By Lucy Erickson, PhD, SWHR Director of Science Programs
The COVID-19 pandemic is wreaking havoc worldwide, but its disproportionate impact on specific communities and groups of people follow along familiar lines, reflecting existing societal inequalities. In the United States, some of these vulnerable groups include the elderly and individuals with pre-existing conditions, homeless people, individuals with disabilities, and racial and ethnic minority communities.
Early data from New York City, the epicenter of the pandemic in the U.S., show alarming trends for increased infection and fatality rates for Hispanic and African American communities. Data from Arizona show a similarly concerning pattern with Native American communities.
However, there is an urgent need for better data, as many cities and states are not providing information broken down by the demographic factors needed to fully understand the impact of COVID-19 on these communities.
To make matters worse, some states are excluding Native Americans from their breakdowns, instead categorizing them as “other.” Abigail Echo-Hawk (Pawnee), director of the Urban Indian Health Institute and chief research officer for the Seattle Indian Health Board, reflected on the significance of this decision in an article by The Guardian: “By including us in the other category, it effectively eliminates us in the data.”
Incorporating gender into this picture is even more complex. Men appear to be at increased risk of dying from COVID-19, but in many other ways, women may be hardest hit by the pandemic. For example, women make up the majority of essential workers, including 77% of health care workers, and they also tend to do much of the unpaid caregiving and domestic work at home, which is currently amplified with children home from school due to social distancing.
At the intersection of ethnicity and gender, women of color are especially likely to bear the brunt of this public health crisis. As a result of historical structural inequities and discrimination, women of color face the compounded harms and challenges associated with both their gender and ethnicity.
In general, African American, Hispanic, and Native American communities tend to have higher rates of pre-existing conditions that are associated with increased risk for COVID-19, such as heart disease, asthma, and diabetes, and lower rates of health insurance.
Women — and especially women of color — are more likely than men to live in poverty, placing them at increased risk of food insecurity at a time when both grocery stories and food banks are experiencing shortages.
Women of color are also overrepresented in some of the industries experiencing the biggest job losses due to COVID-19, such as child care and hospitality. While many women of color have lost their jobs as a result of the current situation, those who are still employed are more likely to be working jobs on the front lines of the pandemic, without the option of working from home in safety.
Among women who do remain at home, some may experience unsafe conditions due to domestic violence. Although domestic violence impacts women from all ethnicities, there may be additional challenges for women of color, especially immigrant and undocumented women, who may face limited resources, language barriers, and fear of deportation.
Finally, with the novel coronavirus first occurring in China, Chinese American women and other Asian Americans are dealing with concerning reports of rising xenophobia, with racist threats and attacks surfacing across the country.
Although there is nothing new about these longstanding patterns of injustice and discrimination, the current situation has amplified inequalities and made even more clear how vulnerable these already marginalized communities are. As such, it is imperative that any pandemic recovery plan take these disparities into account.
We need a national dialogue about these issues and to enact policies and plans to address them during the recovery. Many groups, such as the Lawyers’ Committee for Civil Rights Under Law, are urging the government to collect and disseminate high-quality, accurate data broken down by ethnicity and gender as a first crucial step in this process.
Congressional leaders have also repeatedly drawn attention to racial and ethnic inequalities. In late March, a group of five U.S. senators and representatives sent a letter to Health and Human Services Secretary Alex Azar, noting that the government is “currently failing to collect and publicly report on the racial and ethnic demographic information” regarding both COVID-19 tests and patients. More recently, a larger group of Senators asked the Trump administration to do more to ensure that minority communities are not disproportionately affected by the pandemic. Senators have also pushed to ensure COVID-19 vaccine and drug treatment trials include women, racial and ethnic minorities, and members of the LGBTQ+ community.
These efforts appear to be having at least some impact. For example, some information on demographics and COVID-19 is now available on the Centers for Disease Control and Prevention website, along with recommendations on addressing the needs of vulnerable populations. However, there’s still a long way to go to ensure we are armed with sufficient information to understand the impact of COVID-19 on different communities. As challenging as the current situation is, perhaps the COVID-19 pandemic represents a new opportunity for us as a society to reflect on — and finally address — these longstanding social and health inequities.