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When Race, Money, and Health Collide

Three takeaways from the pandemic.

Recent reports show us that COVID-19 is just the latest health disparity disproportionately impacting Black communities. At present, racial minorities in the United States are about two to three times more likely to be diagnosed with COVID-19. Unequal mortality rates are also evident: Black Americans are approximately three times more likely to die from COVID-19 compared to White counterparts.

Basic COVID-19 prevalence and risks don’t tell the whole story. Due in large part to discriminatory presidential rhetoric and permissive social norms, bias-based violence toward Asian Americans is on the rise. The financial impacts of COVID-19 are vast, damaging critical sectors such as food production, agriculture, education, and health care.

Source: Maria Oswalt/Unsplash
COVID-19 has revealed many existing racial and economic divides.
Source: Maria Oswalt/Unsplash

What are we to make of the complex interplay between race, money, and the COVID-19 pandemic?

Whitney Laster Pirtle, Ph.D., an assistant professor in the Department of Sociology at the University of California Merced, recently penned an informative piece in Health Education & Behavior. The article, Racial Capitalism: A Fundamental Cause of Novel Coronavirus (COVID-19) Pandemic Inequities in the United States, brings to light valuable lessons from COVID-19 racial disparities in the Detroit region that can teach us about these matters across the nation.

Lesson 1: What is racial capitalism?

The concept is more than a straightforward combination of racial and economic differences. Racial capitalism comprises a system built on structural racism through the historical blocks of slavery, colonialism, and other processes disenfranchised groups, specifically Black persons. From this perspective, capitalism has rooted itself in America by exploiting the Black community. Current U.S. health care, financial and other systems are inherently set up in a way that further worsens disparate outcomes for Black Americans.

Lesson 2: Racial capitalism insidiously affects health in multiple ways.

As Dr. Laster Pirtle outlines in her piece, racial capitalism is a root cause of health disparities in the U.S. Diabetes, asthma, and other health disparities are directly affected by unequal racially-economically deprived systems. With respect to mental health, some have speculated that we are likely to see an onset of long-term negative mental health impacts of the pandemic. It doesn’t seem an outlandish stretch to expect mental health disparities for Black Americans to emerge that are also driven by racial capitalism.

Racial capitalism has indirect impacts on health, as well. For instance, COVID-19 brings to light existing racially and economically driven disparities in disease risk factors such as isolation, homelessness, and access to quality care. Systems are set-up in such structured to reduce access to health-protective factors such as access to up-to-date health information and supports to obtain food and other basic necessities.

Kat Yukawa/Unsplash
Source: Kat Yukawa/Unsplash

Lesson 3: We must focus public health efforts beyond the individual and interpersonal levels.

As I and others have lamented, current efforts to redress prejudice and discrimination as public health threats have proven to be ineffective. Dr. Laster Pirtle extends this line of critique by accurately pointing to a considerable limitation in the science of prevention: efforts to address racial capitalism are limited to individual and interpersonal levels. A basic assumption of a public health view of prevention entails the need to consider structurally-based solutions. In short, we must think bigger. We must design and implement systemic solutions redressing economic deprivation and racial injustice in health care and other systems. Existing solutions like implicit bias training and self-reflection exercises fall far too short in rectifying the entrenched systemic health care problems.

As the COVID-19 pandemic has reminded us, we have a long way to go in terms of solving racial and economic health disparities. Fundamental rethinking of the intersection of race, economics, and health seems a necessary starting point. We can draw on such paradigms to inform better, more systematic approaches to tackling racial capitalism and health disparities.