Public health expert: ‘Marshall Plan’ needed to redress coronavirus race disparities

The coronavirus pandemic has turned a light on long accepted inequities like the segregation that has created pockets of poverty and violence on Chicago’s South and West sides, requiring nothing short of a “Marshall Plan” to redress them, according to a leading public health expert.

“Many Americans are shocked by the data emerging from multiple cities showing the disproportionate over-representation of African Americans — and in some cities Latinos as well — in terms of COVID-19 mortality,” lauded social scientist David R. Williams of Harvard University said Wednesday in a teleconference by the Robert Wood Johnson Foundation, the country’s largest public health philanthropy.

“The striking disparities we are seeing are not the fault of individuals, families and communities that are experiencing them. Instead, they reflect longstanding policies that have created pervasive social and economic inequalities in the United States,” Williams said. On Sunday, the U.S. surpassed 750,000 coronavirus cases, topping 40,000 deaths.

“The coronavirus is a call to action. It gives us a chance to make a commitment to do better than we have done in the past. Call it a ‘Marshall Plan’ for disadvantaged communities.”

Racial disparities in COVID-19 mortality were first highlighted by officials in Illinois and Chicago. The alarm then sounded nationwide.

By Sunday, Illinois had just over 30,000 cases, and 1290 deaths. While only 15% of the population, African Americans represent about 40% of those deaths.

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“Most Americans are unaware these disparities exist, and coronavirus is highlighting them,” said Williams, one of the world’s most cited public health experts who has served as a member of the Chicago-based MacArthur Foundation’s Research Network on Socioeconomic Status and Health.

“Minority workers are over-represented among essential workers in transit, in service, in grocery stores, in maintenance and so forth. Lower levels of socioeconomic status mean blacks and other minorities are more likely to continue to work outside the home when shelter-in-place directives are given. And in poor neighborhoods, social distancing is not a viable option when residing in high-density, often multi-generational housing units.”

The Centers for Disease Control and Prevention’s early demographic snapshot found African Americans — 13% of the U.S. population — represented 33% of COVID-19 hospitalizations. In several states, they are dying from the virus at a rate more than twice their population.

“Racial inequities actually exist not only for COVID-19 but for almost every disease. And we know access to testing and treatment is a problem,” Williams said, citing a 2003 report by the National Academy of Medicine, which found people of color receive lower-quality health care than whites, even when insurance, income, age and severity of conditions are comparable.

But Williams singled out Chicago’s entrenched segregation — “a powerful driver of inequality in American society” — as wielding a major impact on health outcomes.

“These inequities that have long-term effects on lifelong health are created early in life, at the neighborhood level,” Williams said, citing a January report by Brandeis University, the Child Opportunity Index 2.0, ranking nearly every U.S. neighborhood by 29 indicators.

The report found race a predictor of whether a child lives near good schools, healthy foods, parks and playgrounds, and living-wage jobs. Low opportunity neighborhoods were linked to lower life expectancy and lower economic mobility.

In the Chicago metropolitan area, 81% of African American children and 61% of Latino children were living in low, or very low, opportunity neighborhoods — vs. 12% of white children. Conversely, 64% of white children live in high, or very high, opportunity areas — vs. 9% of African American and 18% of Latino children.

Numerous other studies have documented segregation’s detrimental impact, including Harvard economists David Cutler and Edward Glaeser’s 1997 ”Are Ghettos Good or Bad?”

“They showed in a national sample of blacks and whites, that if we could erase residential segregation overnight, we would completely eliminate black-white differences in income, education and unemployment, and reduce black-white differences in single motherhood by two-thirds,” Williams noted.

So addressing racial disparities in COVID-19 deaths ultimately means eradicating the segregation, disinvestment and economic stagnation that have left communities of color vulnerable to the pandemic, he said.

“In 2060, the majority of persons on Social Security will be white. For every person on Social Security, there will be only two people paying into the Social Security system — one of those two will be black or Latino. Those kids are in kindergarten today,” he said.

“This is in all of our best interests. It’s really about creating opportunities for all Americans. There is high quality scientific evidence of the kinds of strategies we could implement that would reduce and eliminate these disparities. We just need to create the political will to do it.”