Coronavirus lays bare health disparities amid Michigan protests

George Floyd’s death under the knee of a Minneapolis police officer set off global protests against police violence. But in places like Detroit, still reeling from the devastation of COVID-19, Floyd’s death is a piece of larger, systemic inequities that leave African Americans to suffer and die at greater rates than whites. 

It’s why, for Detroit-born Riana Elyse Anderson, “I can’t breathe” amounts to more than the last words of Floyd and others who have died in police encounters. It represents the physiological stress suffered by generations of African Americans when confronted by racism.

“Discriminatory stress in particular tends to impact black people's ability to breathe, even when it's not someone kneeling on their neck or a respiratory disease” such as coronavirus, said Anderson, an assistant professor at the University of Michigan’s School of Public Health.

Citing Floyd’s death and COVID-19, Democratic lawmakers (and a notable Republican) introduced a joint resolution Wednesday, declaring racism a public health crisis.

“The COVID-19 crisis has laid bare deeply rooted inequities in health care and socioeconomic opportunity that have existed for centuries before this pandemic,” Rep. Cynthia Johnson, D-Detroit, said in a statement. “We must speak truth to power and recognize racism for what it is — a public health crisis.”

State Sen. Dale Zorn, R-Ida, who was criticized in April for wearing a mask that appeared to have a Confederate flag design, was a co-sponsor, along with Democrats, on the Senate resolution.

Herbert Smitherman, a Detroit doctor and vice dean at Wayne State University’s School of Medicine, said he sees a connective thread between a black man’s death on a street in Minneapolis and the heavy toll COVID-19 has imposed on African-American communities. Indeed, across the United States, Floyd’s death has given rise to a broader examination of racial wounds, from corporate diversity, to displays of the Confederate flag, to how the media should cover the Black Lives Matter movement.   

Smitherman called Floyd’s death “an epidemic of poverty superimposed on a pandemic of coronavirus, then a public lynching.

It is, he said, “a crisis within a crisis within a crisis for Black America.” 

What the numbers reveal and hide 

Health disparities between African Americans and other groups have been long reported and frustratingly hard to curb. 

African Americans are far more likely than whites to suffer hypertension and heart disease. In Michigan, black residents suffer higher rates of diabetes, kidney disease, pneumonia, flu and blood poisoning, according to a report by the Michigan Department of Health and Human Services. They are more likely to die in a car accident, or from suicide. 

Add to that a University of Michigan report last year identifying “hotspots of environmental injustice,” which noted that residents in high-minority census tracts were more vulnerable to environmental hazards but also to social factors that plague many of these communities, including poverty, unemployment and poor education. 

Increasingly, public health officials say it misses the point to conclude that African Americans are predisposed to underlying medical conditions and leave it at that, because it ignores the impact that discrimination itself plays in health.    

“Just saying that more black and brown people are likely to die from COVID-19 because they have high blood pressure is actually lazy thinking … it’s a lot more complicated than a genetic predisposition,” Sujitha Selvarajah, an OB-GYN and organizer of Race and Health, a global healthcare collective, told the medical news site, STAT. “There’s no biological basis for race, so saying that there’s predisposing conditions for those disparities is lazy and doesn’t address structural racism.”

Lisa Braddix, director of population health and health equity at the Greater Detroit Area Health Council, agreed that discussions of health disparities can be too narrowly focused.

“It’s 2020 and we continue … to think of health as being doctors and hospitals and the absence or presence of illness,” Braddix said.

Health outcomes, she said, can also be tied to education and economics, and throughout March, April and May, COVID-19 was a deadly reminder of those disparities.

African Americans comprise 14 percent of Michigan’s population but 40 percent of virus deaths. Nationally, they represent 13 percent of U.S. residents, but account for nearly 1 in 4 COVID-19 deaths, according to the U.S. Centers for Disease Control and Prevention.

A growing body of research indicates that racism can impact physical health. 

Under stress, hormones flood the sympathetic nervous system, which regulates heartbeat and breathing, among other things, said Anderson, who studies how racism affects the mental health of African Americans and recently blogged on the issue for Psychology Today.

Danielle McMillon, who helped lead protests against police violence in Grand Rapids, is a full-time business student at Grand Rapids Community College and worked part time at a restaurant before she lost her job in the COVID-19 shutdown.

She said she tries to follow the law. Yet, when she has been pulled over by police for speeding, she can feel tension grip her body. One time, her younger brother was with her. She quickly instructed him: Keep your hands where they can see them. Be still.

“I can’t even reach over and grab my license and registration because you never know,” she said.

White people may not think twice about calling 911 if they’re in trouble, she said. For African Americans, there’s inevitably a calculation: Will someone with a badge make things better or worse if I call?

“We’re tired of having to explain to people why our lives matter, why my little brother’s life matters, and my sisters’ lives matters. [As a white person], you don't have to do that. It’s outrageous. It pisses me off frankly.” 

Detroit’s battle 

In Detroit, COVID-19 filled hospitals and morgues for several weeks this spring. Thousands of front-line health workers, police officers and firefighters were sickened; some died.

Personal protective equipment was promised, but there was not close to enough during the height of the outbreak. 

Of the seven patients Smitherman admitted in the first week of the crisis, five died within days. The mix of stress and grief in hospitals and homes was profound. He said he has wondered how many contracted the virus because they had nowhere safe to isolate those first weeks. 

“How are the homeless and the poor who are trying to stay warm while they’re packed into warming centers [to] social distance? How are Detroiters supposed to stay clean when their water is cut off?”

One national survey of 773 adults found that black Americans were three times more likely than whites to know someone who died from COVID-19. 

Against this backdrop, the CDC urged social distancing and Gov. Gretchen Whitmer ordered Michiganders to shelter in place — which proved easier for white-collar workers who could more easily work from home at laptops or ride out a temporary job loss. Lower-income earners, particularly in cities like Detroit, were more likely to take mass transit to service jobs that forced them to interact with strangers during the pandemic. 

Enrique Neblett said he remembers early news reports that seemed to focus on the new coronavirus’ deadly toll on seniors.   

“But when I would look on the news locally, and also on my social media, the people who were dying looked like me and were the same age as me” — black men and women in their 40s and 50s, said Neblett, a professor of health behavior and health education at the University of Michigan and associate director of the Detroit Community-Academic Urban Research Center.

Then, in late May, George Floyd’s death was caught on a video that played in viral loops across a country that was, until then, still largely in lockdown — a moment, Anderson recalled, “when we were just trying to live.”

One crisis quickly found itself crashing into another. 

For Clayton Prude, 19, a Kalamazoo Valley Community College student, Floyd’s death pushed the coronavirus to the backburner, even after an uncle had been hospitalized with the virus. 

Prude said it made him think back to 2012, when a black teenager in Florida, Trayvon Martin, was shot dead by a white man who said Martin looked suspicious as he walked through his neighborhood. (George Zimmerman, the shooter, was later acquitted of murder and manslaughter.) 

Prude told Bridge the deaths of Martin, Floyd and others prompted him to strap on the same mask he now uses at his McDonald’s job and join the crowds protesting police violence in Kalamazoo and Grand Rapids.

“We’re still in the middle of a pandemic, but we pushed it aside,” he said of protesters. “There are even larger issues here. We’re fighting to be equal in the minds of everyone.”

Smitherman, meanwhile, joined hundreds of doctors, nurses, medical students and staff at the Detroit Medical Center who dropped to one knee on June 6 for 8 minutes, 46 seconds in memory of Floyd’s anguished last moments.

In Lansing Tuesday, Ingham County Commissioners declared racism a public health crisis, citing police violence against minority communities and the COVID-19 crisis. 

Commissioner Derrell Slaughter called the confluence of crises “a double whammy” against African Americans with deadly consequences.

Slaughter said the circumstances of Floyd’s death would have sparked outrage any time, but the past months have also allowed people time to grieve, reflect, and ultimately clarify what’s important to them. That has sustained the protests and possibly involved others who otherwise might have been distracted.

“We have been captive to our phones and our computers,” he said. “We’re feeling anxious. Our emotions are raw. The combination of all that, then seeing his murder so vividly displayed on all social media — this would not be the same under normal times.” 

The ‘cancer of racism’

Certainly, black communities don’t have the same access to insurance or health care — which is all just part of the “cancer of racism,” said DeMeeko Williams, a leader of the Detroit protest efforts and founder of Hydrate Detroit, a local nonprofit providing emergency water deliveries for Detroiters who had lost service.

“We’ll never know the true extent of what COVID-19 on black communities,” he said. “We have asked. We still don’t have answers.”

But Williams said he worries that focusing on health disparities during the pandemic dilutes the point of the current protests — police violence against black communities.

He said most Black Lives Matters protesters wear masks, yet they likely will be portrayed as the reason for a COVID-19 resurgence rather than the mostly white crowds who protested Whitmer’s executive orders that closed Michigan’s economy. It’s a tactic, he said, to “push people back in the house.”

“They try to throw COVID-19 out there to make it look like we’re putting the country at risk, and that’s racism as well,” he said.

“What they did to that man was unacceptable,” he said, referencing Floyd. “I don’t want that mixed with health disparities.” 

Chantel Watkins, a 29-year-old spa manager, is handing out donated N95 masks to Detroit protesters.  

A long-time activist who also worked on water shut-offs and evictions, Watkins said she understands the health risks of protesting during a pandemic. But she, too, has made a calculation.  

Ultimately, she said, “racism is the first pandemic in America. 

“And if we don’t fight racism, we’re going to be out here again.”