To the shock of those unfamiliar with racial health disparities in the United States, African Americans (and other racial minorities) have been infected with, and died from, COVID-19 at a much higher rate than white Americans. The explanation given by Dr. Anthony Fauci (Director of the National Institute of Allergy and Infectious Diseases and high profile member of the White House Coronavirus Task Force), Dr. Jerome M. Adams (United States Surgeon General), and other health professionals is that African Americans disproportionately suffer from underlying conditions such as diabetes, hypertension, obesity, and asthma that make complications from COVID-19 more likely and more severe. Dr. Adams also pointed to “social determinants [such as] fewer job opportunities and living in densely packed living environments,” as factors behind the disparities, but he did not explain why people of color have more difficulty finding good jobs or are more likely to live in those environments. Other health professionals and pundits suggest or outright state that the higher prevalence of underlying diseases is the result of poor diet and lifestyle choices, thereby placing the blame on the patients themselves for their own susceptibility to illness and death. Such victim-blaming and focusing only on the end result and not the causes of racial health disparities have the effect of absolving others, particularly the government, from any responsibility for causing the health disparities and for failing to take effective steps to eliminate them.
Better informed voices have spoken out against such simplistic explanations and have pointed out the role that discrimination by private individuals and entities, as well as racist government policies and practices, have played in creating and perpetuating racial health disparities. In fact, research has proved that the stress caused by experiencing racism or watching others of the same race being discriminated against, has a direct and negative impact on African Americans’ physical and mental health. That explains why the disparities persist even when controlling for education level and income. For example, infant mortality rates are not only higher for African American women as a general matter, rates are highest for African American women with a doctorate or professional degree.
Now that the issue of racial health disparities is in the spotlight and at least some leaders have expressed an interest in taking steps to eliminate those disparities, it is crucial that those leaders understand the true causes. If they focus only on the underlying illnesses and poverty without acknowledging and understanding the role that racism has played in fostering illness and poverty, then we will end up with solutions that focus solely on changing the behaviors of people of color. But changing behaviors will not prevent the implicit biases of healthcare professionals that may lead them to undertreat racial minorities. It will not prevent law enforcement from targeting people of color because of preconceived notions about who is a criminal and who is not. It will not prevent the undervaluing of people of color that contributes to communities being neglected and underserved. It will not change the stress of living in a racist society from taking its toll on our health. Change requires a willingness to acknowledge and overcome implicit biases that perpetuate inequality, and it requires deliberate and targeted eradication of the racist policies and practices that lead to poor health and early death.
Teri Dobbins Baxter is the Williford Gragg Distinguished Professor at the University of Tennessee College of Law where she teaches Constitutional Law, Torts, a Family and Privacy Seminar, and Secured Transactions.