I spent the morning of April 7, 2020, trying to obtain my regular prescription of hydroxychloroquine. I had already moved all of my medicines to a new pharmacy to try to obtain 90-day refills since I have lupus and I wanted to limit the times I had to go to the pharmacy due to COVID-19. However, my new pharmacy only had enough pills to cover me for 30 days. This incident has occurred because there is a stockpiling of those pills in case hydroxychloroquine works as a possible treatment for the coronavirus. But it made me wonder when we as a nation will realize that we need to take everyone’s healthcare seriously.
COVID-19 appeared to have a death rate of around 3.4% overall in early March, but the numbers remain in flux. However, as more data is compiled, particularly demographics of those infected and those who have perished in the U.S., the numbers are showing that African Americans are dying at much higher percentages when matched against other races. In Los Angeles, African Americans make up 9% of the population; however, the death rate from COVID-19 in this group is 17%. In Chicago, the death rate is 72% for African Americans when the population is only 30%, and in Louisiana, the death rate is 70% and African Americans make up 32% of the community.
African Americans appear to be particularly susceptible to this pandemic and their death rate is much higher than it should be. This pandemic is revealing once again how ongoing socio-economic disenfranchisement manifests with dire consequences in the midst of a national crisis, whether it is an economic recession, a natural disaster or today’s global health pandemic.
Throughout the 20th and 21st century, housing and segregation have been at the foundation of racial economic inequality in the United States. An important civil rights act, The Fair Housing Act, was passed in 1968 and amended in 1974 and 1988, making discrimination in housing illegal in the United States. The protected classes within the act are race, color, religion, national origin, sex, disability and familial status. As part of the amendments to the law, the Secretary of Housing and Urban Development has a duty to affirmatively further fair housing in the country. If this duty had been robustly implemented, communities in the U.S. would be closer to integration throughout the country instead of still being segregated.
The poor implementation of affirmatively furthering fair housing (AFFH) has taken a significant toll on the health of African Americans. The AFFH rule that is currently being rolled back under the Trump Administration (despite being statutory in the federal Fair Housing Act) is designed so that everyone, no matter their race, can live in a non-segregated neighborhood. The lack of use of this provision and the decimation of using a rule to enforce fair housing throughout the country has contributed to African Americans not having equal access to adequate schools, food, and in particular, healthcare.
“African Americans are disproportionately treated at healthcare facilities with the fewest technological resources, the most poorly trained professionals and least experienced clinicians serve predominantly Black patient populations,” according to the Brookings Institute. Public health reports show that racial residential segregation is a fundamental cause of healthcare disparities between Whites and Blacks. Socioeconomic status differences between races include employment and education, both of which affect health.
Giving access to affordable housing opportunities for all Americans should reduce the gap of healthcare received by all Americans. The Affirmatively Further Fair Housing rule had specific requirements for communities to include an assessment of fair housing in their consolidated plans and public housing assessment plans to ensure that affirmative work towards fair housing occurred. It also included requirements for the public to have opportunities to discuss such plans.
By pushing this rule forward, the U.S. can work to integrate communities. This integration would positively impact African Americans in the quality of healthcare and healthier living conditions. In the fair housing community, the statement has always been that your zip code affects all the aspects of your life. Based on the information, that appears to be true. Therefore, we need to make zip codes and communities equal to allow all Americans to have a healthy life and a chance to survive against the next pandemic. Reinstating the 2015 AFFH rule would give us that chance.
Tracy McCracken is NCRC’s Director of Fair Housing