On Friday, CDC Director Walensky noted disproportionate Covid case counts and deaths in communities of color and declared racism a serious public health threat. But that’s not supported by the data. According to the latest data from the CDC (April 7, 2021), it’s actually whites that are suffering a public health crisis. Whites are disproportionately dying from Covid-19 – not communities of color. Proportional to racial/ethnic populations there have been 4,318 more white deaths, and 6,542 fewer community of color deaths (Latino, black, Asian, Native American, Hawaiian and Pacific Islanders).
Among the communities of color, one group has a disproportionately high death rate, and four have disproportionately low rates. The high rate is for blacks (14.6% vs 13.4% of population), but this is not due to racism, any more than any other high or low rates are due to racism — or privilege. It is due to the disproportionate presence or absence of pre-existing conditions that are known to contribute to higher death rates. The presence or absence of pre-existing conditions that are also unrelated to racism, but they are related to weight, active or sedentary lifestyles, and being diligent or remiss with preventative health measures.
Sedentary lifestyles. A study between 1988 and 2010 found the percent of men reporting no physical activity jumped from 11% to 42%, and from 19% to 52% for women. People that meet the CDC’s exercise guidelines are low across races/ethnicities. For whites 25.7% met guidelines. For blacks it was 19.9%, and Native Americans 19.1%. (Asians 22.9%, Latinos 21.4%.) Asedentary lifestyle increases the presence of medical disorders, including heart diseases, diabetes, kidney disease, cancer, hypertension, dementia, obesity, and respiratory diseases. These are all very common Covid comorbidities.
Obesity. From 1999 to 2018, the prevalence of obesity and severe obesity in America leapt from 30.5% to 42.4% and 4.7% to 9.2% respectively. Being overweight is the single greatest, or a significant, contributing factor to all of the Covid comorbidities just noted. Culturally, blacks generally accept “larger body sizes and feel less guilty about overeating than other ethnic groups.” Blacks are 13.4% of the population and 25% of the overweight, 19% of the obese, and 22% of the severely obese populations. Native Americans are 1.2% of the population and 7.6% of the overweight population. Latinos are 18.5% of the population, and 21% of the obese population. Whites are 60% of the population, and 64% of the severely obese population.
Pre-existing conditions. According to the CDC, being overweight (emphasis on obesity) may triple the risk of hospitalization from Covid. It also increases the risk of dying from Covid by 148%. All other pre-existing conditions that dramatically increase the risk of dying from Covid also correlate with being overweight and sedentary. This includes cardiovascular disease (225% increase in risk), heart failure (203%), diabetes (148%), kidney disease (325%), cancer (147%), and hypertension (182%). The CDC found that 38% of people categorized as dying from Covid also had heart-related diseases, 16% diabetes, 9.8% kidney failure, 19.1% hypertension, 13.7% dementia, 63% respiratory diseases, and 45.7% influenza and pneumonia.
Blacks are most disproportionately represented in six out of seven of the dramatically increased-risk categories and all of the most common comorbidity categories. Whites are most likely to have cancer. Suffice it to say that all races/ethnicities have too many people in all of these risk categories.
The flu as a comorbidity. The presence of the flu or pneumonia as comorbidities correlate to vaccination rates. Low vaccination rates occur across all races/ethnicities. Vaccination rates are especially important for older people, particularly during the pandemic because 80.5% of the dead thus far are 65 or over. Depending on the racial/ethnic group 29-51% of people over 65 did NOT get vaccinated in the 2019/2020 flu season. For pneumonia, 24-46% of people over 65 have never been vaccinated. The reasons people choose not to get vaccinated are commonly personal. Latinos don’t get vaccinated because of time, money, fear of needles, side effects, feeling healthy… Some whites don’t think getting sick is a big deal. Blacks commonly said they didn’t get vaccinated due to reasons related to a history of racism. Turns out during Covid, not getting vaccinated contributed to dying.
Insurance. The presence of healthcare insurance does not appear to have an effect on the different health outcomes. Today uninsured include 21% of Latinos, 11% of blacks, 11% of Asians, and 8% of whites. Most people that aren’t insured today are young people who don’t qualify for Medicaid and do not see the cost of healthcare as a good economic decision.
Prescription for health. Disproportionate Covid deaths like the disproportionate presence of many other health conditions correlate to different lifestyle and personal decisions. African American Dr. Richard White from the Mayo Clinic has studied the correlation between health literacy, chronic health diseases and obesity in minority populations. He said: “It’s really going to require the African American community to come together as a unit to really say, ‘you know what? This is our health as a community, this is something that we’re going to take the initiative and interest to improve ourselves and not necessarily rely on outside or external forces to try and make it happen for us.” His advice appears to be spot on for the black community. In one study, it was found that African American health habits are not influenced by external sources, like medical doctors or government health advisories. Blacks, instead, must draw their own conclusions and then act on them. That sounds like a sensible solution for all Americans. Covid deaths have hit every racial/ethnic group too hard, and all Americans should be thinking about choices and decisions to have a healthier life.
If you want to learn more about the correlation between racism and other health maladies, or disproportional outcomes in education and law enforcement, you might to read America’s Discrimination Circus.