America’s crises are boiling over, one into another. Amid the coronavirus pandemic, masses of people are taking to the streets to protest police brutality after the death of George Floyd in Minnesota and other victims of racial violence.
These two stories are linked. They are both public health stories. The link is systemic racism.
“The same broad-sweeping structural racism that enables police brutality against black Americans is also responsible for higher mortality among black Americans with Covid-19,” Maimuna Majumder, a Harvard epidemiologist working on the Covid-19 response, tells Vox.
“One in every 1,000 black men and boys can expect to be killed by police in this country,” she says. “To me, this clearly illustrates why police brutality is a public health problem; anything that causes mortality at such a scale is a public health problem.”
As the Covid-19 crisis continues, it’s also become clear that black communities, and other communities of color, have suffered a disproportionate burden. Law professors Ruqaiijah Yearby and Seema Mohapatra recently explained this in detail in the Journal of Law and Bioscience:
African Americans make up just 12% of the population in Washtenaw County, Michigan but have suffered a staggering 46% of COVID-19 infections. In Chicago, Illinois, African Americans account for 29% of population, but have suffered 70% of COVID-19 related deaths of those whose ethnicity is known. In Washington, Latinos represent 13% of the population, but account for 31% of the COVID-19 cases, while in Iowa Latinos comprise are 6% of the population but 20% of COVID-19 infections.
The African American COVID-19 death rates are higher than their percentage of the population in racially segregated cities and states including Milwaukee, Wisconsin (66% of deaths, 41% of population), Illinois (43% of deaths, 28% of infections, 15% of population), and Louisiana (46% of deaths, 36% of population).
These racial and ethnic disparities in COVID-19 infections and deaths are a result of historical and current practices of racism that cause disparities in exposure, susceptibility and treatment.
Many racial and ethnic minorities, Yearby and Mohapatra write, have been classified as “essential workers,” and are unable to work from home, leave their job, or access paid sick leave. They live in denser housing and more often polluted communities than whites — a result of years of racist housing policy that puts them at greater risk during a pandemic. And when they do get sick, their access to health care is often limited (as is their ability to pay for it).
Can the mass protests alleviate the Covid-19 burden on these communities? Not immediately. And there is a real risk of making it worse. “The ongoing protests will increase risk of transmission,” Majumder says. But even so, she and many other health experts argue the protests are necessary. (There are ways to reduce the risk of spreading Covid-19 at a protest. Read about them here.)
“We can’t compare these two tragedies directly — but they both are public health crises that are operating at immense scales,” she says. “And in the case of black Americans, they’re interrelated, too. To me, these protests are about structural racism.” And that racism allows police brutality to persist, as it allows disease to spread.
Many other epidemiologists, doctors, and infectious disease researchers have also defended the current protests, highlighting the inextricable link between the heavy toll of Covid-19 on black communities and the history of racism:
1/ Those who earned big platforms from #covid19– your silence on racism will be deafening.
They are deeply interlinked
Until the deepest inequities are addressed— #racism being at the center of those…
— Abraar Karan (@AbraarKaran) May 31, 2020
Angry commenters are trying to “gotcha” me on this tweet so let me be clear:
Yes, I condemned the anti-lockdown protests. Yes, I support the #BlackLivesMatter protests. No, those aren’t contradictory views. COVID is a public health emergency. So is racism. We need to fight both. https://t.co/ilZHpcS5Te
— Ellie Murray (@EpiEllie) May 31, 2020
For the record, my personal opinion is that some injustices are too great to remain silent, where risks become acceptable because the damage they cause outweigh the benefits of not taking them. Epidemic racism meets that threshold. #BlackLivesMatter
— Dr. Angela Rasmussen (@angie_rasmussen) June 1, 2020
“What is the greater harm to society? Current and intergenerational trauma, which stems from police violence, or risk related to Covid-19?” Jaime Slaughter-Acey, an epidemiologist at the University of Minnesota, says. “The fact that people are out there protesting, despite the risks of Covid-19, tells you that the fear of police brutality, racism, is much more terrifying.” That said, Slaughter-Acey does worry about Covid-19 spreading at protests, and that it “would disproportionately affect the black community again.”
The forces that put many minority communities at risk during a pandemic have also put them at risk of police violence. Years of diminished economic opportunity, of marginalization, of structural racism, have led to both.
“In almost any way you measure it, the American criminal justice system is prejudiced against black Americans, and black people are much more likely to be subjected to state-sanctioned violence in the US compared to white Americans,” Vox’s Dylan Scott writes. Similarly, by almost every measure, black Americans face much larger risks when it comes to public health. They suffer heart disease, diabetes, asthma, and obesity in disproportionate numbers, too.
Systemic racism has also made the outcomes of the Covid-19 pandemic worse, too, because it creates mistrust in public institutions. ProPublica recently investigated the first 100 Covid-19 deaths in Chicago. Seventy of the deaths were African Americans, and ProPublica spoke to the families of 20 of them.
“Even though many of these victims had medical conditions that made them particularly susceptible to the virus, they didn’t always get clear or appropriate guidance about seeking treatment,” ProPublica writes in summary. “They lived near hospitals that they didn’t trust and that weren’t adequately prepared to treat COVID-19 cases.”
These people did not go to their community hospitals “because they did not feel that they were going to be treated,” Slaughter-Acey says. “And that is the same thing with police violence. Black Americans are less likely to call the police, even in a situation where police may be needed, because of fear that they might experience discrimination or be perceived as a perpetrator.”
Right now, the news is filled with images of mass gatherings at a time when social distancing should still be exercised. And more Covid-19 infections may come out of it. This is rightfully concerning. But that concern can exist alongside the concern of violence and death that black communities face, pandemic or not.
Confronting the racism that puts black Americans at higher risk of dying at the hands of police means confronting the racism that puts black Americans at higher risk of dying from Covid-19. There are policies and ideas that can be implemented to help reduce police violence. There are also policies and ideas that can ease the coronavirus burden on black and minority communities (Yearby and Mohapatra discuss more in their paper, which you can read here).
But, at least for now, the goal of the protests is the same goal as the response to the pandemic: saving lives.