Health Care Workers and Covid-19
June 18, 2020
Parenting in a Pandemic
August 17, 2020

By: LaTonya Trotter

8/14/2020

When the novel coronavirus first began to spread in the US, some opined that “we were all in this together.” The virus is impersonal; it does not care who one happens to be. This statement may be true for the virus, but “who one is” matters in terms of shaping risk of infection, prognosis, and how deeply the pandemic impacts economic and social well being. As the pandemic tightens its grip, there are clear signs that the intersecting pathogens of white supremacy and patriarchal ideology are responsible for disparate and unequal outcomes.

Using data that they had to file a lawsuit against the Centers for Disease Control and Prevention to obtain, the New York Times found that Black and Latinx individuals were three times more likely to be infected with the coronavirus, and two times more likely to die from Covid-19 than their white counterparts. This broad pattern held true regardless of whether one lived in a dense city, a quiet suburb, or a small, rural town. While pre-existing health conditions account for some of these mortality differences, the primary determinant of who dies is who gets infected. A primary source of infection for Black and Brown communities is unequal risk at work.

Black and Brown workers are much more likely to be exposed to the coronavirus through work. The longstanding devaluation of care work—whether typified by direct caregiving or by service work–has meant that Black and Brown workers are disproportionately represented in the lowest paid sectors of the essential workforce. This risk is an intersectional one. Black and Brown women are overrepresented in work that requires face-to-face interaction with the public. Collectively, such workers not only bear an increased risk of infection, but are also less likely to have access to the quality health care that could increase their chances of survival. The precarious nature of the low-wage, essential workforce also means that workers have little power to negotiate for better workplace protections, do not have access to sick leave, and are often explicitly pressured to choose between working while ill and losing their jobs. 

However, the pandemic’s toll on communities of color extends beyond the ravages of the virus itself. It has also exacerbated pre existing health disparities. An illustrative example is the case of maternal mortality. Large disparities between Black and white maternal deaths were present before the pandemic. There is evidence however, that the coronavirus is amplifying those disparities. Some of this impact is due to differences in exposure: Black and Latinx people with pregnancies are more likely to test positive for the coronavirus than their white counterparts–in part due to their increased rates of exposure. However, in straining the health care system, the pandemic has created new hurdles to prenatal, labor and delivery, and postpartum care–making services that were already difficult to access, even harder. Patients report struggling to get appointments, obtain appropriate follow-up, and to have their concerns taken seriously. Moreover, the often life-saving advocacy of family, partners, and doulas that many Black women rely on to mitigate the racist bias and disregard they face within health care, has been curtailed by pandemic-specific policies that bar everyone but the patient from entering hospitals and clinics. 

The coronavirus may not discriminate. But structural inequalities clearly shape who is most vulnerable to infection, illness, and mortality. The virus did not enter a world where we all share the same risks, but one where Black and Brown people were already challenged by the intertwined “preexisting conditions” of racism and gender oppression. While scientists race to find a vaccine, policy makers should move with similar urgency to tackle the scourge of institutionalized inequality.

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