COVID 19 Presents Opportunity to Fix Underlying Race Class Issues in Health Systems
With over 3 million reported cases of COVID-19 worldwide, the virus’ impact on racial and ethnic groups is still emerging. However, internationally, reports have highlighted a disproportionate bearing of illness and death among racial and ethnic minority groups. On April 27, The University of the West Indies (The UWI) hosted a virtual Vice-Chancellor’s Forum themed, Race, Class and COVID-19 to examine why some racial groups and socio-economic classes seem to be more vulnerable than others and what strategies are key to interrupting this worrying trend. The forum brought together a panel of experts who presented the current situations in the Caribbean, US, UK and South America. It was organised by Ambassador Dr Richard Bernal, Pro Vice-Chancellor and Professor of Practice, Global Affairs at The UWI along with the University’s Centre for Reparation Research and moderated by Professor Rupert Lewis, Professor Emeritus and Director of The UWI PJ Patterson Centre for Africa-Caribbean Advocacy.
Dr Kenneth Connell, Lecturer in Clinical Pharmacology, The UWI Cave Hill and Chairman, Barbados National Drug Formulary Committee who opened the presentations noted that the African Diaspora generally bears an unusual burden when it comes to health, a situation that appears to be magnified by the current health crisis. Additionally, as at 2020, 80% percent of the world’s cardiovascular disease burden is being felt by low to middle income countries with vulnerable economies and health care systems like those in the Caribbean.
Dr Connell stated that COVID-19 offers the urgent opportunity to change this circumstance in the Caribbean. His recommendations include aggressively addressing individual barriers and using simple, strategic messaging about health; agitating an immediate call to action to drive political change, holding governments accountable; disaggregating health data to identify potential biases specific to race; acknowledging the historical forces that may now result in perpetual vulnerability and continuing to activate for justice in all communities of black, Asian and minority ethnic groups (BAME) including reparatory justice.
Dr Melissa Creary, Assistant Professor, Health Management and Policy from the School of Public Health, University of Michigan contextualised the case for African-Americans. She shared data which show that African-Americans are disproportionately affected by the virus. The US White House Coronavirus Task Force she said, highlighted that this is due to underlying medical conditions and that the US Surgeon General attributed conditions such as diabetes, hypertension, obesity and asthma as key causes for why they end up in the Intensive Care Units [ICU] and ultimately have higher death rates from COVID-19.
Dr Creary explained: “It’s important to understand that while the numbers show the unequal burden, the full picture is that other Americans also suffer from these conditions.” She pointed out that this racial disparity occurs often, and echoed Dr Connell’s views that that COVID has actually exposed existing fault lines within our societie. She added: “The thing that is truly underlying in this narrative is the structural inequities…this scenario of unequal burden which was in place before COVID-19 became the latest threat.” She also disclosed that among the structural inequities that exist for African-Americans are higher rates of being uninsured; lower median incomes that provide less economic cushion; limited access to healthcare—limiting preventative care and testing; poorer quality of care; systemic distrust with the healthcare system; racial residential segregation and high risk jobs.
Professor Anthony Bogues, Asa Messer Professor of Humanities and Critical Theory, Director, Center for the Study of Slavery & Justice and Professor of Africana Studies at Brown University, in his presentation, echoed the point that pandemics tend to be events which unmask a society’s ills, exposing weaknesses which are hidden in plain sight. “It has always been that way” he said, adding that “If we look back at the Spanish Flu which occurred from 1918-1920, at the end of the First Imperial War, one would see that the pandemic also exposed the vast inequalities in the US and many other societies.” He stressed that even during that time, the death toll among non-whites was much higher than that of whites; so the present scenario is something that has a historical precedence.
Professor Bogues also cited data from the Swiss Bank which shows that 1% of the world controls 44% of the world’s wealth and suggested that we have to consider what that means in terms of globalisation and questions of health and inequality. He noted that we have also seen a lack of a certain type of global cooperation to fight something that is a global illness. He made mention of examples of US interventions in transporting medical equipment from China headed to another country and in another instance cargo meant for Barbados. He said there’s a certain unravelling of an order that was established in the post-Cold War (1991-1992) and it’s not just around trade and multilateralism but rather include the ways in which inequality has ravaged many nations around the world and at the heart of that equality are communities of colour and we are now seeing this again in the contemporary world.
Ms Esther Ojulari, Human Rights and Displacement Consultant at the United Nations, provided a Latin American, specifically Colombian, perspective. “This pandemic has given us an opportunity to think about the right to health,” she stated. The Human Rights and Displacement Consultant at the United Nations affirmed that the systematic denial of the human rights of people of African-descent is rooted in the ongoing colonial paradigm of racism and is intricately related to the global economic system which puts the interest of private profit over the lives and bodies of people of African descent. She stated that the current crisis and its impact on black communities reconfirms what black movements around the world have been arguing historically and currently. Painting the picture of the situation in her current location in the Pacific region of Colombia, she said it has been historically marginalised, underinvested in, lacks infrastructure and socioeconomic indicators show it to be under the average of the country. This she said, is a direct legacy of enslavement and structural racism.
The final presentation was by Priscellia Robinson, Barrister at Law, Queens Court Chambers (UK) and a Human Rights Defender. She presented the UK context of the BAME and COVID-19. Notably, she said that the Windrush generation of persons from the Caribbean who arrived in the UK between 1948 and 1971 and whose descendants still live in the UK, comprise much of the BAME community. She cited recent data which show that BAME patients account for a third of those in hospital despite comprising only 14% of the population. In addition, she said that black and ethnic minority victims account for 71% of the overall National Health Service [NHS] COVID-19 deaths, despite only making up 44% of the service workforce. Similar to the case of African-Americans and people of African descent in the Pacific Colombian region, she made reference to the historical societal treatment of minorities in the UK and the fact that they are also disproportionately affected by COVID-19. In conclusion, she emphasised that action needs to be taken that leave no room for another Windrush scandal.
In their closing remarks, after fielding an impressive number of questions from the online audience, the experts called for a meeting of minds to assist in shaping the health care system post COVID-19, the examination and creation of policies to address race and class issues and the right to health, including disaggregating data in the health care systems as well as ensuring that academics play a role in teaching and creating understanding of the history and work of the black Diaspora. It was also noted that these issues give new revitalisation to the need for reparation particularly during the current UN Decade for People of African Descent (2015-2024).