By MARC H. MORIAL
National Urban League
“Far too many African Americans still struggle to lead healthy and economically secure lives. This is due to the long-standing effects of racism, which touches all African Americans, regardless of socioeconomic status. These effects can be reversed, but it will take real commitment and systemic change. It shouldn’t have taken an international pandemic to prove to America’s leaders what civil rights activists have known all along: a system in which people can’t afford to seek medical care and are forced to go to work sick is a recipe for national disaster.” – Jamila Taylor, director of Health Care Reform and Senior Fellow, The Century Foundation
At every point along our health care and economic systems, Black Americans are more vulnerable to the most serious effects of the coronavirus crisis. We are more likely to have underlying health complications, like asthma. Our complaints are less likely to be taken seriously by medical professionals. We are less likely to receive treatment for our complaints. Even with treatment, we are less likely to experience positive outcomes. The high level of disparity erodes Black Americans’ trust in the health care system.
Although the Affordable Care Act extended health insurance to 2.8 million African Americans, 9.7% remained uninsured in 2019, compared with 5.4% among Whites. Out-of-pocket health care expenses represent 20% of household income for Black families, compared with 11% for White households.
Several months ago, researchers found that a process used to guide health care decisions for millions of people was beset with racial bias, drastically underestimating the needs of the sickest Black patients.
According to the Washington Post, the algorithm wasn’t intentionally racist – in fact, it specifically excluded race. Instead, to identify patients who would benefit from more medical support, the algorithm used a seemingly race-blind metric: how much patients would cost the health care system in the future. But cost isn’t a race-neutral measure of health care need. Black patients incurred about $1,800 less in medical costs per year than White patients with the same number of chronic conditions; thus the algorithm scored White patients as equally at risk of future health problems as Black patients who had many more diseases.
Because of systemic barriers, African Americans receive less health care – so the algorithm identified Black patients as less in need of care, creating a vicious cycle of neglect.
We cannot allow this neglect to continue in the face of a deadly epidemic. We must insist that testing and treatment are available in underserved low-income neighborhoods and communities of color, and that the care is commensurate with that offered in other communities.
The nation’s two-pronged response – delivering health care and economic relief – presents a unique opportunity to address bias and disparity and, and to begin to build a more equitable system.
The National Urban League is leading the effort to shape the nation’s response so that the communities hardest hit by the crisis are not overlooked. We are working with Congressional leaders to ensure that coronavirus response legislation must take racial equity into account – not just in the wake of the crisis, but permanently.
Black families need access to quality, affordable health care – not just now, but all the time. Schoolchildren need broadband access – not just now, but all the time. Workers need paid sick leave, paid family leave and unemployment compensation – not just now, but all the time.
Times of crisis expose the cracks in an institution’s structure. Now is the time to repair them.
Marc H. Morial, former mayor of New Orleans, is president and CEO of the National Urban League. He can be reached through http://nul.iamempowered.com.