Category: Healthcare

African American Prisoners/Healthcare for COVID-19

I am invisible, understand, simply because people refuse to see me. Like the bodiless heads you see sometimes in circus sideshows, it is as though I have been surrounded by mirrors of hard, distorting glass. When they approach me they see only my surroundings, themselves or figments of their imagination, indeed, everything and anything except me. Ralph Ellison, Invisible Man (1952)

A Personal Story

I think there are great deal of folk that have had the experience of have a male family member incarcerated only to find out that they were not the same young man they knew before the incarceration.  I don’t know that we all can identify when trying to reconnect that not only are they different, but we too have evolved this makes for strange bedfellows.  Personally, I have interacted with a family member only to find myself more frustrated at the behavior of said individual than realizing he is different.  I don’t know what it is like to be incarcerate (in jail) albeit I have my own struggles where I voluntarily opted for incarceration metaphorically.  Non-the-less, I don’t know what it’s like to wake up in the same cage day after day, week after week, month after month, year after year and/or decade after decade.  I haven’t got a clue what it must be like to be controlled i.e. told what to wear, when to get up when to lay down, when I can shower, when I can a make a phone call.  I don’t know what  it’s like to be locked up with nothing but men/women without any freedoms that you and I take for granted on any given day.  I don’t know why the history of Black men has positioned a person to fall into the category of inmate, jail bird, or felon.  I’ve heard the idea that the construction of prisons were/are constructed based on 3^rd grade scores – Experts often cite third grade as a decisive year for students and schools. In fact, there is common folklore that asserts that public officials will forecast prison construction based on a state’s third-grade literacy rates.   An article in The Atlantic called this phenomenon “An Urban Myth That Should Be True.” The article goes on to say, “U.S. prison planners don’t use local third-grade reading scores to predict future inmate populations. But maybe they should.” This is a two topic writing on the healthcare of the inmate and that of the Black American and Covid-19.

The persistent and pervasive notion of African American male criminality which was injected into the American consciousness during the post Reconstruction period persists steadfastly today in the United States. It is a driving force behind the nation ’ s post-1970 mass incarceration binge for which economically disadvantaged Black males are the primary victims. It also serves as fuel for insensitive comments, unwarranted surveillance, and other microaggressions such as those now in the media glare. Few African American males, regardless of their achievement, social standing or economic status, are immune to the stress associated with these subtle forms of hostility

Healthcare and the Inmate

Imprisonment, homicide, non-lethal assault and other crime, chronic and infectious disease, substance abuse, suicide, and accidents all contribute to the much wider gap in the community-level sex ratios found among African Americans compared to those observed found among other ethnic and racial groups in the United States. This wide array of causes and correlates of African American male mortality, disability, and confinement suggests that one area in need of interdisciplinary inquiry that examines the intersection between public health and public safety. These lines of inquiry must situate and contextualize the lived experiences of the African American male. Health analysts and social scientists across many disciplines have all studied African Americans and their communities extensively over the past decades because this population has disproportionately high levels of disease, disability, premature death, and exposure to the criminal justice system.

A large body of research has documented black, white disparities in health and mortality in the United States ( Adler & Rehkopf, 2008 ; Frisbie, Song, Powers, & Street, 2004 ; Geruso, 2012 ; Pampel, Krueger, & Denney, 2010 ; Williams & Jackson, 2005 ; Williams & Mohammed, 2009 ). Racial differences in socioeconomic status (e.g., income, education) largely account for these gaps with individual and institutional discrimination, residential segregation, and bias in healthcare settings also explaining some of the variation in black, white disparities (Braveman et al., 2011 ; Williams, 1999 ; Williams & Jackson, 2005 ).

Afro-American Healthcare & COVID-19

Speaking of the disparities in health care among Blacks and Whites brings me to another topic – Covid-19.  As most people in the world are now acutely aware, an outbreak of COVID-19 was detected in mainland China in December of 2019.  Coronaviruses are a family of viruses that can cause mild to moderate upper-respiratory tract illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).  When an infected person coughs or sneezes, the new coronavirus may be transmitted through expelled droplets. These droplets can enter a person’s system through “contact routes,” such as the mouth, eyes, or nose. It is also possible for the droplets to be inhaled into the lungs.

The concept of COVID-19 hit the news airways like the plague.  Folk ran out and emptied the grocery story of every roll of tissue paper, alcohol and contamination cleaning products.  Addictions rose, folks died, both individuals and establishments lost their lives, and the country was shut down.  This would cause the sanest person to question the reason for living. 

Statistical data document that African Americans have a worse health profile and higher rate of death than White Americans for practically every illness. Broader surveys of self-assessed health using a comparative framework have found that African Americans are nearly twice as likely as White Americans to rate their health as “fair” or “poor,” and twice as likely as White Americans to rate their health as “fair” or “poor,” and that self-rated health is a strong predictor of sickness and early death (Bratter and Gorman, 2011).  Middle-class African Americans have a better health profile than their less affluent counterparts, but many report serious health challenges as common in their families.

Much like the prisoner many Black Americans suffer the same inequalities of healthcare whether locked up or free.  With that said how will Black Americans come out as the victor during these turbulent times?

What We Know

Black communities share common social and economic factors, already in place before the pandemic, that increase their risk for COVID-19. Those factors include:

• Living in crowded housing conditions. “Crowded living conditions are a difficult challenge that is the result of longstanding racial residential segregation and prior redlining policies,” Golden says. “It is difficult for 10 individuals living in a three-room apartment to appropriately physical distance.” She says advocacy on these broader policy issues could help prevent future disparities in disease outcomes.

• Working in essential fields. Golden notes that people working in environmental services, food services, the transportation sector and home health care cannot work from home. These positions put workers in close contact with others.

• Inconsistent access to health care due to lack of insurance or underinsurance. Being able to afford doctors’ visits, medications and equipment to manage chronic disease is essential to lowering the risk of death from COVID-19 and other conditions. For instance, a patient with badly controlled diabetes or asthma due to inconsistent treatment is more at risk for severe, even deadly, coronavirus infection.

• Chronic health conditions. Golden points out that people of color have a higher burden of chronic health conditions associated with a poor outcome from COVID-19, including diabetes, heart disease and lung disease. In a study cited by the U.S. Centers for Disease Control and Prevention (CDC), about 90% of those hospitalized with severe COVID-19 had at least one of these underlying medical conditions.

• Stress and immunity. Studies have proved that stress has a physiological effect on the body’s ability to defend itself against disease. Income inequality, discrimination, violence and institutional racism contribute to chronic stress in people of color that can wear down immunity, making them more vulnerable to infectious disease.

Distrust

Why is that the Black American holds on to memories of years gone by when it comes to their health.  The now infamous Tuskegee Syphilis study is perhaps the most widely known study exclusive to African Americans males.  Yet in present day the number of references to this experiment in conjunction with the COVID-19 vaccine are astronomical.  African  Americans  have  experienced  something  that others have not: the unique combination  of racism, slavery and segregation. It has caused African  Americans to develop  not  only  different  behavioral patterns, values, and beliefs but also different  definitions, standards, and  differences  in  value  systems  and  perspectives(Randall,  1996). Distrust  of  the health  care  system  by African  Americans  runs  from  the  feelings  or  ill  gains for  participation  in clinical trials to being used  only as guinea  pigs. In addition,  there  are feelings  by  African Americans  whether  the physician,   intentional   or not,  do  treat  minority  patients  differently  than  White patients  (Lake,  Snell,  Perry,  & Associates  2004).  If that is true then the reluctance to take the vaccine is valid.  Additionally many Americans feel that the vaccine was rushed and not enough due diligence has been put forth.