Several Saturday mornings ago, I sat at my desk at home and poured out into an email to close friends some of my deepest fears about COVID-19 and its impacts on our community. I shared my concerns that this pandemic, like other health crises, would hit certain communities harder than others. I shared that for reasons that were entirely predictable, some people and places would be disproportionately ravaged by illness and death.
The numbers being reported across the nation are bearing out those fears and predictions. People and communities whose social and economic conditions prohibit them from exercising the caution advised by our public health officials are getting sick and dying at alarming rates. These are people whose housing situations or job requirements limit their ability to “self-quarantine” or “practice social distancing.” These are people who do not have the financial resources to acquire food and cleaning supplies.
These are people who, in the best of times, struggle to get the healthcare they need. These are people who do not have access to accurate information about the virus. Not surprisingly, these people often live in clusters. Public policy, such as zoning, often means that low-income people tend to live near and with other low-income people. This reality is punctuated by race and ethnicity.
Low-income African Americans tend to live near other low-income African Americans.
While factually correct, important context was left out of HP’s April 17 piece about the distribution of confirmed and presumed COVID-19 cases (“New details on Berrien County’s COVID-19 cases: Benton Harbor ZIP code has more cases than any other in the county”). The high density of cases in the 49022 ZIP code is shaped by the fact that it is densely populated by people living in homes that restrict their ability to “self-quarantine” or “practice social distancing,” do not have the enough money to purchase food and cleaning supplies, have poor access to healthcare, and who often fall prey to myths and disinformation about the virus. In other words, their living conditions are significant drivers of the heavy COVID-19 incidence being experienced in 49022. As more racial and ethnic data on the distribution of COVID19 cases become available, it is critical to keep this fact in mind: social conditions drive illness and disease. Behaviors and actions, like self-quarantining, social distancing, eating healthy foods and seeking needed healthcare, are only as possible as one’s environment allows. In the days and weeks to come, as more data is released, we must remember that the distribution of COVID-19 impacts reflect the distribution of social and economic resources and opportunity.
To paraphrase Louise Dettman in Public Health Newswire, the distribution of COVID-19’s impacts results from “social and economic factors, not genetics, and environment and neighborhood conditions, not just behaviors.”
