Racism is as American as apple pie, so it is no wonder that COVID has been yet another front on which Black and brown Americans have had to fight for justice. A recent study from the Johns Hopkins Center for Health Equity found that Black and Latino people are 2.4 times and 3.16 times more likely to get infected as compared to white people. If Black Americans were dying at the same rate as white Americans, 13,000 Black people would still be alive. Those are 13,000 people that were arguably killed by racism (rather than the usual governmental ineptitude).
This disparity is deeply linked to income inequality and poverty; the death rate of a wealthy non-white is three times that of a wealthy white, and the death rate of a poor non-white is nine times that of a poor non-white. Poverty plays a factor, and wealth softens the disadvantages, but since there is such a huge disparity between poor whites and non-whites, and still a disparity between wealthy whites and non-whites, race is still a major factor.
Because this is a health issue, people often focus on overt medical racism, such as higher insurance rates for white populations and worse medical care for Black patients. Indeed, the usual practices of downplaying the pain of Black patients and giving less attentive treatment have continued during COVID, and have no doubt contributed to the disparate outcomes. In addition, frontline workers are disproportionately BIPOC, and also disproportionately women. Being able to work from home is a privilege enabled by racial and class advantage.
While overt medical racism is an important factor in the racial inequities revealed by COVID, this is not a holistic view of health. Part of what is broken with our current health system is our tunnel vision focus on pills and treatment and what is done at a hospital, rather than healthy lifestyles, preventative medicine, and what is done in our daily lives. Both are important, but the latter is often sidelined as simply self improvement rather than a political issue. However, COVID has revealed that the lifestyle-related chronic health issues of Black and brown Americans- born out of corporate and often government-induced conditions- is a life or death issue; 94% of COVID victims who died had other health issues. Chief among these underlying conditions are high blood pressure, diabetes, and heart disease- conditions which BIPOC, and especially Black and Native American people, disproportionately suffer from. Compared to non-Hispanic white people, non-Hispanic Black people suffer from higher rates of high blood pressure (54% vs 46%) but lower rates of blood pressure control (25% vs 32%), as well as higher rates of diabetes (11.7% vs 7.5%). For Native Americans, the rate of diabetes climbs to 14.7%.
These conditions have led these groups to be vulnerable to COVID, but this crisis has only revealed an ongoing, largely unaddressed issue. Even before Covid, the number one killer in America was heart disease, the seventh being diabetes. These ongoing, preventable deaths have taken tens of millions of lives; this is an issue in and of itself that COVID has only drawn back the curtain on. In fact, even this year, heart disease (which takes a yearly 650,000) is still projected to take twice as many lives as Covid (which has so far taken 200,000). But while people furiously wash their hands, they aren’t necessarily furiously chowing down on vegetables. These chronic conditions will always take a backseat because these types of diseases quietly, slowly, undramatically take lives. We simply accept these deaths as a fact of life, but they are not so much treatment diseases as they are preventable diseases. Oftentimes, medication simply serves to clamp down on the symptoms rather than addressing the causes. This is why a complete picture of racial disparities in health must also examine lifestyle, and critically, food.
Just as we live, arguably, in an apartheid state with regard to policing, schooling, and housing, activists have extended the term apartheid to define our current food injustice as not only a “food desert” problem, but rather a food apartheid (see here for more information on food apartheid). Not only do white neighborhoods have four times as many supermarkets as predominantly Black communities (which are preyed upon by junk food restaurants), but Black farmers are also discriminated against in federal loans. Black America has been disempowered on both the supplying and purchasing sides.
The government recommends that Americans eat fruits and veggies in nutrition guidelines, but only gives those foods 0.04% of the subsidies that the meat and dairy industry receive. The whole foods plant-based diet, centered on whole grains, vegetables, and fruits, is the only known reversing treatment for heart disease (link to study here), and also acts as a strong preventative measure for heart disease, hypertension, diabetes, and other common illnesses. The longest living people in the world eat a 95-100% plant-based diet. But America is pitifully far away from even following our own corporate industry-influenced nutrition guidelines (only 10% of Americans eat the government recommended intake of fruits and vegetables), much less a plant-based diet.
Why is this the case? Simply put, the government and corporations are working to usher Americans, especially Black Americans, into a lifetime of bad eating habits. The federal government deeply subsidizes commodity crops such as corn and soy, that are either processed into fast food or turned into animal feed. Fast food companies benefit from the government’s Small Business Administration subsidies through a loophole where chains receive rebates to open up in “experimental locations”. Firms also take advantage of the Work Opportunity Tax Credit, where fast food chains rake in thousands of dollars in tax credit for every low income worker they hire, despite the fact that these chains operate on mechanization and provide as little training as possible (Fast Food Nation, pg. 72, pg. 102). This generous government support has emboldened these fast food companies, whose chains are disproportionately clustered around Black and brown neighborhoods.
Big meat and dairy also profit off of government contracts. The federal government regularly buys surplus meat and dairy that the free market has rejected, and funnels it into government food programs such as school lunches, which Black and brown Americans disproportionately depend upon. While there is a school of thought that supports government intervention for the public good, and the school of thought that wants the market to operate freely, right now we are following a bizarre philosophy of government intervention on behalf of wealthy, corporate interests at the expense of public health and small business interests.
A more lucrative system could not be arranged for both the pharmaceutical and food industry. One gets to make a profit off of poisoning us, the other gets to make a profit off of barely keeping us alive with expensive drugs, and Black and brown Americans get the worse end of both sticks. Solving the American health crisis is going to take more than better testing or medical treatment; it requires rethinking our relationship to food.