Why Coronavirus Presents A Unique Challenge For African Americans

Dr. Stephanie Miles-Richardson of Morehouse School of Medicine notes an often overlooked consideration

COVID-19, the disease caused by the novel coronavirus is continuing its unabated spread around the world and through the United States. As medical professionals keep putting out messages of prevention, particular concern about how it is affecting minority communities is rising. 

Black people already face disproportionate health issues when compared to whites. Our community is already at risk for heart disease, diabetes, and other chronic illnesses, which ultimately will make Blacks bigger targets for contracting and succumbing to the coronavirus. Comorbidity, or the simultaneous presence of two chronic diseases in one person, also makes it doubly hard to treat the virus. It’s for that reason Dr. Stephanie Miles-Richardson, associate dean, Graduate Education in Public Health at Morehouse School of Medicine says the emphasis for the Black community has to be on practicing preventative measures that are crucial for our survival. 

Miles-Richardson spoke with about the risks, what we need to do to stay safe and how she and other public health professionals are addressing the pandemic. Can you explain why comorbidity and COVID-19 is so problematic for Black people?
Dr. Stephanie Miles-Richardson: There are lots of coronaviruses, but this is a new one and because this is a new one, nobody’s immune system has antibodies to fight it. So it’s new for everybody. The people who are going to have the most challenges with it are the people who have other diseases already, and those we refer to as comorbidities.
Oftentimes in the African American community, you see more chronic disease, so there are more people who are likely to have other diseases, which suggests that their immune systems might not be as strong. That’s why we’re concerned about the elderly for example, people who have any other immune compromises. They’re just not going to be as strong to fight this new disease. Because it’s new, we all have to fight it as a stranger, and you can only do that when your immune system is strong. 

This is why we believe why this isn’t impacting children as much because they have stronger immune systems. Kids who go to child care and school, they get all kinds of stuff and they bounce back because they have strong immune systems.
Also, when you think about our cultural practices, for example, church, social gatherings, those are not the places to be now because the virus will spread person to person through respiratory droplets. This is where social distancing comes in: to create space so the virus doesn’t have the opportunity to keep infecting more and more people. Is there anything we can do in particular to better fight the disease?
Dr. Miles-Richardson: It really boils down to prevention. Two things: washing your hands, because when you wash your hands, that’s actually the most effective weapon because it destroys the membrane of the virus, so you kill it. The other thing about the hands is that people tend to put their hands in their face and you never imagine how many times you put your hands to your face until you pay attention. It’s not a fantastic story, it’s just been developed into one by lack of information and the paranoia that goes along with that. The Black community thrives on… community.  We go to church. We go to our social gatherings. Do you think it will be harder for us to do social distancing or are people finally getting the message?
Dr. Miles-Richardson: I think it’s going to be harder because it’s a behavior change and people are social beings anyway, particularly in the African American community. However, it’s absolutely necessary for the season, which will [eventually] pass, but it will not pass unless we allow some distance that will prevent the spread of the virus. So we have to do it. We have to do things differently. We have to use technology.
I was just talking to my parents and I said you can try to get an iPad or I can send you a Zoom link, they don’t know what I’m talking about, but I can show them that we can still be face-to-face with that safe distance so that we can prevent the continued spread of the coronavirus. There’s no precedent for this, but have you seen things like this in the African American community?
Dr. Miles-Richardson: This is a new one for everybody. I think that one of the challenges that’s been from the outset with this particular pandemic, when it was considered an outbreak and even before we knew it was in the United States, is really about the messaging. Certainly the lack of tests made it difficult to contain because tests contain the virus because you isolate and you quantitate, but without tests, you can’t do that.
This is all very new from the standpoint of having to get information out quickly to multiple populations in different ways and it’s all a public health message. We can do this, I think we just have to craft messages for the population we need to get to. Be it New York, Atlanta, Los Angeles, many of us live in densely populated areas from crowded cul-de-sacs to over populated public housing. Is that also a risk factor against us?

Dr. Miles-Richardson: It’s up to an individual responsibility of washing hands and using sanitizer if you don’t have soap and water, and cleaning surfaces with disinfectant because the virus is believed to be transmitted through respiratory particles while sneezing and coughing. If you’re in a densely packed area you have to be more vigilant about cleaning and you have to be more vigilant about washing your hands.
Social distancing is said to be six feet away from another person. If that is not possible, you have to do the prevention like the cleaning of the hands, not touching your face and cleaning the surfaces. More importantly, if there’s a dense area and for example, there’s an elder who lives with a family, you really have to be careful about creating an opportunity for distance for that person who may be older or for that person who may have some other chronic diseases. The most marginalized among our community is the homeless. They may not have a place to make themselves distant and the message might not get to them. How is public health going to respond?
Dr. Miles-Richardson: That’s the question of the day. Here at Morehouse School of Medicine, we have a public health program that does community engagement and we’re wrestling with that right now. Part of it is information, but the other larger issue is resources. I don’t know how we’re going to handle that at this point, but that is definitely on our minds because what will happen is if everyone is not a part of this prevention effort, if everyone is not a part of the social distancing effort, we can’t get control of this virus.
Every population gets to be equal in this situation. We’re trying to figure that out, but that’s a tough one. When you have a transient community that doesn’t have the resources or the ability to distance, to sanitize, to wash hands, that’s a tough one.

For the latest on the coronavirus, contact your local health department and visit the Centers for Disease Control and Prevention website.

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