Demonstrations are flaring up across the country to protest the deaths of Black Americans at the hands of police. They’re also calling attention to broader inequalities. One of those areas—health disparities—kills Black Americans in massive numbers.
Black residents of Marion County, where Indianapolis is located, are more likely to be infected with COVID-19 than white residents. They are also more likely to suffer from diseases like diabetes and kidney failure.
“There's nothing about black residents in Indianapolis in particular that makes them more susceptible to coronavirus," says Matt Nowlin. He co-authored a new report from SAVI, a program affiliated with the Polis Center at Indiana University Purdue University Indianapolis, about health disparities.
“What it is, is it's sort of a result of so many layers of inequity. At the end of the day, these systemic inequities can be a life or death issue.”
One result: a big difference in life expectancy. Researchers from SAVI and the Richard Fairbanks School of Public Health found a few years ago that people in a mostly white suburb of Indianapolis lived to age 83 on average. Fifteen miles south in downtown, where there were more minorities, the average was only 69.
The pattern in Indianapolis holds true in cities across the Midwest and U.S.
And though health issues aren’t a focus of street protests, some experts say they contribute to the unrest.
“We know that African-American, Latino patients and other minority patients are more likely to have poorer living conditions on average,” says Dr. Curtis Wright, CEO of Eskenazi Medical Group, the city’s safety-net hospital. “They're more likely to have issues with food insecurity, they're more likely to have access to non-healthy diets.”
Wright says some patients might be unaware they are high-risk because of poor access to healthcare. "There's known to be lack of trust in medical providers regarding medications, education about certain conditions and some preventive measures.”
Tony Gillespie is vice president of public policy for the Indiana Minority Health Coalition, which has been involved in these issues for years.
“We're one of the states with the lowest public health investment in the country,” he says. “You know, you really can't adequately address public health if you don't address social justice issues or social determinants of health.”
Social determinants are factors like unsafe housing, lack of transportation, or scarce grocery stores. They all contribute to health problems—and make solutions even more complex.
“I think when things become just like part of the landscape, it becomes deprioritized and nobody really pays attention to it,” Gillespie says. “And it just becomes yet another issue that has to be addressed along the public health continuum.
He says the recent protests and outrage are partly a response to these historic inequalities.
“I think those people, they are in the thick of it, so they know something is wrong,” he says. “Do they attribute that to a public health issue? No, probably not. I think there are people who in public health don't necessarily make that connection.”
But now many are asking what can be done.
The Minority Health Coalition wants the state to spend more money on health. The Indiana Black Legislative Caucus is working to address disparities with COVID-19, and many local clinics offer special programming related to diabetes. And Wright sees a big opportunity in education.
The American Cancer Society’s Bryan Hannon has lobbied lawmakers to make public health policy changes for years. He says change won’t come easy.
“We shouldn't fool ourselves into thinking that this is a problem we can solve with one policy, or with one conversation, or with one campaign, and certainly not one legislative session or one budget cycle,” he says.
This story was produced by Side Effects Public Media, a news collaborative covering public health.