Like many Memphians, TaJuan Stout-Mitchell has been putting some distance between herself and novel coronavirus by wearing a mask and standing 6 feet away from strangers.
What she hasn’t been able to do, though, is distance herself from news of people she either knows, or knows of, who have been sickened or killed by COVID-19.
The husband of one of her friends died from COVID-19. Another friend’s aunt was sickened by COVID-19, and the friend’s uncle died from it, Mitchell said.
Another friend’s cousin died from COVID-19 after attending a funeral in Mississippi, where several people wound up contracting the virus. And one of her husband’s co-workers died from it.
If it sounds coincidental that the novel coronavirus would cut its lethal swath through Mitchell’s circle of friends, it really isn’t.
That’s because Mitchell, a mother and grandmother, is African American. The friends who have lost loved ones to the virus are African American. All are in Memphis, except one in Olive Branch and another from Nashville.
And African Americans are dying from COVID-19 in Memphis and across the nation at higher rates than whites.
“When I see what is happening, I see how we are vulnerable,” the former Memphis City Councilwoman said. “I have a friend who works at a warehouse, and she’s vulnerable…
“When I say hi to my sanitation workers, and they have no masks on, I think about how they’re vulnerable. They’re all essential workforce, and they’re all vulnerable.”
Where race, poverty and poor health outcomes converge, the most vulnerable suffer.
Shelby County’s population is 54% black. But according to the Shelby County Health Department, 71% of the county’s COVID-19 fatalities are black, while 70% of coronavirus patients are black.
Nearly 1 in 3 black county residents and more than 1 in 3 black Memphis residents live below the poverty line. And of 95 counties in Tennessee, Shelby County falls in the bottom third of health outcomes, according to a 2020 report from the Robert Wood Johnson Foundation that considers factors such as poverty, smoking, diet and exercise and access to health care.
Across the country, the burden of COVID-19 is falling hardest on black people. In Louisiana, where 33% of the population is black, 70% of COVID-19 deaths were African American. As of Thursday, all of St. Louis’ coronavirus fatalities were black, in a city that is 46% black. Milwaukee County’s population is just over 27% black, but blacks make up 50% of coronavirus deaths.
In New York City, where the virus has claimed more than 5,800 lives, blacks accounted for 28% of deaths, behind Latinos at 34%. Blacks make up 22% of the population, and Latinos are 29%.
The disparities are so stark, in fact, that even the White House has acknowledged them.
“Health disparities have always existed for the African American community,” said Dr. Anthony Fauci, a member of the White House coronavirus task force.
The pandemic is “shining a bright light on how unacceptable that is because, yet again, when you have a situation like the coronavirus, they are suffering disproportionately,” he said.
“When they do get infected, their underlying medical conditions, the diabetes, the hypertension, the obesity, the asthma — those are the kind of things that wind them up in the ICU and ultimately give them a higher death rate.”
The term used to explain why African Americans are more susceptible to COVID-19 is “comorbidity” — which simply means a person has more than one health condition at a time, said Ruby Mendenhall, Ph.D., assistant dean for diversity and democratization of health innovation at the Carle Illinois College of Medicine at the University of Illinois.
But to understand why African Americans disproportionately suffer from such conditions, Mendenhall said it’s important to examine “the plethora of societal conditions that can create wear and tear on the body and mind, too: grief from the premature death of loved ones, subtle forms of racism, overt forms of racism, substandard housing, et cetera.”
Add to that the disparate treatment and often substandard care blacks receive from the healthcare system, and it’s no surprise more African Americans are being infected with and dying from coronavirus, said Harriet Washington, a medical ethicist and author of “Medical Apartheid: The Dark History of Medical Experimentation on Black Americans From Colonial Times to the Present.”
“We’re talking about a system which is engineered to fail people of color,” she said.
Western medicine’s doctor-patient relationship assumes the doctor is responsible for the patient and that the patient trusts the physician, but that dynamic has never held true for African Americans, Washington said.
“Preserving the fitness for work has dominated healthcare for African Americans, I would argue, to the present day,” Washington said.
“Healthcare for African Americans was predicated not on preserving health and not on caring for the patient, it was predicated on preserving fitness for work…it was the planter, the slave owner, who was the patient, the slave owner would engage the doctor. He would give permission and withhold permission for different treatments, and it was a slave owner who had to be satisfied with the result,” she said.
Shades of that dynamic exist today.
Today — and especially in Memphis and Shelby County — it is black people who make up a disproportionate share of essential but low-wage workers, such as grocery store clerks who are expected to report for duty even though they may not have health insurance and can’t afford to stay home if they’re feeling ill.
Work and health are inextricably linked, said Dr. Bruce Randolph, public health officer for the Shelby County Health Department. “It is through your employment that most people get access to healthcare via insurance; employment plays a major role in contributing to the health status of people.”
Randolph said he supports a single-payer healthcare system: “Making healthcare available, increasing the pay, all to me are health measures.
“If folks are really serious about trying to improve the overall health of a population, you have to improve their standard of living.”
Mitchell, however, said if nothing else, the coronavirus crisis should make everyone more aware of the plight of African Americans who clean their homes, pack their boxes, pick up their garbage and ring up their groceries — and who do all the tasks essential to everyone else’s ease and survival.
“I would hope that we’ll all take a minute to not only pray for them but to be advocates for them,” she said.
This story was produced in partnership with The Commercial Appeal. MLK50: Justice Through Journalism is a nonprofit newsroom focused on poverty, power and policy in Memphis. Support independent journalism by making a tax-deductible donation today. MLK50 is also supported by the Surdna Foundation, the Racial Equity in Journalism Fund at Borealis Philanthropy, Southern Documentary Project at the Center for the Study of Southern Culture, the American Journalism Project, the Community Foundation of Greater Memphis, and Community Change.