Coronavirus disease 2019 (COVID-19) has demanded global attention as it claims the lives of more than 560,000 humans globally and more than 135,000 humans in the United States alone. COVID-19 death data in the United States by race, reveals a striking image of inequity. The data indicate that there are disproportionate deaths in Black and Latino communities. Certainly, minority communities have disproportionate rates of pre-existing medical conditions such as hypertension or high blood pressure, obesity, and asthma all of which increase the risk of severe illnesses from COVID-19. However, many of these pre-existing health conditions are the result of systemic issues, such as limited access to healthcare, that uniquely impact the health outcomes of minorities. A bigger picture is playing out in the United States, one in which COVID-19 has lifted the veil on a healthcare system that, like many aspects of the American society such as its criminal justice system or public education, have disturbing inequalities rooted in systemic racism and biases.

Prior to the rapid spread and growth of COVID-19 in America, the American healthcare system was in an ongoing battle to understand and address racial disparities in health care. This battle continues during the COVID-19 pandemic that has further exposed severe racial inequities in America’s healthcare system. A leading indicator of an individual or community’s health is access to healthcare which includes management of existing health conditions, preventive care, and early intervention. Systemic barriers like racism have prevented African Americans from accessing a quality education, securing employment and high-paying jobs that typically offer health insurance as part of its benefits package. These barriers are inhibitors to African Americans accessing quality healthcare in a country where universal healthcare is not a basic right, but merely a privilege that is reserved for…the privileged.

Many of the modern-day racial inequities that have been identified in America are the result of historic structural racism that stands firm on the foundation of the American government’s discriminatory policies and practices. One of the most successful and commonly used tools of structural racism in America is the criminal justice system. A system so perfectly designed to oppress minorities that it is frequently referred to as modern day slavery. Study after study has revealed that minorities receive longer and harsher sentences for the same crimes committed by their White counterparts. Infractions that typically result in a free pass or warning for White Americans often results in the arrest or death of African Americans. As prisons have proven to be profitable corporations, America has incarcerated its poor and minority communities at alarming rates. Researchers have demonstrated that incarceration has a negative effect on health outcomes by increasing the mortality and morbidity rates. Other examples include the practice of redlining that was intentionally designed by the American government to segregate America’s communities by race thereby largely contributing to the racial wealth gap we see today. The American government’s redlining practice not only limited home ownership for African Americans, significantly reduced the wealth of African Americans, and segregated America’s communities, but it also forced African Americans into areas with higher rates of deadly land and air pollution. Not by surprise, the hazardous areas that many African Americans were forced to live in resulted in serious health conditions such as cancer.

Furthermore, scholarly journals offer current and historic examples of studies that demonstrate less than adequate care provided to minorities even after controlling for economic status and insurance coverage. These studies further support the idea that racists and those with similar biases have created institutions that perpetuate racist views and biases through its culture by way of policies, hiring practices, and patient care. Thus, as can be predicted, when COVID-19 rapidly spread throughout the United States, it is minority communities that would bear the brunt of its impact and suffer from disproportionate deaths. COVID-19 merely pulled back the curtain on existing systemic healthcare inequalities that were plaguing the United States. The question becomes how did the revelation of COVID-19’s disproportionate impact on minority communities influence America’s response to the pandemic? Is this pandemic yet another example of how the American government responds or chooses to inadequately respond when the poor and politically powerless are most impacted? Knowing that poor and minority communities are America’s most severely impacted by COVID-19, how did governments choose to disseminate critical and limited COVID-19 resources such as funding, hand sanitizer, face masks, viral tests, antibody tests, etc.? These are the types of questions that we should all seek to answer and the type of questions that should fuel scholarly research and discussions. This is especially true in the field of public administration where issues of social equity, like those discussed in this post, are special editions in journals or viewed as important to a small group of predominately minority researchers. After all, what better support for social equity as the fourth pillar of public administration than the systemic inequalities in the American healthcare system and their effect on the COVID-19 pandemic.

Kenneth Dukes is a doctoral student in the Askew School of Public Administration at Florida State University. His research interests are issues of social equity, government accountability, and evidence-based policymaking.  Learn more about Kenneth on Linkedin.

The feature image is from City on a Hill Press.