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COVID-19 Sacrifice Zones: Coronavirus Devastates Black Communities Historically Denied Healthcare

Web ExclusiveApril 09, 2020
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In Part 2 of our interview, family physician and epidemiologist Dr. Camara Phyllis Jones explains why the coronavirus is taking a devastating toll on black Americans. “People who are devalued and those people with limited opportunity are going to be impacted the worst,” says Dr. Jones. She also outlines principles for “valuing all individuals and populations equally” and achieving health equity. Her recent piece for Newsweek magazine is headlined “Coronavirus Disease Discriminates. Our Health Care Doesn’t Have To.”

This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: This is Democracy Now!,, The War and Peace Report. I’m Amy Goodman, with Nermeen Shaikh. Detroit bus driver Jason Hargrove died on Wednesday from complications of COVID-19. Hargrove was 50 years old. He was a father of six. He was an African-American bus driver. A week and a half ago, he posted a video on Facebook, after a woman on his bus coughed several times without covering her mouth. His video publicized the dangers blue-collar workers face during the pandemic, and has since been viewed close to a million times. This is an excerpt of that video.

JASON HARGROVE: This coronavirus [bleep] is for real. And we out here as public workers doing our job, trying to make an honest living, to take care of our families. But for you to get on the bus and stand on the bus and cough several times without covering up your mouth, and you know that we in the middle of a pandemic, that lets me know that some folks don’t care. That [bleep] was uncalled for. I feel violated. I feel violated for the folks that was on the bus when this happened. It was about a good eight, nine people on the bus, and she stood there and coughed, never covered up her mouth.

AMY GOODMAN: That was Jason Hargrove, 50-year-old bus driver. He got sick a few days after making this video, and he has since died.

Today we’re continuing to look at the devastating toll the coronavirus is taking on black Americans, disproportionately dying from the virus across the country. In Michigan and Illinois, African Americans make up 14 to 15% of the population but account for 41% of the COVID-19 deaths. In Chicago alone, black people account for 70% of the city’s deaths but under a third of the population. In Louisiana, one of the hot spots of the coronavirus, African Americans comprise just about a third of the population but, again, 70% of the COVID-19-related deaths.

We now turn to Part 2 of our conversation with Camara Phyllis Jones, a family physician, epidemiologist, past president of the American Public Health Association. She recently wrote a piece for Newsweek magazine headlined “Coronavirus Disease Discriminates. Our Health Care Doesn’t Have To.”

Dr. Jones, if you can comment on this heartbreaking video of a bus driver, who understood the implications of what was happening on his bus? He’s considered an essential worker. And so many of the essential workers, whether we’re talking about bus drivers or healthcare workers, whether we’re talking about delivery people, people who are running our transportation, so essential at this time, are people of color.

DR. CAMARA PHYLLIS JONES: That’s right. And we are not valued. That piece, I use to talk about three principles for achieving health equity, that are always going to be principles to guide our actions, to help us evaluate policies, to identify holes. Those three principles, the first one is perhaps the most important: valuing all individuals and populations equally. And what Mr. Hargrove’s video demonstrates and what all of these black and brown bodies piling up so fast demonstrates, that we have — we’re not even valuing that essential work that is allowing others of us to safely shelter in place. We’re not providing people with the protective equipment they need. We’re not providing them with hazard pay. We’re not allowing — there’s some people out there on the frontlines who only wish that they would be able to shelter in place, but they don’t have the wealth to fall back on. The package from Congress is supposed to be getting — you know, providing paid sick leave, keeping people on the job, unemployment insurance, but even that is hard to access. It shouldn’t be hard. But this valuing piece is very important.

I just want to mention the other two principles, because maybe you want to go deep on those, as well. The second principle for achieving health equity is recognizing and rectifying historical injustices. And the third is providing resources according to need — not equally, but according to need.

NERMEEN SHAIKH: And, Dr. Jones, I mean, it’s not just — as we were mentioning earlier, it’s not just New York Governor Andrew Cuomo who initially said that the coronavirus is a “great equalizer.” I mean, there were people all over the world who thought that, you know, it was a great equalizer, because all kinds of people were getting it.


NERMEEN SHAIKH: And, of course, we heard much more about very prominent people who were infected, now including the British Prime Minister Boris Johnson, who’s in the ICU. But can you tell us what is it that brought to light — because it’s not just in the U.S., but around the world. It’s working-class people who are suffering disproportionately, and it is, exactly as you pointed out, working-class people who have the most health and other vulnerabilities.

DR. CAMARA PHYLLIS JONES: Yes. So, it is true that in December of 2019, no human on this planet was immune to this virus. So, it could have been the great equalizer. It should have reminded us that we’re all in this together. And if opportunity were equally distributed and risk was equally distributed around the world, or even in a given society, then we would not see differences in who’s getting sicker and who’s dying from this, no matter how you sliced and diced the population. But opportunity is not equally distributed. Risk is not equally distributed. And so that’s why this virus is like a heat-seeking missile landing squarely on the backs of working-class people, people who have been devalued, people who have limited opportunity.

In the United States, where many people still deny that racism exists and has continued profound impacts on the health and well-being of the nation, then people are acting surprised. But I think that even people in the United States might look at another country, say, India, where they recognize that there is a caste system in Hindu — in the Hindu population and that they might — U.S. people looking at India, if they have any sense of it, might say, “Mmm, yes, maybe the Dalit caste, the ones that some people term 'untouchables,' maybe they’ll get it more and they’ll die from it more than the Brahmin caste,” that some people, you know, think of as the highest caste. They could see that in India. But when we get to the United States, people do not recognize that U.S. racism is casteism based on so-called race, based on the social interpretation of how we look. So, that is why, however you structure opportunity and assign value in any society, those people who are devalued and those people with limited opportunity are going to be impacted the worst.

AMY GOODMAN: So, let’s turn to the words of Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, speaking on Tuesday.

DR. ANTHONY FAUCI: We have known, literally forever, that diseases like diabetes, hypertension, obesity and asthma are disproportionately afflicting the minority populations, particularly the African Americans. Unfortunately, when you look at the predisposing conditions that lead to a bad outcome with coronavirus, the things that get people into ICUs, that require intubation and often lead to death, they are just those very comorbidities that are, unfortunately, disproportionately prevalent in the African-American population. So we’re very concerned about that. It’s very sad. It’s nothing we can do about it right now except to try and give them the best possible care.

AMY GOODMAN: That’s Dr. Anthony Fauci, right now the top doc in the United States, the scientist, who so often President Trump disregards. And I wanted to put that issue also in the context of environmental racism. New York City health officials just released data suggesting the coronavirus is hitting low-income New Yorkers in a way that it is not hitting others. The low-income neighborhood, for example, of Mott Haven, you have it known as “Asthma Alley” because of the extremely high levels of air pollution. Residents are hospitalized for asthma at five times the rate of the national average. And then you’ve got, oh, the area from New Orleans to Baton Rouge known as “Cancer Alley” —


AMY GOODMAN: — the EPA recently suspending environmental regulations designed to protect the predominantly black communities in that part of the state. Can you relate this horrific disparity, that is being most reflected in the high mortality rate of African Americans with coronavirus, to issues of environmental racism?

DR. CAMARA PHYLLIS JONES: Absolutely. Do you know that there’s even a term called “sacrifice zones” to describe areas around polluting industries, which are almost uniformly populated by black and brown people, or at least poor people? Yes, absolutely.

As I was listening to Dr. Fauci, whom I respect, the way he was talking about this excess burden of disease caused by environmental hazards, caused by limited access to healthy resources, green space, he was talking about this as, “Unfortunately, we know that these populations have more of this,” as if that was something that — he did say, “We can’t do anything about it in the short term except give more resources,” but this doesn’t just so happen. It is entirely about the conditions of our lives and the exposures in our lives. People who study racial — “racial” — health disparities have come to the conclusion that racism is at the base of all of that. So, all we have to do is restructure our society. I say “all we have to do,” but that is possible to do that.

We should — in this country, people act as if the present were disconnected from the past and as if the current distribution of advantage and disadvantage were happenstance. We are ahistorical. People act as if structures and systems were invisible and irrelevant, because we are narrowly focused on the individual. People act as if it’s your fault if you get sick or if you live in a poor neighborhood or in a polluted neighborhood, because we endorse this myth of meritocracy, that if you work hard, you will make it. Never mind that there are people who are working just as hard or harder as people who have made it, who will never make it because of an uneven playing field.

There are, I have actually distilled, seven different kind of societal or cultural barriers to achieving health equity — those are the first three — that are contributing to the situation in which we find themselves and that we need to address. We need to address the opportunities, and we need to address these values pieces, as well, to get to equity.

AMY GOODMAN: And then, where we’re headed after the pandemic. You have the White House now talking about opening up the country as fast as possible. We see President Trump didn’t want to issue a federal stay-at-home order. He has been resisting so much of what his doctors have said, now wants to open up the country as fast as possible. We know what he was saying, right before Easter, that he would have the country open by Easter so people could go to their churches, which of course would, in the end, infect more people. But in opening up the country and the economy — as we’ve heard all over the world now, the level of smog that has gone down —


AMY GOODMAN: — because economies were brought to a halt.


AMY GOODMAN: Now, of course, economies brought to a halt is not a good thing. But the effect, what does this mean, as we’ve seen during this time President Trump, for example, has issued the largest rollback of environmental protections we’ve ever seen, and what it means if the country is then revved right up? Who are going to be the most affected by this?

DR. CAMARA PHYLLIS JONES: Well, Amy, you know. It’s like you want me to say it. We all know, everybody listening to this knows, that the people who are going to be the most affected are those who are most vulnerable. And they’re not vulnerable because they’re biologically different or less hard-working. They’re most vulnerable because of how we have structured our society.

You know, I have to say this: We have a dangerous leader right now in this country. He has been dangerous for three-and-a-half years. He is particularly dangerous, because of his narcissism and his limited future orientation, to be shepherding us through this pandemic. So what we need to do is to make change. We need to organize. While we are physically distanced, we need to be socially connected. We need to be organizing. And we need to be focusing on November 3rd, because, God forbid, we keep with this same leadership, we and the whole world are doomed. The other —

AMY GOODMAN: Is this your prescription, Dr. Jones?

DR. CAMARA PHYLLIS JONES: It is my prescription. It is definitely my prescription.

The other thing, just as an epidemiologist looking at the epidemic curve, people have been talking as if, “Yes, OK, we’re reaching the top of the curve, we’re going to peak, and then we’re going to go down.” This is going to be a series — depending on how we handle this, it’s going to be a series of curves. And this idea of flattening the curve, it’s not just going to be one curve. We’re trying to flatten the curve so that we don’t exceed our healthcare resources at any given time. But more and more people are going to get this disease until we have a cure or a vaccine, or until enough of us have gone through this and survived and come out on the other side, that we can provide what’s called herd immunity.

But what we’re actually doing is we’re freezing the body politic, in the same way that a few rich people, just before they died, had their bodies frozen, because they figure, “I’m dying from disease X. Pretty soon there’s going to be a cure for disease X. They can thaw me out when they have the cure, and then — boom! — I’ll be, you know, forever alive.” Well, what we’re doing is we are trying to freeze the body politic and wait for a cure or a vaccine. That is going to be a 12-month to an 18-month process. To the extent that we open up too soon, we’re going to be doing this as opposed to this. Right.

AMY GOODMAN: Camara Phyllis Jones, we want to thank you so much for being with us. Dr. Jones is a family physician, an epidemiologist, the past president of the American Public Health Association. She teaches at Emory Rollins School of Public Health in Atlanta, as well as the Morehouse School of Medicine. She’s currently the Evelyn Green Davis fellow at the Radcliffe Institute for Advanced Study at Harvard University. We’ll link to her recent piece in Newsweek magazine headlined “Coronavirus Disease Discriminates. Our Health Care Doesn’t Have To.”

This is Democracy Now! To see Part 1 of our discussion with Dr. Jones, go to I’m Amy Goodman, with Nermeen Shaikh. Thanks so much for joining us.

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