Why has the coronavirus had a heavier impact on African Americans? The answers are in economics and sociology

The coronavirus is having a heavier effect on African Americans, putting new attention on the disparities in their health and the socioeconomic factors that influence health.

Preliminary figures show that 12 percent of the Kentucky deaths attributed to covid-19 were among African Americans, who comprise 8.3 percent of the state's population. Even greater disparities have been found in other states, and some places in Kentucky.

"Data from Lexington-Fayette County Health Department released Thursday shows that roughly 30 percent of the county’s more than 188 coronavirus patients are black. Yet, black people are only 15% of Fayette County’s population," Beth Musgrave reports for the Lexington Herald-Leader.

"Moreover, black patients tend to get sicker than white patients with the highly-contagious respiratory illness, county health department data shows. Roughly 30 percent of black patients were hospitalized from complications from the virus compared to 13 percent of white patients, according to the data."

During a health-department online roundtable Thursday, "Devine Carama, a hip-hop artist and community activist, said higher poverty rates in the black population mean less access to health care and worse health outcomes," Musgrave reports. "Carama said when he was younger and poorer going to the doctor was a luxury he couldn’t afford."

Chart from 2017 Kentucky Minority Health Status Report

Health inequalities between whites and blacks in Kentucky have existed since such things were first measured. "Black Kentuckians are more likely to die of asthma, have higher mortality rates for certain cancers and have higher rates of diabetes than whites," Musgrave notes, citing the health-equality office in the state Department for Public Health.

She notes that the Centers for Disease Control and Prevention says underlying health conditions such as diabetes and lung disease can make people more likely to develop covid-19 from the coronavirus, and points out these findings in the 2017 Kentucky Minority Health Status Report : 

• Blacks are more likely to die from asthma than any other racial group.
• The age-adjusted mortality rate for diabetes is greater for blacks than whites.
• Blacks have a higher mortality rate for cerebrovascular disease— diseases or conditions that affect blood flow to the brain— than whites.
• Blacks have a significantly higher cancer mortality rate than whites for prostate, breast and colorectal cancer.

Musgrave notes, "Research has shown a direct correlation between health outcomes and income and poverty, the report noted. Black Kentuckians are much poorer than white Kentuckians. . . . Overall, the poverty rate for black Kentuckians is 31.4%, almost double that of whites in Kentucky at 17.1%."

Kentucky expanded Medicaid in 2014 to include people with incomes up to 138 percent of the federal poverty threshold, which has reduced the share of Kentuckians to about 5 percent. But the Minority Health Status Report showed that nearly 9 percent of black Kentuckians ages 18-64 were uninsured in 2016. Hispanics in Kentucky even less insured; nearly 30% lack health insurance. 

Having insurance "helps people manage chronic diseases such as diabetes, asthma and cardiovascular disease," and makes it more likely they will get screened for cancer, Musgrave notes.

Kacy Allen-Bryant

African Americans' culture can also get in the way, said Kacy Allen-Bryant, a public-health nurse who chairs the Fayette County Board of Health. “We don’t often go [to a doctor] when it’s in an early phase when many of the complications can be prevented,” she said during the online discussion.

Another cultural factor may have played a role in the pandemic, Allen-Bryant said: “We are very social,” typically attending Sunday family dinners and weekend cookouts, but now isn't the time.

“I think people think, ‘We’re family, we can visit’,” she said. “But you can’t do that.”