COVID-19 lays bare health, economic neglect

State Sen. Brenda Gilmore

“The coronavirus does not discriminate.”

I’ve heard some variation of that assertion made many times since the first case of COVID-19 appeared in Tennessee in early March.

Even so, we are seeing a new, but all too familiar trend unfold again: People of color, specifically Black Americans, are getting infected and dying at disproportionately higher rates than White people.

Of the novel coronavirus cases in the U.S. in which a person’s race was identified, 30% of those people were Black or African American, according to statistics released by the CDC. That’s despite Black Americans accounting for only about 13% of the U.S. population.

In Louisiana, 59% of people who have died from COVID-19 are African Americans, but African Americans make up only about one third of the population of Louisiana.

In Tennessee, state health officials only began releasing COVID-19 data related to race and ethnicity on April 8—more than a full month after the first confirmed case of coronavirus in the state. The early numbers reported by the state show 21% of Tennessee’s coronavirus cases are African Americans, who makeup only 17% of the state population.

Dr. Lisa Piercey, the head of Gov. Bill Lee’s state health department, said on April 7: “Race and ethnicity data is important to ensure that we are maintaining access across all ethnicities and to eliminate or mitigate any disparities that we might identify.”

With all due respect, the African American community already knows these disparities well.

These inequities have long been part of our economic, political and health systems in Tennessee—disadvantages like generational poverty, underfunded schools, food deserts, unaffordable housing and inaccessible health care.

These disparities have disproportionately affected a Black person’s ability to lead a healthy, productive and free life.

Well before the coronavirus, African Americans were dying or suffering more often than White people from common health conditions, including pregnancy, heart disease, asthma, diabetes, cancer and other health issues.

For hundreds of years, Black neighborhoods have been among the first and worst affected by societal horrors like natural disaster, economic collapse, pollution, resource shortages and health crises, which now includes the coronavirus.

While it is a new disease, COVID-19 is exploiting the same inequities our Black and Brown communities grapple with every day.

Despite the seriousness of these complex and deep-rooted challenges, there is hope.

Many of these health disparities are preventable, but overcoming these barriers will require individual and collective political will power to make a change.

Immediately, scaling up testing and tracking is key. While we must continue educating communities of color about the importance of basic prevention like social distancing and hand washing, there must also be a considerable effort mounted to test, track and contain the spread of the virus.

A report issued by the University of Tennessee Health Science Center called for hiring hundreds of workers “to do classic contact tracing, provide evaluation, and give quarantine direction to persons who test positive.” The report also says more communication is needed to persons who have tested negative and to high-risk individuals.

Urgently, state policymakers must rid our health care system of the inequalities that have marginalized many people of color in this crisis. Whether it’s gaps in health insurance coverage, uneven access to services or poor quality health care, Black Tennesseans see these health care challenges first hand.

The UT report put it this way: “We were unprepared for a pandemic due to a long-term de-emphasis on public health infrastructure.”

Top of the agenda: Make affordable, quality health coverage available to hundreds of thousands of Black, Brown (and White) Tennesseans by expanding Medicaid.

Every Tennessean should be able to take their kid or themselves to the doctor when they get sick, but affordability is a major obstacle.

Our state is less prepared for this crisis today because the majority party in the legislature has for a decade refused to accept federal dollars that would extend health coverage to working Tennesseans through TennCare, the state Medicaid program.

In states that have not expanded Medicaid under the Affordable Care Act, African Americans and other people of color are most likely to fall within a coverage gap—meaning they earn too much to qualify for the traditional Medicaid program, yet not enough to be eligible for premium tax credits available in the <Healthcare.gov> marketplace.

Increasing access to quality health coverage generates major cost-savings for taxpayers in the long run and leads to better health and economic outcomes.

Beyond Medicaid expansion, which would have profound and positive effects on the health and wellbeing of our state, there are additional measures we can pursue to protect our economy by improving our health in the face of a pandemic:

  • Limit the cost of premiums and out-of-pocket costs, such as deductibles, prescription drug costs, point-of-service charges and surprise medical billing;
  • Ensure access to quality health care providers. We must both increase the size of the health care workforce and also train more Black and Brown workers for health care jobs.

Does the virus discriminate? Surely not, but COVID-19 is laying bare the real consequences of neglect, segregation and injustice. We’re seeing that far too many Black Tennesseans are struggling to live healthy and financially secure lives.

Substantial gains can be made if we intentionally commit to equitable change, but it will take all of us working together to demand it.

(Sen. Brenda Gilmore (D-Nashville) represents state Senate District 19, which stretches across Davidson County from North Nashville to Antioch).

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