Blacks, Hispanics Hit Harder by the Coronavirus, Early U.S. Data Show

“We have a particularly difficult problem of an exacerbation of a health disparity,” Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases, said at a recent White House coronavirus task force briefing. “The things that get people into” intensive care and require them to be put on a ventilator — something that often leads to death — are the very factors, Fauci said, “that are, unfortunately, disproportionately prevalent in the African American population.”

About 1 in 5 U.S. adults under age 65 are at higher risk for severe illness from COVID-19 because of an underlying health condition that can aggravate the disease. In minority communities, the numbers are higher. More than 1 in 3 (34 percent) American Indian/Alaska Native adults and 27 percent of black adults under age 65 are at higher risk of serious illness from COVID-19 due to underlying health conditions, a May analysis from KFF found.

What’s more, researchers at Boston University found that 11 percent of black adults and 18 percent of Native Americans had multiple risk factors putting them at high risk for a severe case of COVID-19, whereas this was true of only 8 percent of white subjects. Among Americans 65 and older, the same study, which looked at data from the 2018 Behavioral Risk Factor Surveillance System, found that 69 percent of Native Americans and 61 percent of black Americans had one or more additional risk factors beyond age, compared with 54 percent of white adults.

Better messaging, data and testing could help

Better communication about the virus in minority communities is needed “so that everyone understands what it’s going to take for us all to protect one another,” White House coronavirus task force response coordinator Deborah Birx, M.D., said at a recent news briefing.

Thomas acknowledges that messaging is vital but says that “the messenger can be more important.”

In minority areas, credible messengers often “don't have M.D.s behind their name; they don't have Ph.D.s behind their name,” he says. “They may be the local barber or the local stylist in the hair salon. They have tremendous trust and credibility.”

But social distancing guidelines and stay-at-home orders mean that most barbershops, churches and community centers are closed. This has left a big gap in communication channels in neighborhoods across the country, Thomas says. “Who’s making sure that they have the information, the evidence-based information, to help dispel myths, to shut down conspiracy theories and to ensure that African Americans recognize, ‘Hey, this disease is affecting us’?” he asks.

Beyond culturally relevant communication strategies, experts say more data — especially statistics that break down COVID-19’s impact by race and ethnicity — is also important. Knowing who is “in the crosshairs of the epidemic” can lead to more testing sites and health services in the areas that need it most, Thomas says.

“That’s what we have to do right now, to bend the curve,” observes Carlos Rodríguez-Díaz, associate professor of prevention and community health at the George Washington University Milken Institute School of Public Health. “We need to bring resources to the community, because we know what’s happening.”

Economic factors complicate

There are also social and economic elements at play, according to experts. More than 1 in 3 (35 percent) adults under age 65 with household incomes below $15,000 are at higher risk of serious illness if infected with the coronavirus, compared to about 1 in 7 (16 percent) of adults with household incomes greater than $50,000, a report from the KFF shows.   

Without a vaccine or approved drug therapies, health officials say one of the best ways to decrease the risk of infection from the coronavirus is to keep a physical distance from other people and to stay home as much as possible. But for many in minority communities, that is not an option.

“If you work and you cannot work from home, then you have to make a very difficult decision” about how you are going to put food on the table and pay rent, Rodríguez-Díaz says. “And, therefore, you probably decide to risk your health and expose yourself or your family by actually working.”

Data from the U.S. Bureau of Labor Statistics show that fewer than 20 percent of black workers and roughly 16 percent of Hispanic ones are able to telecommute. About two-thirds of employed Hispanic adults say they would not get paid if the coronavirus caused them to miss work for two weeks or more, a Pew Research Center survey found.

“African Americans and Latinos and other minority groups are the ones out there in the warehouse, emptying food trucks, delivering your Grubhub or Uber Eats. They’re out there at risk” for catching the coronavirus, Thomas says.

Health experts, including Birx, stress that while African Americans and other minority groups are not more inherently susceptible to getting infected by the coronavirus, they are more likely to have a harder time recovering if they are infected.

“We experience social factors that are constantly putting us in a disadvantaged place to respond to an epidemic and to recover from diseases,” Rodríguez-Díaz says, pointing to unstable housing and lack of access to health care as two of the circumstances that aggravate health outcomes and disproportionately affect minority populations. “Social factors represent a significant [role] in our ability to be healthy. And if we don’t have access to those social resources, then we are in worse conditions to deal with a pandemic.”