While African Americans make up just less than 15% of Illinois’ population, they account for approximately 43% of the state’s 596 COVID-19 fatalities and 28% of its 17,887 confirmed cases, according to the Illinois Department of Public Health.
In a virtual town hall meeting on the issue earlier this week, state public health and African American community leaders agreed that COVID-19 is not creating, but is laying bare longstanding public health disparities along racial lines.
“COVID-19 is putting these long-lasting inequities on display,” said Congresswoman Robin Kelly, a Democrat who represents Illinois’ 2nd Congressional District in the south suburbs of Chicago and serves as the Congressional Black Caucus Health Braintrust chair. “The adage is true — when they get a cold, we get pneumonia.”
IDPH Director Dr. Ngozi Ezike said a number of factors — such as preexisting conditions like high blood pressure and diabetes, which are more prevalent in black communities — are contributing to the disproportionate impact of COVID-19, making the “horrific” statistics “not totally unexpected.”
Ezike and various leaders also said African Americans often live in more crowded, multigenerational homes, and many still must work in public-facing positions because they are essential yet low-wage workers who cannot afford to take time off.
“We believe that these disparities, or these differences, are the result of injustices, things like redlining (excluding certain neighborhoods from access to financial services), economic disinvestment, less access to health care or health insurance, food insecurity, the list goes on,” Dr. Kiran Joshi, co-director of the Cook County Department of Public Health, said in the virtual town hall.
While Joshi said there is an “increasing understanding” in public health and government that the underlying reason for such disparities is “structural racism,” he noted, “No single local public health department or health care organization or elected official could do this on their own.”
For leaders throughout African American communities statewide, current efforts are focusing on local community outreach with trusted organizations, a call for greater testing and data collection, and a focus on promoting available state and local resources.
On Friday, Gov. J.B. Pritzker announced plans for greater testing and available alternative housing in black communities as well.
‘With black communities, not for black communities’
In Chicago, where the deaths are greatest and the racial disparity appears to be the largest, nearly 70 percent of recorded COVID-19 deaths were in African-Americans as of earlier this week, according to reports from WBEZ-FM radio and the Chicago Tribune.
Sophia King, an alderman in the nation’s third-largest city, said in order to address longstanding inequities, “we have to identify all of those buckets of disparity and turn them on their head.”
“We know kind of where this is impacting our communities, what communities have been impacted,” she said. “We need to pour resources of testing into those communities, we need to make sure that those communities are marketed to well, we need to make sure that those communities have the access to health care that they need.”
Candace Moore, Chicago’s chief equity officer, said while the city has been advocating widely for the stay-at-home order, more targeted outreach to the African-American community is needed. The city launched a racial equity rapid response team this week to lead the hyperlocal effort.
“I think one of the core tenets that we think about as we approach this is we have to have conversations with black communities, not for black communities,” she said.
That includes working with community organizations and using two-way communication to learn what efforts and resources might be needed in individual communities.
She said some topics could include the importance of social distancing as it pertains to buying groceries and to someone who still goes to work at a public-facing job, as well as what protections are necessary for those who live in crowded homes.
‘Historical mistrust and fear’
Of the 596 recorded deaths from the virus in Illinois, 398 — or 67% — are in Chicago and Cook County, while 152 are in the collar counties of Will, Lake, Kane, McHenry and DuPage. That means only 46 deaths have been recorded outside of the Chicago area.
Still, downstate African American community leaders are taking a proactive approach in warning their communities of the dangers of the virus, in large part because the spread is believed to be wider than what has been confirmed through testing.
Sangamon County had 42 confirmed cases and two deaths as of Friday. For Doris Turner, an alderman in county seat and state capital Springfield, that meant recording a video on social media with her great-granddaughter and other family and community members, including a local high school basketball player.
“I think one of the reasons why it's been impactful is because it is very simple, but it's also coming from people who the average person can identify with and have contact with and it's delivered in a manner that people can understand,” she said. “And also it's being played in venues that people have access to.”
While the constant flow of information from state and public health leaders is important, she said, outreach from community and religious leaders can have a greater impact in black communities.
In the African American community, there is just a historical mistrust and fear of those medical and governmental systems,” she said. “So you want to get the information out there that, you know, it is a medical crisis, but then we have to break that down into why it's important.”
In the tri-county region of Peoria, Tazewell and Woodford counties, there had been 45 confirmed cases and three confirmed deaths as of Friday.
The Rev. Marvin Hightower, president of the Peoria chapter of the NAACP, said local messaging seems to be working, but as the weather warms it will become more important.
Hightower stressed hyperlocal outreach as well, including social networking, Zoom meetings and, much like in Chicago, “working through the various networks that we all have to get the word out.” He said area Democratic state Rep. Jehan Gordon-Booth has been vital in the effort.
“It's a conversation with black elected leaders, as well as the community members that have been discussing and talking about how important it is for our community to take this virus serious,” he said.
Lack of data
While racial data on deaths is sparse and decentralized, Chicago and Illinois do not appear to be alone in the disparities. Other Midwest cities such as Milwaukee and Detroit are seeing similar disproportionate impacts, according to Propublica, and The New York Times.
In the jurisdiction of the East Side Health District, which provides health and wellness services to four predominantly black townships in the Metro East area, including East St. Louis, Canteen, Centreville and Stites townships, there were 34 confirmed cases and six pending tests as of Thursday. The district has recorded three deaths, all in African-Americans. Other demographic data in the St. Clair County area were incomplete.
Linda Davis Joiner, a spokeswoman and program director for the district, told the Belleville News-Democrat now is the time to collect more data on COVID-19’s impact to better inform public health initiatives beyond the virus’ spread.
“Hopefully we can do something about it by tracking the statistics. It’s just too disproportionate. We've got to figure something out here,” she said. “We can maybe start with some intentionality with this virus since we’re tracking everything else associated with it.”
But a national shortage in testing and a lack of uniform reporting of racial data on a broad level make this effort difficult, experts and leaders agree.
U.S. Rep. Kelly and other congressional leaders have called on the U.S. Department of Health and Human Services, “demanding national demographic data for diagnostic testing because the anecdotal evidence has been deeply troubling.” Thus far, however, HHS has not released such data.
On Friday, the governor’s office released its first breakdown of testing demographic data gathered from a survey conducted when a person is tested, but demographic data was voluntarily left blank in about half of the 87,527 people tested. Otherwise, 25 percent of tests were conducted in white people, 13 percent in black people, 4 percent in Hispanic people and 2 percent in Asian people.
It is also widely accepted that the virus’ spread is much broader than the confirmed cases depict, as testing has fallen short nationally and the state tests about only 6,000 people daily. That’s short of the 10,000 daily goal set by state officials, who have said the state cannot adequately track the virus’ spread and trace contacts of confirmed cases without hitting that number.
“The one thing that we, as well as pretty much everybody else is concerned about, is making sure more tests are available for our area,” Hightower said of the Peoria area, where testing has reached into only the hundreds.
In an appearance with black leaders during his daily briefing Friday, Pritzker echoed the comments on racial disparities and announced the expansion of testing and new alternate housing options for COVID-positive persons that need to isolate.
The governor said a partnership with Ann and Robert H. Lurie Children's Hospital of Chicago and four federally qualified health centers on Chicago’s south and west sides will “expand testing in these communities over the next several days to an additional 400 tests per day.”
Three locations in the Metro East region will offer up to 470 swabs per day starting early next week, Pritzker said, and those will be sent to Anderson Hospital in Madison County for testing.
He also announced a state-run south suburban drive-thru testing center will open early next week in the Markham-Harvey area, and it will run “hundreds of tests per day.”
“We must increase testing everywhere,” Pritzker said. “It isn't just in Chicago, just in Cook County or just in the black community — everywhere in the state. In fact that is going to be the key for us, getting out of this crisis.”
Pritzker also noted alternate housing will be available for people who need isolation, such as those living in multigenerational homes.
These rooms will be available to residents who tested positive for COVID-19 but do not require hospital-level care or who need social distancing as a precautionary measure. These rooms will also be available to medical professionals and first responders and can be accessed through local health departments.
Pritzker said previously the state has also planned the reopening of recently-closed health care facilities in black communities to ensure access to care as well.
— Kelsey Landis of the Belleville News-Democrat contributed to this report.