About 1 in 3 people who become sick enough to require hospitalization from COVID-19 were African American, according to hospital data from the first month of the U.S. epidemic released by the Centers for Disease Control and Prevention.
Even though 33% of those hospitalized patients were black, African Americans constitute 13% of the U.S. population. By contrast, the report found that 45% of hospitalizations were among white people, who make up 76% percent of the population. And 8% of hospitalizations were among Hispanics, who make up 18% of the population.
The study of about 1,500 hospitalized patients in 14 states underscores the long-standing racial disparities in health care in the U.S. It also echoes what has been seen in other coronavirus outbreaks around the world — people with chronic health conditions have a higher likelihood of developing a serious illness after being infected with coronavirus. The findings appear in the MMWR, the Morbidity and Mortality Weekly Report.
Overall, the report found that about 90% of people in the hospital with COVID-19 had at least one underlying health condition. Half (50%) had high blood pressure, 48% were obese, 35% had chronic lung disease and 28% had diabetes and cardiovascular disease.
Hospitalizations were highest among people 65 and older, and about 54% of those hospitalized were men.
People who were hospitalized had a wide range of symptoms. The most common symptoms at the time of hospital admission were cough (86%), fever or chills (85%), and/or shortness of breath (80%). Upset stomach and gastrointestinal symptoms were documented as well: 27% had diarrhea and 24% reported nausea or vomiting.
Asked about the reports of health disparities and racial divide at a White House coronavirus task force briefing on Tuesday, Dr. Anthony Fauci of the National Institutes of Health said that African Americans do not seem more likely to be infected by coronavirus.
But he added that "underlying medical conditions, [including] diabetes, hypertension, obesity, [and] asthma" might make it more likely that African Americans are admitted to the ICU or die from the disease. "We really do need to address" the health disparities that exist in the U.S., Fauci said.
"These findings underscore the importance of preventive measures (e.g., social distancing, respiratory hygiene, and wearing face coverings in public settings where social distancing measures are difficult to maintain)," the authors of the report write, "to protect older adults and persons with underlying medical conditions, as well as the general public."
'Torn up': African American family mourns 4 loved ones as COVID-19 racial disparities exposed
A lopsided death toll shows blacks in U.S. are bearing the brunt of the pain.
(OP: Video is not showing up when I try to embed but is available at the source.)
The most vulnerable: COVID-19's disproportionate toll on black communities.
These communities were fighting for their health long before the disease struck. Now, they’re grappling with limited access to tests and protective equipment, and staying home is not an option.
In the span of just 10 days, Kevin Franklin lost his 86-year-old mother and three big brothers to the coronavirus pandemic, and he says his loved ones didn't know they had the disease until it was too late.
"No one seemed sick. Nobody complained about nothing," the 56-year-old Franklin told ABC News. "We didn't know my mom had it until my mom went into the hospital."
Long-time residents of New Orleans, the Franklin family survived Hurricane Katrina, but the floodwaters that devastated the city in 2005 were a bit easier to battle because they could at least see them. Like Katrina, though, the coronavirus, also known as COVID-19 appears to be bringing a disproportionate amount of pain to African Americans like Kevin Franklin, who is mourning his mother, Antoinette, his brothers Herman, 71, Timothy, 61, and Anthony, 58, all at the same time.
"I'm just torn up right now," Kevin Franklin said. His life has been one of anguish and anxiety since March 20 when Herman Franklin was the first of the four to die at Ochsner Baptist Medical Center.
Preliminary data from coast to coast has suddenly cast a harsh spotlight on the pandemic's lopsided toll on the African American community in Louisiana and across the nation.
A woman holds a child as she walks past people waiting in line to receive testing during the coronavirus pandemic outside Roseland Community Hospital, in Chicago, April 7, 2020.
Blacks accounted for 70% of the 702 deaths in Louisiana linked to the coronavirus as of Thursday. Louisiana Health Department data shows that 66% of those who have perished from the pathogen suffered from hypertension, 43% had diabetes, 24% were dealing with obesity and 22% had cardiac disease. Blacks account for 32% of the population of the state and 13% of the country as a whole, according to Census data.
"We have a particularly difficult problem of an exacerbation of a health disparity. We’ve known, literally forever, that diseases like diabetes, hypertension, obesity, and asthma are disproportionately afflicting the minority populations, particularly the African Americans," Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and a member of President Donald Trump's Coronavirus Task Force, said at White House briefing this week.
“Unfortunately, when you look at the predisposing conditions that lead to a bad outcome with coronavirus -- the things that get people into ICUs that require intubation and often lead to death -- they are just those very comorbidities that are, unfortunately, disproportionately prevalent in the African American population," Fauci added. "So we’re very concerned about that. It’s very sad. There’s nothing we can do about it right now, except to try and give them the best possible care to avoid those complications."
Data in many locations across the nation appears to mirror what's coming out of Louisiana (as of April 9):
- Of the more than 6,600 confirmed cases of coronavirus in Chicago, 52% were black. Of the 196 deaths in Chicago linked to the disease, 67% were black, most with underlying chronic conditions, according to a daily tally provided Thursday afternoon by the city. Blacks make up 30% of the city's population, per the Census.
- In Milwaukee County, Wisconsin, 45% of the more than 1,500 people who had tested positive for the virus as of Thursday were black. Of the 68 people in the county to die from the disease, 45, or 66%, were black, according to numbers provided by officials there. Some 27% of the population is black in the county, the Census said.
- In Michigan, blacks accounted for 40% of the more than 1,000 deaths, and 33% of confirmed COVID-19 cases, despite being 14% of the population. In Detroit, blacks, who represent 79% of the population, accounted for 76% of the 272 deaths in the city. But whites, who account for 15% of the population, represent 4% of the deaths and 3% of the cases.
People wait in line to for coronavirus testing outside Roseland Community Hospital in Chicago, April 7, 2020.
- While blacks comprise 22% of the population of North Carolina, they accounted for 39% of the more than 3,600 confirmed COVID-19 cases and 38% of the more than 60 deaths. Whites in the state accounted for 55% of confirmed cases and 63% of deaths, but make up 71% of the state's population, according to the state Health Department.
- In Maryland, blacks make up 31% of the population and 40% of the 138 deaths, according to the Maryland Department of Public Health.
- In Ohio, blacks represent 13% of the population and 20% of the 5,500 confirmed cases and 13% of the 213 deaths, according to state data. Whites make up 81% of the population in Ohio, but 61% of the deaths.
- And in Minnesota, blacks make up 9% of the population, but represent 8% of the more than 1,200 COVID cases and 2% of the 50 deaths, according to state data. Whites make up 84% of the population and 88% of the deaths.
She stressed that the only way to learn from the pandemic and prepare for the next is to drill down into the data and pinpoint ways to make sure the health care system doesn't neglect minority communities. She urged other states to collect and release detailed information in order to ''level the barriers to health care and job opportunities, raising a family and education.''
The data provided by other states is less clear when it comes to racial demographics. In some states, like Virginia and Massachusetts, there are large percentages where races are either unknown or not reported, making it tough to get a clear picture.
The Centers for Disease Control and Prevention (CDC) released a portion of preliminary nationwide data on Wednesday amid increased political pressure to do so.
While the CDC report was based on a scant sampling in March of 1,482 patients in 14 states and included race and ethnicity information on about 580 hospitalized cases, it showed that blacks, who represent 13% of the U.S. population, made up 33% of hospitalized coronavirus cases "suggesting that black populations might be disproportionately affected by COVID-19."
The CDC report does not mention deaths.
There were more than 466,000 confirmed coronavirus cases in the United States, as of Thursday evening, and the virus had killed more than 16,600 people in the nation, so the sampling in the CDC report is just a fraction of the known cases in the U.S.
Vice President Mike Pence said a group of African American leaders have been invited to the White House to discuss concerns raised by the early data.
'Lack of information will exacerbate existing health disparities'
In a letter sent on March 30 to Health and Human Services Secretary Alex Azar, Sen. Elizabeth Warren and Rep. Ayanna Pressley, both Massachusetts Democrats, ask for comprehensive demographic data on people who are tested or treated for COVID-19.
''Any attempt to contain COVID-19 in the United States will have to address its potential spread in low-income communities of color, first and foremost to protect the lives of people in those communities, but also to slow the spread of the virus in the country as a whole,'' the lawmakers wrote to Azar. ''This lack of information will exacerbate existing health disparities and result in the loss of lives in vulnerable communities.''
The Poor People's Campaign, a nonprofit grassroots organization that is a revival of the one started by Rev. Martin Luther King Jr. and led to the 1968 Poor People's March on Washington, issued a statement Wednesday calling on hospitals and health departments across the country to begin reporting coronavirus cases by race and ethnicity, poverty and income.
MORE: Coronavirus is disproportionately killing the black community. Here's what experts say can be done about it
''Failure to do so masks underlying inequalities and hampers efforts to ensure prevention is equitable,'' the organization's COVID-19 Health Justice Advisory Committee, which is made up of experts from Harvard University, UCLA and other schools, said in a statement. "To mitigate the spread of the virus, everyone must have access to free and respectful medical testing, a safe place to recover, and high-quality medical treatment. Poor people and people of color must not be denied equal access to care."
'It's sick, it's troubling, it's wrong'
New York City Mayor Bill de Blasio on Wednesday warned that a day of reckoning is at hand for the disparities wrought by an American health care system that he says generally bases its level of care on the content of an individual's pocketbook.
''It’s just abundantly clear that it’s sick, it’s troubling, it's wrong," de Blasio said. "Our nation has still not come to grips with the fact that health care is provided so unevenly and all based on how much money you have."
Richard Spot, left, and Keith Newsome, bottom left, watch as their friends Keith Gibson, and Mike Williams, play spades on St. Bernard Avenue in New Orleans, amid the COVID-19 outbreak pandemic, April 7, 2020.
In New York City, the current epicenter of the global contagion, longtime disparities in the health care system are being dramatically exposed in overwhelmed hospital wards and show another minority community, Hispanics, bearing the burnt of the daily bad news.
Of the more than 5,100 people whose deaths in New York City have been attributed to coronavirus, blacks, who comprise 22% of the city's population, accounted for 28% of the deaths, while whites, who make up 32% of the population, accounted for 27% of the deaths. In the state as a whole, whites make up 74% of the population, but 61% of the deaths and blacks, while comprising 9% of the population made up 17% of the more than 7,000 fatalities.
Public health officials in the city also expressed concern about the Hispanic population. Some 34% of New York City's were Hispanic, despite making up just 29% of the city's population, according to data released on Wednesday by the New York Department of Public Health.
"I am very concerned when I see the large percentage of Latinos who have died from this illness even though we have made lots of efforts to reassure people that our public hospitals see individuals independent of their immigration status, independent of insurance status," Dr. Oxiris Barbot, commissioner of the New York City Department of Health and Mental Hygiene, said at a news conference on Wednesday.
MORE: 'Lot of fear': Coronavirus pandemic compounds dire situation for poor Americans
"The overlay of the anti-immigrant rhetoric across this country, I think, has real implications in the health of our community and certainly concerns about Public Charge are something we need to dig into," she said, referring to federal laws denying immigrants visas or permission to enter the country due to disabilities or lack of economic resources.
Dr. Patricia Tellez-Giron, associate professor at the University of Wisconsin School of Medicine and Public Health and co-chair of the Latino Health Council of Dane County, Wisconsin, said education and language barriers also pose roadblocks to proper health care for the Spanish-speaking community.
"We were very lucky to [have] very good interpreting services set up for our hospitals before this crisis. However, when this pandemic started we didn't have enough resources that were language and culturally appropriate for our communities," Tellez-Giron told ABC News.
"This pandemic really hit hard in my community because we can't take advantage of the social nets that other people can take, like unemployment," she added. "We're on the front lines cleaning the hospitals and the stores and in the stores, and yet many of the undocumented community that we have will not take advantage of that."
In Wisconsin, Hispanics made up 10% of the cases as of April 9 and 3% of the deaths. They make up 7% of the population.
Tellez-Giron has recently participated in Spanish radio programs in Wisconsin and spent nearly three hours taking questions from listeners about the COVID-19.
"We knew we needed to do these as soon as possible," Tellez-Giron said. "We jumped on the radio and started talking about prevention and people had very good questions about prevention. However, most of the questions were about what am I going to do now when I lose my job? How am I going to pay the rent? How do I protect my family?"
'A call-to-action moment'
Both Chicago Mayor Lori Lightfoot and New York Mayor de Blasio announced this week that they are working on launching programs to reach their devastated minority communities.
''This is a call-to-action moment for all of us. When we talk about equity and inclusion, they are not just nice notions,'' Lightfoot said at a news conference on Monday. ''They are an imperative that we must embrace as a city. And we see this even more urgently when we look at these numbers.''
Lightfoot said the city would be deploying racial equity rapid response teams into the community to identify and help vulnerable people get medical services.
De Blasio said he would like to see something similar in New York City.
MORE: Intelligence report warned of coronavirus crisis as early as November: Sources
''We’re going to have to find a way to get health care professionals out into communities to educate people, to answer their questions, to help them address their immediate challenges, but in a way that is safe for those health care workers," de Blasio said.
People wait in line in their cars to get tested for COVID-19 at Roseland Community Hospital in Chicago, on April 3, 2020.
In an appearance on ABC's "The View" on Wednesday, Sen. Kamala Harris, D-California, said no one should be surprised that the virus is taken an uneven toll on the African American community -- noting that 20% of black children suffer from asthma, that 40% of blacks have high blood pressure, that black women are three times more likely than white women to have lupus.
"Those who had preexisting health conditions based on racial disparities, based on socioeconomic disparities are doing even worse in the midst of this pandemic," Harris said. "So it requires us to address it in a way that also recognizes the historical nature of it."
She suggested that one way to confront the problem would be for the Federal Emergency Management Association to direct resources to those communities that the data shows disparities in health care are most evident.
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"For years, I have been working on black maternal mortality, which before this pandemic was very real," Harris said. "We were talking about it, black women are three to four times more likely to die in connection with childbirth than white women. When we looked at the issue, it had nothing to do with that woman's education level or her socioeconomic level. It literally had to do with the fact that when a black woman was walking into a hospital or a clinic or a doctor's office, she was not being taken seriously."
(1) Racism: The most dangerous 'pre-existing condition'.
OP: Lest fellow Canadians think this is only a U.S. issue...
(2) Racial discrimination could exacerbate COVID-19 for African Nova Scotians: advocates.
OP: Indigenous communities in Canada suffered disproportionately from the H1N1 pandemic of 2009, so indigenous communities will soon need help in the face of Covid-19: "A particularly concerning occurrence was the spread of pH1N1 2009 into First Nations communities in Canada. Although Aboriginal peoples constitute only 3.8% of Canada’s population, members of the First Nations were 6.5 times more likely to be admitted to an ICU with pH1N1 2009 influenza than non-First Nations, and had rates of hospitalization nearly triple that of the national cumulative crude rate for all Canadians." (From this reference.)
(3) 35 COVID-19 cases on First Nations: Indigenous Services Canada.
OP: In Europe, structural inequalities combined with the pandemic have resulted in tragedies as well.
(4) Italy's migrants living through an emergency within an emergency. In Castel Volturno, thousands of undocumented migrants are caught between coronavirus and the mafia.
(5) Third of critically ill COVID-19 UK patients from [Black and Minority Ethnic or] BME backgrounds. Release of figures comes amid wider concerns coronavirus is exacerbating health inequalities in the country.
(6) Covid-19: Doctors warn of humanitarian catastrophe at Europe's largest refugee camp. A UK based charity that provides healthcare to residents at Europe’s largest refugee camp has warned that overcrowding could prompt a humanitarian catastrophe in the wake of the covid-19 pandemic. Siyana Marhroof Shaffi, director of the UK based charity Kitrinos Healthcare, which runs a medical clinic on the island of Lesvos, Greece, warned of an “alarming” risk to thousands of vulnerable refugees in the Moria camp.
OP: Please note the trigger warnings.
PS: Fixed the formatting issues...