital.
This family's story is so upsetting.
In a Detroit case that made national news, 56-year old Gary Fowler died at home on April 7, having been denied a test at three hospitals. His father had died of COVID hours earlier. His wife was hospitalized the same day. His children later tested positive, including stepson Keith Gambrell.
I understand now why Black people are the highest affected mortality rate with this, because we're being pushed home to die and infect our family.
That's one reason why Reverend Sheffield has started a testing program that's already served thousands.
We understand that, because of the hue of our skin, you know, we're being treated differently than other people. And COVID-19 just vividly portrays just how that exists.
And continues to.
For the "PBS NewsHour," Paul Solman.
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