8 Scientific American, August 2020 Illustration by Dani Pendergast
SCIENCE AGENDA
OPINION AND ANALYSIS FROM
SCIENTIFIC AMERICAN’S BOARD OF EDITORS
The U.S. has been roiled this year by two crises that seem on
the surface to be unrelated: the coronavirus pandemic and law-
enforcement killings of black Americans—the latter leading to
mass protests and police violence toward protesters. Although
the immediate causes of these two tragedies seem distinct, both
have their roots in structural racism. The virus has killed a dis-
proportionate number of black people (as well as other people of
color), and black people are by some estimates 2.5 times more
likely than white people to be killed by the police. Support is
building for police reform, and we can take concrete steps imme-
diately to protect the health of black Americans.
Deep health inequities have always existed in the U.S., but the
pandemic has shone an especially harsh light on them. A report
from the Centers for Disease Control and Prevention on a sample
of 580 people hospitalized with confirmed cases of COVID-
found that 33 percent of patients were black in a population sam-
ple where just 18 percent of the people were black. White people
made up 59 percent of the same population, but only 45 percent
were infected. Through April 16 in New York City, the death rate
among blacks was 92 per 100,000 people and among Latinx peo-
ple 74 per 100,000—whereas the numbers for white people and
Asian people were 45 and 35 per 100,000, respectively. These
trends are not limited to New York: the coronavirus has infected
and killed an outsize number of black people across the U.S.
Many people of color work in so-called essential industries such
as nursing or home health care, grocery stores and mass transit,
where they are more likely to come into close contact with people
who are sick. To make matters worse, these jobs are often poorly
paid, and a large proportion of such workers lack health or life
insurance. In addition, many black, Latinx and indigenous com-
munities have high rates of underlying health conditions, includ-
ing diabetes, hypertension and heart disease, which are known
risk factors for severe illness and death from COVID-19. These dis-
parities can be traced back largely to the racism and redlining that
have resulted in poor, overcrowded housing and exposed people
of color to more severe levels of air pollution—factors that exacer-
bate all these health problems. The Families First Coronavirus
Response Act and the Coronavirus Aid, Relief, and Economic Secu-
rity (CARES) Act, both of which Congress passed in March, did
very little to protect the health of essential workers, according to
policy experts across the political spectrum, because they focused
more on providing economic relief than medical care or benefits.
Tackling these health inequalities fully will require major
reforms in our health insurance system and a true effort to address
deep-seated racial and economic injustices. Some possible short-
term solutions are out there: the nonpartisan Brookings Institu-
tion published a report in March that called for enrolling all unin-
sured frontline essential workers and their families in a new “Medi-
care COVID” program that would cover all testing, treatment and
vaccinations related to COVID-19. (The CARES Act mandates that
insurance providers cover COVID-19 testing but not treatment.)
A proposal from the progressive advocacy group Center for
American Progress (CAP) asks for hazard pay for essential work-
ers and paid medical or family leave for workers to care for them-
selves or a sick family member (the Families First legislation includ-
ed a provision for two weeks’ paid sick leave but was full of exemp-
tions, mostly for large businesses and health care providers). CAP
also called for Congress to ensure coverage for COVID-19 testing
and treatments, regardless of immigration status. The House
recently passed a $3-trillion bill that would include many of these
provisions, but the legislation appears doomed in the Senate.
We should adopt these measures as a stopgap. But in the long
term, we need to expand access to affordable health care for all
Americans, and it should not be tied to employment. The Afford-
able Care Act (ACA) has made great strides toward this end and
has proved popular with most Americans, despite Republican
efforts to dismantle it. At minimum, we need to reopen ACA enroll-
ment in every state and provide incentives for all states to expand
Medicaid, which insures about 75 million low-income Americans.
Too many people of color lack access to even the most basic
health care, and others risk losing coverage for themselves and
their families if they lose their jobs. The next time there is a pan-
demic—and there will be a next time—we cannot allow the same
appalling racial disparities to determine who lives and who dies.Black Health
Matters
The coronavirus has killed a disproportion
ate number of people of color in the U.S.
There are ways to reduce the harm
By the Editors
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