Washington State Must Consider Racial Inequalities When Rebuilding After COVID-19
It is substantially easier to talk about racial disparities in America than it is to actually fix them. We’ve heard of the disproportionate effect COVID-19 has on black communities in many U.S. urban cities like Chicago, Philadelphia and New Orleans. In Chicago, African-Americans account for “more than half of those who have tested positive and 72 percent of virus-related fatalities, even though they make up a little less than a third of the population.” These stories of black lives no doubt reflect larger inequities of health care access, historical mistrust of health institutions and socio-economic gaps. However, this sounding of the alarm isn’t surprising. This isn’t the first time that black people have been disproportionately affected in crisis. Jim Crow rendered the treatment of African Americans appalling during the Spanish flu where they often received substandard care in segregated hospitals. “Even in death, black bodies were neglected by white public infrastructure” as white sanitation departments refused to bury them. Is the COVID-19 pandemic history repeating itself? Jim Crow traded for other forms of systemic oppression like redlining and mass incarceration. Eradicating racial disparities would mean not only acknowledging our nation’s race problem but also recognizing that racism is fundamental to America. There has not been America without slavery. Without the massacre of blacks and Native Americans. Without the suffocating reality that I, while a doctor, am still three times more likely to die from pregnancy related complications compared to a white woman with less than a high school education. For a black woman in America, it is impossible to imagine a nation where my black body is valued beyond what profit it generates for those in power, pandemic or otherwise.
While Washington State has not released race and ethnicity demographics for COVID-19 cases, there is growing suspicion that we, too, may see racial inequalities for both the number of positive cases as well as resources mobilized. One of the best proxies for this is the comparison in rates of COVID-19 cases between King and Yakima counties. Most recent data from the Washington State Department of Health reports a total of 3,884 positive cases in King County which represents about 17.7 cases per 10,000. Despite being the eighth largest county in Washington, Yakima reported 427 positive cases which is also approximately 17.1 cases per 10,000. Racial disparities may, in fact, account for the similar rates of positive cases in both counties despite large population density differences. According to the latest U.S. Census Bureau data, Yakima County’s population is about 50 percent Hispanic and 42 percent white, non-Hispanic compared to King County where about 10 percent of residents are Hispanic and almost 60 percent are white, non-Hispanic. In 1990, only about a quarter of Yakima was Hispanic or Latino. This increase comes as mostly naturalized immigrants from Mexico have relocated to Yakima County year round for farming opportunities. COVID-19 has already caused significant disruption for this season as the U.S. suspended H2-A visa processing. This has undoubtedly had significant ramifications on Yakima’s already fragile economy where its poverty rate is 1.8 times more than the state’s. Despite Governor Inslee’s stay-at-home order, thousands of vital farmworkers still report to work every day given our state’s food supply would be at risk.
According to the Bureau of Labor Statistics, black and Hispanic workers are more than twice as likely to earn poverty-level wages compared to their white counterparts. These include service jobs like farmworkers, grocery store clerks and health care custodians who have been deemed essential during this pandemic. Most do not have access to paid sick leave and are at an increased risk for COVID-19 exposure. Fortunately, Washington State does require all employees have paid sick leave but some companies combine sick leave with paid-time-off (PTO). My family member works as a cashier. After much coaxing, I am finally able to convince her to use two weeks of PTO in order to have time off during the expected virus peak. The reality is many of us have multiple family members working on the frontlines. As a doctor, I care for children sick enough to be admitted to the hospital. I have two other family members who are nurses both caring for high-risk patients at nursing homes. One has shared that she often “fears” going to work due to the lack of personal protective equipment in her small facility. She dreadfully awaits the day when they will have a positive COVID-19 case but still needs to be able to pay her rent and provide for her son.
The Center for American Progress reported in 2016 that the median wealth for black and Hispanic families was $17,600 and $20,700 respectively compared to the median wealth for white families of $171,000. This persistent wealth gap between blacks and whites often “leaves African Americans in an economically precarious situation and creates a vicious cycle of economic struggle” which is only exacerbated under the current, financial circumstances. Unfortunately, we continue to see how inequitable practices, even as our federal government attempts to provide aid, unfairly disadvantages those who are already most vulnerable. Those set to be amongst the first to receive a stimulus check must have direct deposit. In 2017, 17 percent of black households were “unbanked” compared to 3 percent of white households.
Communities already at the margins continue to suffer during this pandemic. Intellectualizing risk factors for poverty, sickness and untimely death is easier to think about than racism is. To responsibly solve the problem of racism would involve a level of social and financial reckoning and accountability that is just too unsavory. While the revelation that COVID-19 disproportionately impacts marginalized communities is not novel, the lack of race and ethnicity COVID-19 data in Washington State may make targeted solutions and resource allotment more challenging. I am urging Washington state and local authorities to partner with both public health and the Center for Disease Control to make our state’s race and ethnicity COVID demographics known. This data would be integral to forming a plan that keeps minority, Washington residents at the forefront as we look toward rebuilding our state’s economy and infrastructure. This pandemic has created a shared, collective experience that impacts everyone and has allowed us to empathize with each other across racial and class divisions. The unique opportunity has arisen again for us to use the struggles of the masses in order to address the inequities of the few. I hope that we do not repeat history.