A Louisiana pastor prays as his parishioners die, first from cancer and now from COVID-19. An Indigenous community in New Mexico lacks adequate health care as the death toll mounts. A sick hospital worker in New Jersey frets about infecting others in her heavily populated neighborhood.
As the country cries out for a vaccine and a return to normal, lost in the policy debates is the reality that COVID-19 kills far more people of color than white Americans. This isn’t a matter of coincidence, poor choices or bad luck – it’s by design.
A team of USA TODAY reporters explored how the policies of the past and present have made Black, Asian, Hispanic and Indigenous Americans prime targets for COVID-19. They found:
Start the day smarter. Get all the news you need in your inbox each morning.
America’s education and economic systems are still unequal, disproportionately leaving people of color out of higher-wage jobs. When COVID-19 struck, more people of color were serving as essential workers directly in the path of the virus.
Decades of discrimination in housing corralled people of color into tightly packed neighborhoods, fueling the virus’ spread. Those neighborhoods tend to lie in “food deserts,” leading to diabetes, obesity and heart disease that make people more likely to die from the virus.
Environmental policies designed by white power brokers at the expense of the poor has poisoned the air they breathe, fueling cancers and leaving communities weakened in the path of the virus. A lack of federal funding left the most vulnerable communities cut off from healthcare at the most critical moment.
Put simply, America’s history of racism was itself a preexisting condition.
Of the 10 U.S. counties with the highest death rates from COVID-19, seven have populations where people of color make up the majority, according to data compiled by USA TODAY. Of the top 50 counties with the highest death rates, 31 are populated mostly by people of color.
“COVID-19 has brought out into the open, with painful clarity, these divisions in our society that have been there for a long time but, for one reason or another, people were able to overlook them,” said Philip Landrigan, director of the Global Public Health Program at Boston College.
With nearly 1,000 people a day dying from the virus and scientists scrambling to grasp exactly how the virus spreads and kills, federal and state data has not provided enough demographic detail to show the full impact on communities of color. The race and ethnicity of people who contract the virus is known in 52% of cases, according to the Centers for Disease Control and Prevention.
But study after study has shown clear patterns in whom the virus kills.
Black people are more than twice as likely to die from the virus than white people, and Hispanics and Native Americans are 1.5 times more likely to die, according to The COVID Tracking Project.
“You can’t change the fact that America is so segregated and that people of color tend to live in communities where the environmental conditions are worse, and that can increase your risk of heart disease or lung disease and diabetes,” said Richard Besser, former acting director of the CDC and president and CEO of the Robert Wood Johnson Foundation, the nation’s largest philanthropy dedicated solely to health care. “You can’t change that in the short run.”
A team of USA TODAY reporters pored over lawsuits challenging housing and health care policies, analyzed demographic data for communities hit hardest by COVID-19 and studied documents that reveal how government and business leaders worked together to marginalize populations. They interviewed the descendants of enslaved Americans who were denied homeownership in white neighborhoods and Indigenous Americans who had been funneled into reservations in exchange for federally funded health care that never came. They walked through Black communities on the fence line of polluting chemical plants, spent time with Latino farmworkers unable to afford the very food they harvested, and entered the homes of Asian immigrants afraid of being attacked by neighbors if they tested positive for the coronavirus.
Housing policies speed spread of virus
In Essex County, New Jersey, decades of housing policies, laws and unspoken pacts excluded communities of color from spacious suburbs and forced them to cram into poor, often neglected neighborhoods in the urban core of Newark. Now, Essex has the 12th-highest death rate from COVID-19 in the country, according to data compiled by USA TODAY, fueled in large part by the high numbers of Black Americans living in segregated, low-income neighborhoods.
That includes Ahou Yao, 40, a respiratory therapist at a local hospital who contracted COVID-19 in April and was forced to self-isolate in her bedroom in the two-bedroom apartment she shares with her husband and two young boys. She struggled from fever, shortness of breath and body aches and was unable to work for a month. Her husband had to go out for food, run errands and navigate their crowded neighborhood.
“Now I’m scared,” she said, “scared that he has it, too.”
Her husband has since developed a cough and chest pains, prompting a trip to the emergency room. He started self-isolating, passing the responsibility of venturing outside back to his wife.
Environmental policies make people vulnerable
In Louisiana, along a stretch of the Mississippi River between New Orleans and Baton Rouge, former slave plantations house massive chemical plants that spew chemicals deemed dangerous by the Environmental Protection Agency. When the plants were constructed, white homeowners had the means to move away, in time leaving a mostly Black population to breathe toxic air and suffer from such high rates of cancer that the entire region was dubbed “Cancer Alley.”
One of those plants, in St. John the Baptist Parish, is the only one in the nation that produces neoprene. The synthetic rubber is used to make wetsuits and laptop cases, and the emissions from the production process are so harmful that the EPA lists the predominantly Black neighborhood next door to the plant as having the highest risk of cancer in the entire country. In September, St. John the Baptist Parish had the 27th highest death rate from COVID-19 in the nation, according to a USA TODAY analysis.
The Rev. Lionel Murphy of the Tchoupitoulas Chapel, which sits 2 miles from the chloroprene plant, has counseled many Black families over the years as they’ve come down with diabetes, respiratory illnesses and rare cancers. Now, he’s seeing his neighbors die from COVID-19. And still, smoke billows from the plant down the road.
“People get sick, people die, you go bury them,” Murphy said. “But there’s no fight to erase the problem.”
Health care missing when needed
In McKinley County, New Mexico, many locals struggle to find health care.
Year after year, Congress has failed to allocate enough money to fulfill its legal obligation to provide health care to Indigenous tribes, including the Navajo, Hopi and Zuni people who make up the majority of McKinley County’s population. A 2018 report from the U.S. Commission on Civil Rights titled “Broken Promises” found the federal government spends nearly four times as much on health per person through government programs than it spends for each Indigenous person.
That helps explain why McKinley County has the nation’s sixth-highest death rate from COVID-19, according to USA TODAY data, with more than 240 people dying in the isolated corner of the state.
Anna Marie Rondon, executive director of the New Mexico Social Justice and Equity Institute in McKinley County (who is Diné, as the Navajo people call themselves), said the ravages of COVID-19 are not an isolated tragedy but the latest chapter in Indigenous people’s long history of abuse and neglect from the U.S. government.
On the Navajo Nation, inadequate resources have resulted in widespread water poverty, food insecurity and high rates of illness. These daily realities were devastating long before the pandemic, but they’ve also helped fuel a high COVID-19 death rate.
“It’s really an unbelievable chain of oppression – it’s still squeezing us, it still has its grip,” Rondon said. “And it’s still killing us.”
Food deserts make people vulnerable
In California, Imperial Valley is considered the nation’s winter breadbasket, producing 80% of the country’s fresh vegetables during the cold months. But the predominantly Hispanic workers who pick alfalfa, lettuce, sugar beets and carrots can rarely afford to buy them.
Nearly 75% of adults and 13% of children are obese or overweight for their age, according to state data. On the other end of the spectrum, 31% of kids in Imperial County don’t get enough to eat each day, according to a 2018 report by Feeding America, a national anti-hunger organization based in Washington, D.C.
“If they’re already on food stamps, to spend the extra money to get fruits and vegetables, it’s expensive,” said Jessica Solorio, executive director of Spread the Love, a local food bank.
Those figures show why COVID-19 has been so fatal in the county, with 16 deaths per 10,000, nearly three times the national average, according to the USA TODAY analysis.
Cultural barriers complicate response
In San Francisco, community activists are worried that the number of Asian Americans getting COVID-19 is being vastly underreported.
Of the county’s nearly 12,000 positive test results, only 12% are Asian American, yet Asian Americans have made up 38% of the death count. Experts attribute that alarming disconnect to a number of factors, including the fear of losing a job after a positive test, language barriers, lack of health care, growing anti-Asian hate crimes, and what’s called the “model-minority myth” – an assumption that education and financial successes enjoyed by some Asian Americans applies to all 20-some Asian ethnicities.
Judy Young, executive director of the Southeast Asian Development Center, a nonprofit that helps residents from Vietnam, Laos and Cambodia, said her community suffers from an average household income a quarter of the city’s average, low high school graduation rates and obstacles to health care. Add a COVID-19 testing regime tailored to those proficient in English and an often fatalistic attitude toward the pandemic in the community, and Young said the virus has been painful to the Asian American community.
“I’ve asked our clients why they’re not getting tested,” she said. “Often the reaction I get is, ‘I’m going to die anyway, and if I test positive, then I can’t go to work.”
‘We become invisible’
Ask Beverly Wright, executive director of the Deep South Center for Environmental Justice, why so many people of color across the U.S. are dying from COVID-19 and she goes back 400 years to the arrival of the first enslaved Africans to colonial U.S. shores.
Racism is so entrenched in the American way of life, she said, that it’s impossible to separate the high death rates of marginalized communities from the nation’s historic treatment of each of them. From the broken promises of reparations to the terrible treatment of immigrants, from redlining practices that excluded Black Americans from homeownership to the GI Bill money that went mostly to white service members returning from World War II, Wright says COVID-19 is once again revealing the precarious position people of color often find themselves in.
But with no national response from the federal government and only limited actions taken by states or localities, Wright said her people are still stuck in the same situation: invisible.
“We have built-in systems that work against Black people moving up the economic ladder,” Wright said. “That pattern continues.
“Racism is so entrenched that we become invisible.”
MORE IN THIS SERIES
This article originally appeared on USA TODAY: ‘An unbelievable chain of oppression’: America’s history of racism was a preexisting condition for COVID-19