Why COVID-19 Has Hit Black, Indigenous, and People of Color Hardest

COVID-19 has hit Black communities, people of color, and low-income families the hardest, both in terms of health and finances. Black and Latinx Americans are twice as likely to contract and die from COVID-19 as their white neighbors. Native Americans have also been disproportionately impacted by the virus, making up over half of COVID-19 cases in New Mexico and one-third of deaths in Montana. Meanwhile, people of color are almost twice as likely to report job loss and economic hardship due to the pandemic, making it especially difficult to afford crucial products for health and hygiene this back-to-school season. Read on to find out why COVID-19 has hit communities of color especially hard.

1) Black and Latinx Americans are more likely to be employed in essential roles, increasing their potential exposure to the virus.

Non-white Americans make up over 40% of the essential workforce, and they’re overrepresented in occupations with the highest risk of infection. A disproportionate amount of Black Americans work in public transportation and child care and social services, while a disproportionate amount of Latinx Americans work in building cleaning services and meatpacking industries.

Black and Latinx Americans are also more likely to work low-wage jobs, with fewer protections like health insurance and paid sick time off. As for those who do have the luxury of sheltering in place, roughly 1 in 5 Black workers and 1 in 6 Latinx workers are able to work from home (compared to 1 in 3 white workers).

2) Black, Native, and Latinx Americans are more likely to be uninsured than other populations, making them less likely to receive preventative care.

People of color make up over half of the uninsured population in the US, and Native and Latinx Americans are uninsured at over two times the rate of white Americans. There are a lot of factors that contribute to this disparity, including income, employment, citizenship, and language.

While the CARES Act has allocated funds to cover COVID-19 treatment for uninsured folks, there are still limitations to how many providers are participating in the program and how long the funds will last. Meanwhile, the burden of out-of-pocket medical expenses (and long-term medical debt) discourage uninsured folks from seeking preventative care or treatment for chronic conditions like asthma, diabetes, cardiovascular disease, and cancer -- all of which cause an increased risk of severe COVID-19 illness.

3) Black Americans are more likely to have preexisting conditions that increase the risk of complications from the virus.

Because of the way they affect the immune system, some underlying medical conditions make a person more vulnerable to the coronavirus, leading to more severe illness and higher rates of hospitalization. Black Americans in particular are more likely to experience some of these conditions, including diabetes, obesity, asthma, and cardiovascular disease -- often due to historic and current inequalities in housing, nutrition, and health care.

For example, a study from Princeton University found that Black children are twice as likely as other children to develop asthma because of where they lived. Neighborhoods with a majority of Black residents experienced more outdoor and indoor pollution from nearby highways and older homes. Residential segregation has long “trap[ped] minority children in unhealthy, polluted neighborhoods,” and it persists from a history of racial zoning, redlining, and exclusionary neighborhood covenants.

Black Americans also experience higher rates of diabetes, obesity, high blood pressure, and heart disease, and they can be traced to the inequalities in cost and access to fresh, healthy foods in communities of color. One multi-state study found that 8% of Black Americans live in a neighborhood with a supermarket, compared to 31% of white Americans.

4) Language barriers delay the communication of COVID-19 information and impact medical treatment.

As the COVID-19 pandemic was starting, news and information about the virus was evolving quickly and constantly. However, non-English speaking communities were often left out of crucial updates because of language barriers. Coronavirus responses in cities from Idaho to Arizona scrambled to find staff to translate health guidelines and resources into different languages.

Many people of color live in linguistically isolated households (a household where no one over the age of 14 speaks English “very well”), including about a quarter of Latinx Americans and 1 in 20 Native Americans. Even when non-English speaking folks seek out health care, linguistic barriers impact the quality of care they receive, their ability to get a proper diagnosis, and their understanding of treatment and discharge instructions.

5) Black, Native, and Latinx Americans are more likely to live in dense, multi-generational housing.

When folks live in denser areas, they come in contact with more people and increase their risk of being exposed to the virus. Multi-generational households also complicate COVID-19 risks by increasing the exposure of older, more vulnerable populations (which is unavoidable when a household member holds an essential job).

Black households are twice as likely to live in densely populated housing structures as white households, and Black workers are also more likely to live in multigenerational households. Due to growing Native populations and federal underfunding, there’s currently a housing crisis happening on tribal reservations, and it’s forcing Native Americans to overcrowd in multi-generational and multi-family homes. A lot of Latinx Americans live in similar conditions, with some California residents living in apartments shared by 10 or 15 people.

6) Black, Native, and Latinx Americans have less access to medical facilities and necessary medical supplies.

A history of legally segregated healthcare facilities has led to contemporary disparities in access to medical care. Low-income communities of color in both rural and urban areas experience chronic underfunding and even closures of their medical facilities, leaving them especially vulnerable during the current health crisis.

So-called safety net hospitals that primarily serve low-income patients and patients of color are operating with lower budgets and personnel than their private counterparts. A survey of Black health care workers at such facilities detail their lack of staff and medical supplies firsthand.

Even nursing homes with higher Black and Latinx residents have been twice as likely to be hit hard by COVID-19, and several of the affected facilities experienced under-staffing and a lack of protective gear.