Blacks suffer most in crisis
Black Marylanders are suffering disproportionately from the new coronavirus shows information released Thursday by the state for the first time, drawing frustration, but not surprise from area political leaders and observers.
The rate of coronavirus infections and related deaths is higher among African American residents than whites or other groups, according to the new Maryland Department of Health data, which mirrors findings in several other states and cities. In Maryland, 49.4% of those infected whose race was known were black, 36.9% were white and 13.7% were Asian or another race.
African Americans also account for 53% of the related deaths among those whose race was known, while 38% were white and 5.5% were Asian.
Maryland’s population is about 30% black and nearly 60% white, according to U.S. Census data.
In a statement, Gov. Larry Hogan noted the “troubling disparities” in the data.
“On Tuesday, I directed [the Maryland
Department of Health] to begin publishing everything that is available on racial and ethnic breakdowns on COVID-19 cases, with updates as more data becomes available,” Hogan said. “Today, we are able to publish 75% of the currently available data, which shows troubling disparities and points to a persistent public health challenge that we must address.”
Race data, which is pulled from Wednesday’s count of 5,529 confirmed cases in the state, is not available for nearly 25% of Maryland’s confirmed cases, which rose to 6,185 on Thursday. But Hogan said Tuesday he is directing the state health lab to report such data from its tests and “be as proactive as anyone in the nation” in pushing private labs to do the same.
Hogan said significant data gaps remain because the private labs that do the most testing aren’t required to report on race. But state officials are supplementing their findings with patient information culled from a statewide health information exchange used by medical providers.
On Thursday, the state also announced there have been 138 deaths caused by the
virus. Black residents account for 55 of the 103 cases where race was known.
As racial disparities have emerged in other cities and states, Maryland health officials have faced pressure for about a week from legislators and others to release the racial breakdown of confirmed cases.
State Del. Nick Mosby has been a leading voice pressuring the Hogan administration to release the racial breakdown of coronavirus cases, saying an early analysis of the data is the only way to spot and rectify disparities.
“Wow,” the Baltimore Democrat said after he saw the size of the disparity. “From the data, we should develop our response.”
That race data alone, however, is not enough, Mosby said. Cases broken down by ZIP code would help officials target communities that are hit hardest with resources and information. In a segregated city like Baltimore, a person’s neighborhood determines so much about their predicted health outcomes.
On Thursday, when Baltimore Mayor Bernard C. “Jack” Young said the city’s first drive-thru coronavirus testing center at the Pimlico Race Course will open Friday morning, the city launched an online dashboard that breaks down the numbers of local cases by ZIP code.
Pimlico is in the heart of the city’s heaviest hit ZIP code: 21215 in Northwest Baltimore, which has 64 confirmed cases of COVID-19. About four in five of the area’s residents are black.
House of Delegates Speaker Adrienne A. Jones said she was hopeful the state would continue to press for more information from private labs to get a more accurate picture. Jones said she pressed Hogan last week when they met for a brief bill-signing ceremony. Jones also would like to see cases broken down by ZIP code.
“That way, concentrated efforts can be put in those areas,” said Jones, a Democrat who represents a district in western Baltimore County.
It’s important to ramp up testing as well as education about social distancing in neighborhoods that have high caseloads, Jones said.
“Instead of being reactive, be on the side of being more proactive,” Jones said.
The data in Maryland add to a growing base of information from across the country that officials call disturbing. While race is known for only about 3,300 of the nation’s 13,000 deaths, 42% of those were among black people, according to an Associated Press analysis. African Americans account for only about 21% of the total population in the areas covered by the analysis.
States reporting an over-representation of blacks included Alabama, Illinois, Louisiana, Michigan, Mississippi and North Carolina, as well as the counties and cities of Washington, D.C.; Miami-Dade, Florida; Milwaukee, Wisconsin; and New York City.
Public health experts who have long observed disparities between white and black neighborhoods say there is more than one likely reason for the coronavirus case imbalance. But they said it should push leaders in Maryland and elsewhere to take action in the short and long terms.
“It’s tragic, though not surprising, that African-Americans are disproportionately affected by COVID-19, because of systemic inequities that have resulted in longstanding health disparities,” said Dr. Leana Wen, a George Washington University professor and a former Baltimore City health commissioner. “Based on modeling, the D.C. and Baltimore-areas could be the next epicenters of the outbreak, and we should all be concerned about the disproportionate impact on communities that are already the most vulnerable and already face the greatest burden of racial and socioeconomic disparities.”
Darrell J. Gaskin, director of Johns Hopkins Center for Health Disparities Solutions, said any community that lacks access to health care and is on the lowest economic rung has been shown to be a prime target for chronic and infectious disease.
“There are a number of reasons why, in hindsight, this might have been predictable,” he said of the high COVID-19 cases in black communities.
Low-income black residents often don’t get appropriate primary care, which leads to chronic conditions such as heart disease and diabetes that exacerbate COVID-19. They often can’t stay home and properly distance themselves to avoid infection because of the types of jobs they continue to work even during a pandemic. They drive buses, stock grocery shelves and clean, rather than work on their computers
“They aren’t given personal protective equipment; they get infected and take it home to their families,” he said. “We thought of a solution that works for a large segment of our society, but not those who are marginalized.”
Gaskin said he hopes the data spark improvements in the underlying conditions that are known to make people vulnerable. He said higher wages, stable housing and access to health care are all needed.
“This is a moment in which we could probably get the political will to do something big,” he said.
There are other things to do immediately, Baltimore City Council President Brandon Scott said.
He said officials need to counter the myth that he continues to hear about black people being unable to contract the coronavirus.
“I need every, every, every single person in Baltimore to understand COVID-19 is real, and I need black people in Baltimore to understand it 10-times over,” he said. “We can see across the country we are contracting and dying of COVID-19 more than anyone else.”
In addition to racial data, Scott said, officials need geographic data to understand disparities. He recently introduced a bill requiring the city health commissioner to report patients’ races and ZIP codes during a health emergency.
Others also are calling for that kind of geographic information, including the Democratic members of Maryland’s congressional delegation, which sent a letter Thursday to Hogan.
“We share your concern about the disproportionate impact that COVID-19 appears to be having on black Marylanders and believe that this initial data demonstrates a need for more granular reporting by ZIP code,” said the letter.
“Additionally, we urge you to report complete and comprehensive data for all patients as expeditiously as possible and ensure that this data is informing Maryland’s COVID-19 response efforts,” said the letter from Democratic Maryland Sens. Ben Cardin and Chris Van Hollen as well as Democratic U.S. Reps. Steny Hoyer, Dutch Ruppersberger, John Sarbanes, Anthony Brown, Jamie Raskin, and David Trone.
Baltimore County Councilman Julian Jones, the only black member of the council, added that more testing would be helpful. He’s heard from constituents who had coronavirus symptoms, but whose doctors didn’t order the test.
“That’s been a sore spot in the whole system from the word go, the lack of testing, the lack of available tests for people who need it,” he said.
Hogan mentioned the testing issue during a “town hall” program that aired Thursday afternoon on Fox 45 in Baltimore and WJLA in Washington.
He said the state had a large minority population, so it’s not unexpected to see more testing positive. The disparity, however, may be due to the level of testing in those black communities.
“In the Baltimore-Washington corridor, including Prince George’s, Montgomery County all the way through to Baltimore City, that’s where the highest concentration in numbers are and there’s definitely a higher percentage in the African-American communities,” he said. “We actually are doing far more testing in those communities.”
He said the most testing has been done in Prince George’s County, followed by Baltimore City and then Montgomery County.
But, he added, “some of it is there’s a higher population and a lot more density and some of it is that disparity that we’ve been talking about all across the country.”