Written By: Isha Lodhawala and Emma Bolkovac
The year 2020 is undoubtedly going down in history as one of the most tragic and uncertain times for not just America but the entire world. As the COVID-19 pandemic causes chaos and the Black Lives Matter protests highlight the injustices sought by Black people, a new light has been shone on human rights issues, especially in the area of healthcare. This light has revealed how marginalized groups have a disproportionate access to various social determinants of health, such as quality education, nutrient-rich food, and adequate income which leads to the inability to access proper healthcare. With respect to current events, the lack of these evidently inaccessible amenities puts Black populations at a much higher risk of contracting COVID-19. Thus, the concept of health equity in which everyone has a fair opportunity to live a healthy life is currently an unattainable dream. Unfortunately, this issue is so systemic that it starts in our very own community.
According to a Columbus report, there is an eight year difference in the life expectancy between residents of Hilltop, a Black majority neighborhood, and Upper Arlington, a White majority neighborhood. Having been to both neighborhoods, this is not a shocking statistic. Instead, what is shocking is that these neighborhoods are segregated by race, as depicted in the figure below. As a direct result of the demographics of Hilltop, the available resources and ultimately, the quality of life are compromised and diminished, leading to a lower life expectancy. This is a direct example of how redlining negatively impacts Black health. Although this is just one example of a small neighborhood within a small suburb in Columbus, it illustrates exactly what is happening across our entire country. Redlining, the direct and indirect segregation of minorities, is caused by historically racist policies and the continued stigmas within predominantly white neighborhoods against minority groups. Unfortunately, while redlining continues to play a very debilitating role in every aspect of our Black brothers’ and sisters’ lives, the issue is largely ignored. Although the concept may explain statistics such as why 55% of vulnerable youth in Columbus are people of color, we should never feel okay knowing that Black neighborhoods are more vulnerable to health issues solely because of this historical segregation. Highlighting these issues is the initial step towards fighting systemic racism in the world of healthcare.
Although this is just one example of a small neighborhood within a small suburb in Columbus, it illustrates exactly what is happening across our entire country.
LACK OF QUALITY EDUCATION:
Studying health disparities begins with understanding one of the most fundamental components of a community: education. Lower income neighborhoods, often composed of large Black populations, have a lack of educational opportunities. This is primarily because a school’s funding is dependent on the property taxes it receives from its surrounding area. As a result, a lower income area would have schools that are less funded, leading to less resources for students, such as lack of new technology and textbooks and decreased availability of academic and mental support services. Additionally, low income areas are more likely to have children participate in gang activity and violence. This is largely due to the fact that these children, often minorities, are subject to unique hardships such as poverty, educational setbacks, immigration, drug usage, and an overall lack of resources. These conditions enable gang activity to thrive in these areas and it thus increases victimization rates causing students to avoid going to school entirely, in the fear that doing so may compromise their safety. Thus, this constant fear which students begin to associate with school decreases their likelihood to attend classes, perform well, and eventually graduate.
The combination of the lack of educational resources and high gang violence rates contributes to a lower graduation rate for Black children. In fact, according to the, in Columbus “… the graduation rate in very high vulnerability neighborhoods is 73 percent, compared to 94 percent in very low vulnerability neighborhoods.” The lack of educational opportunities which inturn leads to lower graduation rates makes it extremely difficult for these individuals to make healthy lifestyle decisions in the present and future. Furthermore, these educational hardships prevent upward mobility in employment and financial stability, directly influencing accessibility to healthcare.
These educational setbacks are related to the amount of Black families that live on the poverty line. In fact, according to the Ohio Poverty Report, “At every age, poverty rates are lower – usually much lower – for the majority than for minorities,” This is especially true for zero to five year olds where poverty rates are 42% for minority males and and 15% for non-Hispanic White males, respectively. As a result, these poverty-ridden communities, which have decreased educational and employment opportunities, do not possess jobs which can sustain a family. This requires individuals to travel farther distances to work although transportation is often inaccessible. Furthermore, at these workplaces, Black individuals are likely to suffer economic hardships based on racist hiring practices and their lower qualifications due to predisposed educational disadvantages.
As a combination of all of these difficulties, Black individuals cannot leave to earn money. Instead, they are ‘stuck’ in their situations.
THE UNAVAILABILITY OF HEALTHY FOOD:
These low income areas are also impacted by environmental racism, leading to the formation of food deserts. Food deserts are areas within neighborhoods which have limited access to nutritious food and resources. These areas have increased fast food restaurants and a decreased availability of grocery stores. For example, in Columbus, Franklin county has 92 grocery stores but 588 fast food locations. Because marginalized communities have a lower accessibility to transportation and cannot afford more costly, but healthy groceries, they resort to purchasing the most affordable and conveniently located food options. Unfortunately, these available options are higher in calories and preservatives. Consistently consuming them increases the risk of developing certain health conditions such as diabetes, certain cancers, kidney disease, and hypertension. It is speculated that these health complications may be intensified by the “Slavery Hypertension Hypothesis,” which suggests that African Americans developed an enhanced ability to conserve salts due to the treacherous Atlantic passage. Although the physical concept of slavery has technically been abolished, its impacts are long lived and continue to take major physical tolls on the lives of our Black brothers and sisters.
INABILITY TO ACCESS HEALTHCARE:
The financial barrier created by the lack of educational and employment opportunities has had significant impacts in Black communities’ accessibility to healthcare. Additionally, certain situational issues such as food deserts have increased the need for certain types of preventative care and treatment such as for Hypertension. However, this is unattainable for a large proportion of Black individuals because treatments, prescriptions and check-ups are expensive and therefore, inaccessible. This causes numerous health conditions to go undiagnosed and untreated. Additionally, similar to how schools in underfunded areas have a lack of resources, hospitals work the same way. When patients do not have health insurance or when they are on Medicare, hospitals are reimbursed to only cover the minimal cost of providing care, which is actually not an adequate amount. However, when private payers are covering the costs, hospitals are reimbursed much thoroughly. Unfortunately, Black populations are subject to higher rates of poverty which increase their likelihood of being on government-provided healthcare assistance, if any at all. This decreases the funding of hospitals in high vulnerability areas. As a result, these hospitals may be understaffed, have low quality technology and surgery equipment, and may hold a lower capacity.
INTERSECTION OF COVID-19 AND BLACK LIVES MATTER MOVEMENT:
All in all, the consequences of the unequal access to these social determinants of health such as quality education, nutrient-rich food, and adequate income, which are enforced by redlining, are quite devastating. And with respect to the COVID-19 pandemic and Black Lives Matter movement, the past few months have been an eye-opening testament to how this infection essentially targets vulnerable Black populations. In fact, Black individuals are killed from COVID-19 at 2.4 times the rate of White people. In Ohio, African Americans make up 12% of the population but they account for 20% of the COVID-19 cases.
These startlingly mortality and morbidity rates signify how systemic issues left certain populations disproportionately endangered during the time of crisis. Partially, this goes back to the fact that food deserts make it much more feasible to eat foods which can lead to the development of conditions such as hypertension and diabetes. Additionally, the genetics of African American individuals make them more susceptible to becoming immunocompromised. As a result of the increased consequences of these health complications, Black individuals are at a higher risk of contracting and eventually dying from COVID-19.
Additionally, this increased COVID-19 mortality rate in Black populations relates to the previously mentioned point regarding the interconnection between education, employment, and income. Because Black individuals are more likely to come from lower socioeconomic classes with minimal educational qualifications, they were required to pan out their quarantine as an essential employee. These workers did not have the luxury of working from home and they were forced to be exposed to more people in crowded areas therefore increasing their chances of being infected with COVID-19. To exacerbate these already confounding factors, the available medical treatment and testing for the infection is incredibly expensive for the uninsured. This barrier disproportionately impacts Black populations because considering the systemic issues which affect income level, health insurance is disproportionately inaccessible to these populations. Thus, COVID-19 is taking an immense financial burden on these families who are impacted by it.
Lastly, as the Black Lives Matter Protests have brought considerable attention to the unjust policing systems, it is important to understand how the policing and criminal justice system have impacted COVID-19 rates in Black populations. It starts in Black neighborhoods which are policed more heavily than white neighborhoods. Additionally, Black perpetrators are more likely to serve longer sentences in prison, placing them at a disproportionately higher percentage of the incarcerated population. Although 37.6% of the prison population is Black people, they only make up 13.4% of the American population. Due to the overcrowding of prisons as well as the lack of sanitary hygiene products available, COVID-19 spreads much quicker in incarcerated populations.
Some may claim that health disparities are a class issue and not a race issue, but the ample research and statistics presented here confirm that systemic racism and oppression are great contributors to declining Black health.
Thus, all of this data points to the fact that systemic racism and redlining have a negative impact on the lives of Black people, not just in Columbus but throughout America and the entire world. Some may claim that health disparities are a class issue and not a race issue, but the ample research and statistics presented here confirm that systemic racism and oppression are great contributors to declining Black health. The COVID-19 pandemic has simply brought attention to this overlooked systemic issue.
As more people are becoming aware of the health inequalities among Black people, and more information is being spread about historical racism and bigotry, movements towards social change are being mobilized. The Black Lives Matter movement is working to address the unfair treatment of Black people that is supported by our current racist system and past history. In fact, the Columbus community has been very active in this movement. Numerous protests have been held at the Columbus police station, township halls, and many more have been dispersed throughout the suburbs. This grassroot activism is very important and effective in bringing attention to these largely overlooked issues which continue to plague our society today.
HOW YOU CAN MAKE A CHANGE:
SO GET INVOLVED, and catalyze change in our nation.
As the youth of America, it is our individual obligation to help propel the movement through social action in hopes that these issues can finally be brought to light. Although protesting is wonderful, it may be difficult considering the ongoing pandemic. However, there are still a plethora of ways to instill action simply from home! Other ways include signing petitions, donating to Bail Fund, educating yourself on current events and even sharing information on social media. SO GET INVOLVED, and catalyze change in our nation.
Edited by Sumayyah Farooq