COVID-19 case data reveal serious race and income inequities in America’s health system


Boston #COVID19 cases by neighborhood, showing greater impact upon low-income neighborhoods. The same situation exists in other US cities.

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The case numbers are already there, the locations and the seriousness. Communities of color and of mostly low-income people are suffering proportionately more confirmed cases per population than in other sorts of neighborhoods, and the cases there are more likely to be serious and worse.

The question is, why ? Some suggest that workers in care centers, grocery work, office cleaning, waste fcolland senior citizen comple.xes are disproportionately of color and mostly low-income. True; yet hardly everyone living in such zip codes is a health care worker or nursing home aide. Others cite that grocery workers, office cleaners, janitorial, airport cleaning, and  transit employees are of color. True as well. Nonetheless, the numbers tell a story:

here in Boston, case frequency is higher in East Boston, Hyde Park, and Dorchester, less frequent in West Roxbury, Brighton, Fenway and Downtown. Despite our superb hospitals of worldwide reputation, the inequity is there..

Low-income City neighborhoods tend to be residentially denser. Residents greatly distrust the various governments, which hardly makes authorities’ job easier of warning people. Far less money is invested into hospitals and health clinics sites in low-income neighborhoods. Because residential segregation still exists in many cities — some of it semi-voluntarily — people of color, even if not low-income, are just as much at risk as very one lose living in these neighborhoods.

To be blunt : our health care system literally does not value low-income lives equally with other lives.

Which may not be anyone’s intention, yet the result seems plain.

Low-income people have many other health issues that go relatively unmet. Evidence of this under-investment in their health care include the following : stress and stress-related diagnostic issues ; abundance of diabetes, obesity and asthma cases (much of it aggravated by poverty pressures) ; and the density itself, often in old tenements, poorly maintained, or in poorly built structures readily dilapidated. Low-income people often work two or even three jobs, and they miss sufficient sleep; hours spent commuting by inefficient bus tire the body and stress the soul. 170 years ago, Henry David Thoreau noted that most people live lives of quiet desperation : is much the same not still true ? Fact is that our society accords far less economic or emotional security to low-income people than our ideals of equality promise; add to this deprivation frequent societal uneasiness about non-white skin color – and for those who have it – and you have the worst of health care Situations : isolation from easy pass and from the best health  care (and from much else), unhealthy density in often substandard housing, and a prevalence of poor nutrition.

We now see the consequences : disproportionate COVID19 cases of disproportionate severity, often untreated. The statistics from New Orleans, Detroit, District of Columbia, New York, Chicago,  Miami, and Philadelphia — and even Boston — do not lie, and they do not overstate.

We cannot let this situation continue. Once we get past the immediate battle, policy makers must enact legislation and establish City ordinances that demand a living wage for all workers and put in place solid building codes and aggressive housing inspection. Schools must monitor kids’ diet and insist.upon healthy choices. Of course no reforms that we might agree to do, at the last, won’t matter much if the nation generally does not embrace low-income people as their neighbors and people of color as Strivers, heroes, and success stories.

I may be asking way too much. But so do our national ideals and promises written in the Constitution we profess to revere.

—- Mike Freedberg / Here and Sphere.




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