Coronavirus and Urban America’s Healthcare Disparity
As America and New Jersey have entered their second month of this Coronavirus pandemic and we passed the one-month mark of our statewide shut-down, many of our leaders’ eyes and ears are opening up to a truth that has been there all along. We have health and medical care disparities throughout much of urban America which most adversely affect African Americans and cut across demographics in that most obvious of ways – death rates. These disparities have now become crystal-clear due to the Coronavirus (COVID-19) pandemic. Cities and urban areas account for the largest number of cases nationwide, but we don’t yet have a national demographic breakdown of Coronavirus-infections yet.
In states such as Illinois, Michigan, Louisiana and in North Carolina and South Carolina, African Americans are testing positive and sadly, dying in proportions much larger than their percentage of their population. In larger coastal states, such as California, New Jersey, New York and Washington State, we do not know the racial breakdown of Coronavirus’ impact as no statistics were being collected based on race. Thankfully, New Jersey Governor Phil Murphy recently signed legislation requiring all hospitals to report the race, age, gender and ethnicity of everyone who has tested positive for Coronavirus (COVID-19). According to our state Department of Health, the Coronavirus has killed at least 838 black New Jerseyans and at least 1,879 white New Jerseyans.
As a life-long urban dweller whose hometown is Trenton, NJ, I’ve been fortunate to live in a more diverse community than many of my fellow Americans and I’ve been privy to seeing how national issues (and decisions) work their way to places whose zip codes are more densely populated or less abundant with resources. Co-morbidity has been an issue in urban and poorer communities for decades, but like when the scabs covering the deleterious effects of poverty in inner-city New Orleans were ripped open for all to see with Hurricane Katrina – so too are the continued effects of poverty and disparate access to medical care now with the Coronavirus. In too many American cities, access to primary care physicians or urgent care centers or clinics is a luxury and not a basic of daily existence.
While many urban planners have spent the last few decades arguing over the balance between development and gentrification, our political system and governmental powers have done little in the way of reducing nutritional food deserts, increasing employment opportunities and improving people’s access to decent basic medical care. As a country, we are now paying a price for this inattention. Simply put, up to now, our lack of government preparation and response has placed millions of minorities and urbanites in the crosshairs of this pandemic.
I do not want to place the entire fault for such an urban disparity of protection from the Coronavirus on our local, state or national government. Ultimately, in a crisis, each of us and our family needs to pay attention, prepare ahead of time, heed warnings and react responsibly. We learned this through Hurricane Sandy and September 11th or at least we should have. That is what makes our collective lack of preparation before the pandemic rampaged throughout the U.S. and our tepid response in the first weeks of this crisis so disheartening and worrisome. Immediately “masking up”, “gloving up” or socially-distancing is not something that one demographic automatically does better than another. However, government and business leaders should ask themselves, “Why were our most populous and minority-majority areas so heavily affected and not more prepared for this pandemic?”
Answers to these questions likely lie in the course of history that our country has been on since the end of World War II and the ascendency of the suburbs as white flight began. Once much of White America packed up a moving van and moved to find more space, more grass and trees, less people, less hustle and bustle (and admittedly for some, less people of color) – they took their lives, businesses and economic power with them. Over time, our more urban, individually-oriented and centrally-located medical system grew into one made up of suburban-based, large physician groups, multi-site hospital systems and focused on medical care specialties. And as the Baby Boomer generation grew older, this new world of medical care became very, very lucrative. There had to be a loser in this suburban-based medical system and that seemingly was residents in our cities. The U.S. National Institutes of Health found as much in its groundbreaking study of the effects of racial residential segregation and the closing of public hospitals serving urban communities. This all created an even bigger vacuum of access to medical care and mental health counseling before the Coronavirus came to cities like Newark, Trenton and Camden.
Solutions exist if we can be bold and use the levers of government as a guardrail and not a forceful cudgel against individual liberty. First, New Jersey should create a Home Economics & Finance requirement for all high school, community college and state university students in order to better prepare our educated youth to create and make healthy choices in their lives. Secondly, our state should require large hospital systems and insurance companies to provide free, basic annual physicals in underserved communities as part of their licensure renewals.
Third, for those large hospital systems and insurance companies, we can incentivize success rates for improving health and lowering morbidity in urban and underserved communities in New Jersey with non-transferrable tax credits. Fourth, the Garden State should offer significant tax credits to all businesses with twenty-five or more employees to provide a basic, annual physical and mental health screening to their full-time and part-time employees. Our government and our business community should join forces to attack healthcare disparities as we emerge from this Coronavirus pandemic and build up our defenses before the next pandemic comes.
I believe that all of us want a New Jersey and an America where all of us are prepared and medically-treated equally and equitably during a crisis. Unfortunately, during events such as the AIDS crisis, Hurricane Katrina, the Opioid Epidemic and now, Coronavirus, too many of us see larger societal problems as other peoples’ issues until they surprisingly reach our doorways or our hearts. We will get through this latest crisis together, but we must begin to drastically reduce healthcare disparities in urban New Jersey if we are to flatten any curves to come for this pandemic and to prepare to defeat the next one.
Jennifer Williams is the Chair of the Trenton Republican Committee and holds a MBA from Tulane University
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