“We must recognize that there are many Ohioans who have an increased risk of being disproportionately impacted by COVID-19, and we must do everything we can to protect all Ohioans from this pandemic,” DeWine said.
The disparities in the death rate can be attributed to several underlying factors that have historically plagued the black community, said Dr. Karen Mathews, executive director of health and psychological services at Central State University. The factors include limited access to health-care, living conditions, socio-economic conditions and chronic illnesses such as high blood pressure, hypertension and lung and heat diseases, she said.
“Some of that is genetic and familiar, but a lot of it has to do with having access to good medical care to be able to participate in preventive maintenance, if you will,” said Mathews, a family physician who spent more than 30 years in the United State Air Force’s medical corp. “But if you don’t have transportation to go to a doctor or if you have a job that may not be flexible to allow you to make appointments, you’re not going to be participating in that prevention piece. And then once the diagnosis of the disease is established, then there’s that intervention piece.”
There are more than 777,000 confirmed COVID-19 cases in the United States, and the death toll was at 41,344 Monday afternoon. The state of Ohio is reporting 12,919 cases with 509 deaths since the outbreak, as of Monday evening. The total number of deaths include the CDC’s expanded definition of 18 probable cases, according to the Ohio health department.
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Across the country, including Ohio, race data for COVID-19 cases have been incomplete. Part of the issue is that when COVID-19 patients are being admitted to the hospital, they don’t include their race on the admittance forms. That created a 30% data gap in Ohio several weeks ago.
Dr. Amy Acton, director of the Ohio Department of Health and Ohio Gov. Mike DeWine appealed to people to include their race on forms when they take loved ones to the hospital. It paid off, as the as the data gap is at 21% as of Tuesday morning.
The federal government and some unversities have recently pushed to better track COVID-19 patients by race in recent weeks. The CDC launched a nationwide surveillance system to track COVID-19-related hospitalizations, including by race and other factors. They are also collecting data from death certificates, which will help agency officials know the numbers and percentage of deaths by race in different geographic areas of the country, said spokeswoman Kate Grusich.
Johns Hopkins’ data shows that while black people represent 13% of the population among the states that have reported racial and ethnic information, African Americans account for about 34% of total COVID-19 deaths. The CDC collected data from 10 states that have had at least 100 deaths, and found that nearly 19% of people who have succumbed to the virus in those states are black. In addition, black Americans represented 33% of hospitalizations, despite only making up 18% of the total population studied, according to the CDC.
The COVID-19 normally affects the lungs, but it can also affect all organs, said Mathews, a Dayton native who served at Wright-Patterson Air Force Base just before she retired from the service as a colonel. So while the virus can kill all people, regardless of race, those with a history of underlying health conditions tend to have a more difficult time fighting it off, she said. Black people tend to have a history of hypertension, diabetes, asthma, lung disease, cardiovascular disease, she said.
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In some cases, black Americans don’t know they have these conditions until its too late they don’t have access to health care. But when they do learn about their health conditions, they are unable to practice preventative care for a myriad of reasons, Mathews said. They may not have transportation to go to the doctor, or perhaps they have jobs at which they don’t have health insurance.
Nutrition also plays a role. People who live in food deserts don’t have access to fresh fruits and vegetables, and aren’t getting the proper amounts of nutrients and vitamins, she said.
“And so often, many segments of the African American community, not all, but many are in urban areas, or in really, really rural areas where there are food deserts,” she said.
Some black Americans who are aware that they have these underlying health conditions risk their health because of economic reasons. While others have the option of working remotely, some black people may have blue collar jobs that doesn’t allow them to work from home, so they have to expose themselves to the virus.
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Living condition is another economic factor, and it makes it difficulty for some black people to practice social distancing, Mathews said, noting that she prefers the term physical distancing.
“If you’ve got someone, for whatever reason, is living in a small house or a small apartment, and they’re responsible for other persons in that abode, how easy is it for them to (practice) social distancing?” she said. “It’s very difficult, it can be very challenging.”
Data has piled up for years showing that not all Ohioans have the same opportunity to live healthy lives, said Reem Aly, vice president to Health Policy Institute of Ohio, which provides nonpartisan guidance on health policy.
“Ohioans face consequences of both historical and contemporary racism and discrimination,” she said. “Historical policies and practices like redlining are going to have residual impact on Ohio communities of color and lead to poor health outcomes. But even the biases recorded within the health-care system can also have an impact on some of the disparities that we’re seeing.”
Black Ohioans have 2.9 time worse rates of child poverty compared to white Ohioans, 4.7 times more likely to attend a high-poverty high school, 2.7 times worse rates of unemployment and 1.4 times more likely to be uninsured, according to Ohio Health Value Dashboard published one year ago by Health Policy Institute of Ohio. In addition, are 1.6 times more likely to be unable to see a doctor due to cost, 2.9 times worse rates of infants who die before the first birthday, which is also considered an indicator of broader health stressors, and 1.3 times worse rates of adult diabetes, the institute said.
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These accumulating effects of opportunity, access and health outcomes can fuel gaps in health conditions, which now seem to be contributing to gaps in who is hit hardest during the COVID-19 pandemic.
“We just saw national data that was coming out linking long-term exposure to air pollution to increased risk of death from COVID-19, and black communities have higher exposure to pollution,” Aly said, giving an example of how these gaps in health and social conditions can fuel gaps in the pandemic’s impact.
Coronavirus deaths by race in 10 states with at least 100
Non-Hispanic White: 39%
*Non-Hispanic Black or African America: 18.6%
Non-Hispanic American Indian or Alaska Native: 0.3%
Non-Hispanic Asian: 13.6%
Hispanic or Latin: 26.7%
*Black Americans account for about 13% of the United State’s population
Source: The Centers for Disease Control and Prevention
By the numbers: Health disparities
14%: Ohio black adults with reported asthma in 2017
9.2%: Ohio white adults with reported asthma in 2017
Black Ohioans had a 19% higher age-adjusted heart disease death rate in 2016 compared with whites (Prevalence of heart disease did not differ by race).
Black men had the highest rate of heart disease deaths (273.8 per 100,000) in Ohio in 2016.
Black Ohioans have 1.3 times worse rates of adult diabetes than white Ohioans.
Source: Ohio Department of Health, Health Policy Institute of Ohio