The racial disparities in Minnesota’s coronavirus cases, explained

While people protest the death of a black man at the hands of a white Minneapolis police officer and a president with a history of inflaming racial tensions seemingly incites violence against those same protesters, black communities in Minnesota must also endure Covid-19. There, as elsewhere in the United States, the public health and economic crises are taking a harsher toll among minorities than the white majority.

Across the country, black Americans are getting infected with the coronavirus and dying from it at disproportionate rates compared to their share of the population. The Covid-19 mortality rate among black Americans is 2.4 times higher than it is for white people.

There is not a single explanation for that racial disparity, but many. Black Americans have historically struggled with their health compared to whites, a reflection of the US’s longstanding socioeconomic stratification by race, and black Americans have high rates of preexisting conditions that make patients more vulnerable to Covid-19. They are also more likely to work jobs that have been considered “essential” and cannot be done from home, which increases their risk of exposure to the virus. Spread among intergenerational households and exposure to air pollution could also help explain the high infection rates among black people.

The point is, the disparities in Covid-19’s impact are in many ways the byproduct of America’s structural racism — just like the deaths of George Floyd in Minneapolis, and Ahmaud Arbery in Georgia, and other black people who have died at the hands of white law enforcement officers or civilians. The escalation of the unrest in Minnesota, and President Trump’s inflammatory rhetoric against the protesters, is a reminder of how pervasive these problems remain.

Even in a mostly white state like Minnesota, black people may pay the price for the racial disparities in public health.

The breakdown of coronavirus cases in the state shows many of the same trends we have seen nationwide. Black people make up only 7 percent of the Minnesota population, but they account for 16 percent of the roughly 23,000 confirmed Covid-19 cases.

However, black Minnesotans do not appear to be dying at a disproportionate rate from Covid-19, at least based on the available data. Those trends could be a mirage, reflecting reporting and testing limitations, and/or they might be partially explained by the demographics of the different races in the state.

The average age of Minnesota’s white residents (over 40) is substantially older than that of its black residents (about 27 years old, according to public health experts I contacted). To put it another way, 24 percent of Minnesota’s white population is over 60 years old, while just 7 percent of the state’s black population is. (Minnesota has the biggest Somali population of any state, and that may help some of the age gap; the US-born population in the state skews older than migrants from African countries.)

We know Covid-19 is more dangerous for older people, and most of Minnesota’s confirmed Covid-19 deaths have occurred in nursing homes or other long-term care facilities. So Minnesota may simply be lucky, in a sense, that the black residents who are getting infected happened to be younger and therefore less at risk of a fatal case.

However, the experts I spoke with also warned it’s too early to draw firm conclusions about the fatality patterns between the races in Minnesota. A lot of recorded Covid-19 deaths don’t actually have racial markers attached to them. And biases in the testing may have contributed to an underreporting of black Covid-19 deaths in Minnesota.

If you step back and look at all excess mortality — how many deaths have occurred in 2020 compared to what would be expected during a normal year — the data suggests black Minnesotans are dying at a disproportionately high rate compared to the historical averages.

This inconsistent data reminds us that it is going to take a long time to suss out the precise impact of Covid-19 in Minnesota and across the country.

“Given the incomplete testing and incomplete recording of Covid deaths as such, I think it’s too early for anyone to say definitively that black Minnesotans are less likely to die, given infection, than white Minnesotans, but that pattern certainly can arise from the age differences between different racial groups in Minnesota, which are extreme,” Elizabeth Wrigley-Field, a sociology professor at the University of Minnesota who tracks Covid-19’s population health data, told me.

Nonwhite Minnesotans are also experiencing more economic pain during the coronavirus crisis compared to the white population. Black, Hispanic, and multiracial residents of the state account for 17 percent of the unemployment claims filed in the state since March 2, a slightly disproportionate share. And it must be repeated that black Minnesotans who are still working are more likely to have high-exposure occupations.

As A. Rochaun Meadows-Fernandez wrote for Vox this week, black families — and black mothers, in particular — are enduring compounding crises: the recent spate of police violence and the ongoing pandemic. And the resulting stress can be a health risk all its own. From her essay:

When unmasked, we Black mothers fear our loved ones will suffer from the risks associated with complications from the disease. When masked, we fear the risks associated with complications of bias and racism.

As Black mothers, we are living in an especially troublesome time — sandwiched between the current public health threat of Covid-19 and the longtime reality of police brutality. We are trapped in a double-bind of racism.

While there’s an influx of “pandemic grief guides,” none are useful in teaching Black children that the virus is terrifying, but that racism is the public health crisis more likely to kill you. There are no instructions about where Black mothers are supposed to place their fears and sorrow.

As Black mothers, grief is embedded in our being. It accumulates and manifests as body aches and pains. But many of us have never been taught how to deal with it so it doesn’t become yet another risk to our health.

Recent studies have actually found the mothers of children who face discrimination report worse health over time than the mothers of children who do not.

No crisis happens in isolation. The tragic events of the last week, and the disturbing disparities detected in the Covid-19 outbreak, are a reminder of how these separate challenges combine to harm the health of the people in America who already face structural disadvantages. There is, sadly, little sign those disparities are going to get better anytime soon.

This story appears in VoxCare, a newsletter from Vox on the latest twists and turns in America’s health care debate. Sign up to get VoxCare in your inbox along with more health care stats and news.

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