Minorities, more likely to have jobs that make them 'essential workers,' disproportionately affected by COVID-19

Thursday, May 7, 2020
FAYETTEVILLE, N.C. (WTVD) -- Alfred Payne, of Fayetteville, spent nearly a month in the hospital battling COVID-19. The coronavirus attacked his kidneys, caused him to catch pneumonia and to hallucinate.

"You're waking up in a hospital alone and that was the most horrific thing," Payne said.
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The Fayetteville resident is one of nearly 3,500 African-Americans testing positive for COVID-19 in North Carolina.



"We're predisposed for high blood pressure and heart disease and that makes a huge difference with this virus," Payne said. "Because the virus not only attacks the immune system. But it also attacks the cardiovascular system and that's a huge difference and a huge player in why many of us are not surviving."



While African-Americans account for 22 percent of our population, they account for 36 percent of COVID-19 cases and 35 percent of deaths.

Hispanics account for nearly 10 percent of North Carolina's population but 23 percent of COVID-19 cases.

"These numbers are really upsetting and quite distressing but they fall along the lines of what we know about health inequities in this state and in this country," said Dr. Giselle Corbie-Smith, Director of the UNC Center for Health Equity Research.

Dr. Corbie-Smith said minorities tend to have higher risk factors for poorer outcomes in this pandemic, such as heart disease, diabetes and high blood pressure. In addition, she said:
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"The excess morbidity and mortality that we're seeing in COVID-19 is really a reflection of centuries really of systems that have created this sort of perfect storm, where people have less opportunities to work in places where they're able to shelter in place so minorities are more likely to be those 'essential workers.'"

Payne owns a taxi and limo service. He thinks he got the coronavirus after driving a client.



"I definitely had to work because that's my only way of making a living," Payne said. "There's nothing else for me really to depend on. If I don't transport clients, we don't eat."

Dr. Alexa Mieses Malchuk is a family physician and assistant professor at UNC. She said our Latino population consists of a large number of recent immigrants who may not have the ability to work from home and face other challenges during this pandemic.

"Some of the things that can make it harder to access health care may include being a recent immigrant to this country, not knowing how to navigate this system," Dr. Mieses Malchuk said. "Perhaps you speak a language different than English. Maybe you don't speak English at all. That can make it challenging to access healthcare. If you don't have health insurance or even if you have health insurance but unfortunately your neighborhood doesn't have primary care physicians."

Dr. Mieses Malchuk and Dr. Corbie-Smith say COVID-19 is putting a magnifying glass on health disparities.

"We've seen inequalities by personal characteristics, by race, and gender, by where we live in terms of rural versus urban geographies that play out in our health systems for as long as we've been collecting data on race or health in this country," Dr. Corbie-Smith said.

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"Decades ago, if not centuries ago, marginalized groups were exploited in order to make those advancements," Dr. Mieses Machuck said. "As an example, there are some fields in which African-American women were, without consent, operated on in order to advance the surgical procedures in that field."

"Unfortunately a lot of the remnants of the past still influence how we as health care professionals interact with our patients from marginalized groups," she said.



Moving forward, Dr. Corbie-Smith said we need accurate data on who is getting COVID-19 so we can really understand the scope of the problem.

"I'm hoping that we can come together as a society and really devise novel ways to make our health care system and our health care outcomes more equitable for our citizens," Dr. Mieses Malchuk said.

As North Carolina prepares to ease restrictions, Payne has this message:



"The only thing that we can do is be more diligent in how we handle ourselves. The social distancing is necessary. It's important. It makes it so that we all stay safe."
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