Racial violence and racial health inequities in the midst of the COVID-19 pandemic disproportionately impact on Blacks. Sharrelle Barber reports.

The murder of George Floyd, suffocated by a police officer who, for 8 minutes and 46 seconds, lodged his knee into Floyd’s neck on May 25, is just the latest example of a longstanding history of racial terror and police brutality against Blacks in the USA, and has sparked global outrage. While this act of violence is horrific in its own right, its occurrence against the backdrop of a global pandemic that has wreaked havoc in Black communities—causing over 30 000 deaths within the span of 4 months—has forced a collective reckoning with the fact that racism, in all of its forms, is deadly and has a devastating impact on Black lives.

Due to a reckless and uncoordinated federal response, the USA remains the global epicentre of the COVID-19 pandemic with over 3 million confirmed cases and 135 205 confirmed deaths. Black people and other marginalised racial groups are shouldering a disproportionate burden in the current pandemic. Blacks comprise 13% of the US population but roughly one quarter of COVID-19 deaths and are nearly four times more likely to die from COVID-19 compared to whites (94·2 vs 24·8 deaths per 100 000). Blacks across all age groups are nearly three times more likely than white people to contract COVID-19. These numbers, while striking, are not surprising and mirror well-documented patterns of morbidity and mortality across a wide range of health outcomes that have been observed in the USA for decades. Experts contend that “racism and not race” is the primary driver of these inequities with many citing “interlocking systems of racism” that have converged to increase exposure, transmission, and death among Blacks. These systems—from healthcare, to housing, to the carceral state—are all rooted in an ideology of white supremacy and the institution of slavery that dates back over 400 years and are maintained by racist policies and practices that construct and reinforce inequitable access to power and resources.

For example, racialised economic exploitation vis-à-vis racial capitalism has been cited as a major driver of increased risk of infection among Blacks. According to data from the US census, 43% of Black and Latino workers (compared with 25% of white workers) are employed in service or production jobs that have been deemed “essential” during the pandemic. Employees in these industries have been forced to work with inadequate personal protective equipment, crowded working conditions, and inadequate income protections such as paid sick leave and hazard pay, putting them at increased risk of exposure to the virus. Additionally, due to low wages and lack of affordable housing options, these same workers often reside in racially segregated neighbourhoods that have experienced decades of disinvestment. Structural factors in these communities such as over-crowded housing conditions further increase exposure and transmission. The impact of increased exposure is further compounded by limited access to quality healthcare which limits access to testing and follow-up treatment, discrimination within the healthcare system which makes it more likely for Blacks to be turned away when seeking medical care, and a wide-array of exposures such as toxic environmental hazards, chronic stress, and limited access to healthy foods all of which lead to underlying chronic conditions.