The Coronavirus Pandemic has altered the ways we use shared space fundamentally. Policymakers across the nation have enabled police to deploy the power of the state to limit unnecessary and dense usage of public spaces and private gatherings. Such social distancing policies are critical in flattening the pandemic curve of an effective and efficient airborne virus and lessening the public health burden of an already-strained health care system. Yet, the stickiness of systemic racism persists. Racial inequities underpin the facesgoverning the matrices of the pandemic, policing, and protests.
I am writing during the “socially distanced” summer of Covid. This means that, like almost everyone else, I am trying to figure out what this “new normal” means. Aside from the horrendous toll, the disease itself has taken on family, friends, and colleagues, we are all increasingly aware of the havoc that the necessary efforts to contain its spread are now wreaking on economic and social life, and, in particular, on the public life of cities. Those of us lucky enough to be able to work from home now joke about what the blurring of the line between public and domestic space means for our everyday lives: attending “zoom” meetings in sweat pants (or no pants); how long it has been since we have put on a dress or a suit; the little glimpses of the private lives of our colleagues and bosses that spill over onto the screens. Yet, I don't think we have fully begun to grasp the implications of the sudden withdrawal from public life has meant for our social relations and our politics.
Of course, trying to figure out what this all means while the crisis is still going on is a risky business. By the time you read these words, there is a good chance many of these observations will seem very dated, if not dead wrong! As Nygaard and his colleagues remind us, "history shows us that the ways we organize our cities are often resistant to abrupt change—even in response to catastrophic events” (Nygaard et al. 2020). Or to quote the warning of a recent Noble prize winner: “don't speak too soon for the wheel's still in spin.” Listening to the pundits forecast the end of dense cities and predicting a new middle-class exodus to the suburbs and exurbs, one cannot help but be reminded of the aftermath of “9/11” when many leading thinkers quickly pronounced concentration in central cities a thing of the past and pointed toward a “poly-nucleated” urban future. In the wake of the collapse of the towers, we were told that no one would ever want to work in a tall building again, and certainly no one would want to live in one. Yet, a decade after the towers fell Frank Gehry's “Eight Spruce Street,” at the time the tallest residential building in the western hemisphere, opened a few hundred yards from the World Trade Center site. Today the three tallest residential buildings in the world are all in Manhattan, which should, if nothing else, teach us to be cautious about cliché ridden predictions of urban doom.
Still, there are some things we can say about the dangers of sudden withdrawal from public space if only because the responses to pandemic are accelerating trends that were already underway. The first to note that while the pandemic affects people everywhere, its impacts are greatest in the cities. Or as Nicole Gelinas recently put it, “Covid-19 has hit the cities so hard because of what they do so well: bring people closely together for fun and profit” (Gelinas 2020:A19). Being in public—that is, in the presence of strangers in spa
The impact of COVID-19 on racially minoritized communities in the United States has forced us all to look square in the face of the systemic racism that is embedded in every fabric of our society. As the number of infected people continues to rise, the racial disparities are glaringly obvious. Black and Latinx communities have been hit considerably harder by this pandemic. Both racial/ethnic groups have seen rates of infection well above their percentage in the general population and African Americans have seen rates of death from COVID-19 as high as twice their percentage in the general population. These numbers bear witness to the high cost of racism in the United States.
In 2020, protests erupted around police brutality and other forms of institutional and systematic racism within the justice system. These same forms of structural racism exist in the medical and healthcare industries, and explain fundamentally, why we have large, ongoing, racial health disparities in all health outcomes including COVID-19 (Harris et al. 2006; House 2002; Matthew 2015; Washington 2006). COVID-19 is an acute (short-term), infectious illness that has become an epidemic in the United States. COVID-19 spreads through the air; therefore, it ought to affect people equally. Unfortunately, we are already seeing substantial racial inequality in COVID-19 infections. African Americans are experiencing three times the rate of COVID infection and nearly six times the death rate of White majority counties (Garg et al. 2020; Scott 2020; Webb et al. 2020; Yancy 2020).
In this essay, we examine Black–White racial health disparities and their social determinants. We argue that racism, whether called systematic, structural, or institutionalized (for the sake of this essay these terms are interchangeable), is the primary cause of both explicit and implicit race-based discrimination. Furthermore, we will present and refute biological, behavioral, and social class explanations for racial health disparities. Next, we use the institutionalized racism framework to examine COVID-19. We finish with a set of proposals designed to interrupt the association of racism with health outcomes.
There is a large body of research on racial disparities in chronic health conditions. Chronic conditions, such as heart disease, diabetes, and hypertension are life-long illnesses and syndromes managed through medical treatments. Today, they are the top causes of death (Rana et al. 2020). African Americans have more chronic conditions such as hypertension, diabetes, cardiovascular disease, and lung disease than Whites, increasing their risk of death from COVID-19 (Garg et al. 2020).
What causes African Americans to have more chronic conditions and be more likely to contract infectious diseases such as COVID-19? Dressler et al. (2005) find that most research looks to five types of explanations for racial health disparities, genetic, behavioral, socio-economic, structural-constructivist, and psychosocial stress. We can dismiss the genetic explanation because race is socially constructed as W. E. B. Dubois demonstrated back in 1906. He found that from 1725 to 1853, while Whites lived longer than Black folks, life expectancy improved similarly for both populations, and that differences in mortality rates among Black folks living in different cities were due to environmental differences. Therefore, genetic inferiority could not explain Black peoples life’ span (DuBois 2003).
The research is clear that