Phillip Thomas, a Black, 48-year-old Chicagoan, was a “great guy” according to his sister Angela McMiller. He was loved by his family and well-liked by his co-workers at Walmart, where he had worked for nine years.
“I didn’t know about how many friends he had until he passed away,” said Angela. Thomas, who was diabetic, died from Covid-19 this past March.
After being sick for two weeks and self-quarantining at the recommendation of his doctor, instead of being given an examination, Phillip was then rushed to the hospital, where he died the next day.
Naba’a Muhammad, 59, a writer and Chicago South Shore neighborhood resident, with a lung disease, also contracted coronavirus and was hospitalized.
But while he was fortunate to access the necessary care, he immediately noted health disparities facing other Black Chicagoans in his community.
“Here you have [Donald Trump] who’s got a helicopter flying him to a special wing of a hospital for help when Black people can’t even get an Uber to the emergency room or a Covid test,” he said, referring to the president’s world-class care at the Walter Reed national military medical center on the outskirts of Washington DC, after being diagnosed with coronavirus in early October.
In Chicago, Covid-19 is battering Black communities. Despite only accounting for 30% of the city’s population, Black people make up 60% of Covid cases there and have the highest mortality rate out of any racial or ethnic group.
Most Chicago Covid-19 deaths are hyper-concentrated in majority-Black neighborhoods such as Austin on the West Side and Englewood and Auburn Gresham on the South Side.
“The racial and ethnic gaps we’re seeing of who gets the virus and who dies from it are not a surprise,” said Linda Rae Murray, a Chicago doctor, academic, social justice advocate and former president of the American Public Health Association as well as the former chief medical officer of the Cook county department of public health.
“They are a reflection of structural racism that exists in our society and inequities that are baked into our country.”
Chicago is a hyper-segregated city, blighted by yawning divides across many socio-economic conditions.
The coronavirus experiences of Black Chicagoans are so starkly different from residents in whiter, wealthier communities it has observers asking: do conditions in majority African American neighborhoods make being Black, effectively, a pre-existing condition there?
Muhammad thinks so: “[It] is very true,” he said, adding: “But that truth demands a response. We can’t simply accept that this is going to happen to us.”
Many Black neighborhoods in Chicago, as elsewhere in America, experience higher rates of unemployment and poverty while also being less likely to receive pandemic aid, giving them even less of a safety net than usual in a disease outbreak.
“We have seen patients who went home after recovering from Covid and required home oxygen, but they simply didn’t have money to pay for it,” said Murray.
Metropolitan Chicago’s essential workers are disproportionately low-income and people of color.
Black Chicagoans are more likely to work as cashiers, hospital support staff and in other jobs that increase their chance of catching Covid. But even with the heightened risk facing residents, permanent testing sites are not widely available in predominantly Black communities.
“There aren’t testing clinics near my home,” said McMiller. “There’s nothing in my neighborhood.”
Once infected, Black Chicagoans are living in neighborhoods that worsen their health because of “an epidemic of inequities”, according to a study from the Chicago Urban League, an advocacy group for Black families.
Healthcare remains unfairly inaccessible, as hospitals are scarce on Chicago’s South and West sides and decreasing further with the planned closure of Mercy hospital and medical center. Fewer hospitals increases the burden on remaining healthcare workers, resulting in a lower quality of care.
Angela McMiller believes that her brother suffered from poor medical treatment after his doctors did not examine him despite his prolonged symptoms and diabetes: “I blame the doctors who didn’t do the best job they could’ve done with my brother.”
Black people are more likely to be uninsured and struggle covering medical costs, forcing them to rely on hospitals versus preventive care.
And so-called safety-net hospitals – hospitals that treat anyone regardless of ability to pay – can become overwhelmed and provide poor care; these hospitals are concentrated on the South and West sides, where there is already a lack of family doctors, meaning all residents receive subpar treatment.
“In a lot of the hospitals where people don’t have private paid insurance, you have a higher volume of people who go there,” said Karen Freeman-Wilson, president of the Chicago Urban League.
“The reality of having to deal with the larger volume is that they aren’t in a position to give the same care that you might get in some of the suburban hospitals.”
Other determinants of health such as access to healthy food are not widely available in South and West Side communities, neighborhoods designated as “food deserts”. Residents can struggle to find nutritious food, contributing to poorer health and causing overcrowding at grocery stores, which increases the risk of contracting Covid.
Many predominantly Black neighborhoods are also hubs of pollution, which is linked to zoning policies that place them in close proximity to contaminants from freight rail yards, heavy traffic and industrial sites.
Exposure to air pollution increases the risk of developing asthma and other lung diseases, coronavirus risk factors. And several studies have similarly concluded that living in communities with more pollution increases the risk of dying from Covid.
Chicago’s leaders, such as the mayor, Lori Lightfoot, have promised to tackle Covid disparities beyond just the short term.
Lightfoot has set up a Racial Equality Rapid Response team that has targeted the most affected neighborhoods, distributing masks and informational material, meals and other aid.
“We are all in this crisis together, but we haven’t experienced it in the same way,” Lightfoot said back in April, addressing what she called the “shockingly disproportionate impact” of coronavirus on the hardest-hit, majority Black neighborhoods.
While some experts have praised efforts, others have argued that suggested policies don’t significantly address decades-long disparities.
“We have to be very clear about getting to the underlying causes. I’m afraid of people putting Band-Aids on things,” said Freeman-Wilson.
Residents who have experienced or witnessed the tragedies in their communities are also skeptical.
“I don’t think Chicago is addressing [the disparities],” said McMiller. “Everybody’s just numb. It’s like they’re sitting and waiting for us to die.”
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