Opinion | Michigan’s coronavirus response must confront poverty and racism

Emerging evidence indicates communities in southeast Michigan are hard hit by the COVID-19 infection, with the city of Detroit, Wayne County and Oakland County showing the greatest number of cases and some of the highest rates of mortality. This should come as no surprise. Higher risk of disease and death follow well-established patterns, structured by economic disinvestment and institutional racism that drive lack of access to critical resources necessary to maintain health.

The state’s latest COVID numbers show that non-Hispanic Black (NHB) residents, who make up just 11 percent of Michigan’s population, account for 35 percent of the cases and 40 percent of the deaths attributable to COVID-19 to date.  In Michigan, as in the United States, long histories of racism, segregation and economic disinvestment have contributed to disproportionate levels of poverty among NHBs, Latinx and Native Americans.

The excess poverty experienced by these groups is associated with increased prevalence of multiple chronic conditions, several of which (e.g., hypertension, diabetes) are linked to more adverse health impacts of COVID-19.   The increased vulnerability to more serious health effects is exacerbated by the inability to act on two primary recommendations for reducing risk of COVID-19: social distancing and hand-washing.

For many, social distancing is not an option.  NHB and Latinx residents are more likely to work in essential services (e.g., production and transportation jobs) and occupations in which working at home and taking time off are not an option.  Those living near the poverty line have limited financial resources, making it difficult to stockpile food and requiring multiple trips to grocery stores and food banks to replenish supplies.  While evictions have been temporarily halted in response to COVID-19, those who are already homeless are unable to practice social distancing as they rely on shelters or other temporary living arrangements, often in close quarters with others. 

Compounding this issue is the inability of many residents to act on the simple and effective advice of public health officials to wash their hands to help prevent the spread of COVID-19.  Evidence across multiple studies shows that hand-washing with soap and water, for at least 20 seconds, reduces the spread of multiple respiratory diseases. However, many residents of Detroit and other Michigan communities remain without access to running water. Unable to act on this simple advice, these households experience heightened risk of COVID-19 infection. 

This double jeopardy – greater likelihood of infection, combined with increased lethality of the infection – contributes to the emerging health inequities reflected in Michigan’s latest COVID numbers.

As members of the public health community, we urge the State of Michigan to recognize the role that economic disinvestment and institutional racism have played in heightening the risk of COVID-19 infection and mortality among NHB Michigan residents.  We applaud ongoing efforts outlined in the governor’s Executive Order to restore water service to all households and assure that the water is compliant with federal and state drinking water standards, and to place a moratorium on housing evictions. Such measures can, in the short term, slow the spread of COVID-19 and flatten the curve in Michigan communities. These short-term measures must become part of a longer-term strategy to promote national health by addressing deep-seated and pervasive inequities that increase vulnerability to poor health and premature and unnecessary mortality.


The authors are professors in the Department of Health Behavior and Health Education at the University of Michigan School of Public Health

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Comments

Gerry Niedermaier
Sat, 04/11/2020 - 9:51am

Great issue!

George R Ehlert
Sat, 04/11/2020 - 1:56pm

For over 50 years, we have not been addressing these issues properly. Take access to nutrition as an example. We give out SNAP cards (aka Food Stamps) and do not incentivize good choices. How about adding 15% to the card when used for healthy foods and penalizing the cards an additional 15% for poor choices (cookies, soft drinks, fried chicken, etc.). Use some of the funds to supplement owners/operators of high quality grocery stores in underserved areas - with prohibitions on selling alcohol, tobacco, etc. in order to receive the subsidy. Require them also to have demo kitchens, fresh produce, meat, etc. Create a mobile Eastern Market that can visit areas once per week, with high quality choices only, and subsidize 50% of purchases made w/ SNAP dollars. The ideas are endless....but if we keep doing the same stuff as we have done for 50 years, run by the same entrenched bureaucracies, things will never change.

Arjay
Sat, 04/11/2020 - 8:11pm

When will personal responsibility play a role? So tired of hearing that government is the answer to everyone’s problems. No, it is not. You are responsible for yourself.

George Town
Sat, 04/11/2020 - 11:55pm

I believe that if Home Depot must tape off paint and paint supplies then any business selling Lotto tickets or alcoholic products should also tape off the lotto machines and shelves holding alcoholic products. Allowing someone to make rapairs to a household with materials but not finish the job by painting is not looking at the finished job as a necessity. With all the stress associated with the present health crisis, finishing a job would be helpful in bringing a completed job to a full end. I feel that this situation deserves another look.

A Bellows
Sun, 04/12/2020 - 11:02am

The left's obsession with race has become a mass psychosis.

Billy Whiteshoes
Sun, 04/12/2020 - 12:41pm

COVID-19 has NOTHING to do with race or poverty it’s individuals writing garbage like this to purposely divide the nation and create the victimhood mentality to push your Statist Regressive Ideology in order to create government dependency all for votes control and power period! Where was all the hysteria and economic shutdown during the H1N1 outbreak in 2010 where 60 million Americans were infected 300,000 hospitalized and 60,000 died?? Ahhh yes you were to busy covering and down playing the pandemic because the Statist Marxist Regressive Obama was in office and who did NOTHING until 1000 Americans died and 23 million infected. Quit calling yourself a news outlet your nothing but a propaganda machine for the party of Statism!

True Facts
Wed, 04/15/2020 - 5:59pm

Disease Influenza
Virus strain Pandemic H1N1/09 virus
Location Worldwide
First outbreak North America[1][2]
Index case Veracruz, Mexico[1][3]
Date January 2009 – 10 August 2010[4][5]
Confirmed cases 1,632,710 (confirmed)[6]
Deaths
18,449 (lab-confirmed deaths reported to WHO;[7] flu patients were generally not tested)[8]
284,000 (range 151,700-575,400) (CDC and WHO estimate)[9]

Catherine
Sun, 04/12/2020 - 3:54pm

Thank you for speaking truth. Some clearly close their eyes, ears, minds and hearts to the systemic racism that makes black and brown Americans more vulnerable to every illness, highlighted in a crisis like this one. Enough. We who can make positive, constructive policy and programs, or advocate for them, must do all we can to implement the changes we need.

Rob
Sun, 04/12/2020 - 4:33pm

Why is it that michigan residents can travel to other states like Ohio, but ohio people cannot go to michigan. Interesting rule. Waiting for an answer.

Tom T
Sun, 04/12/2020 - 9:02pm

Lottery sales are probably the most intimate transaction done in the stores. Lottery sales can only be done in cash. Require a lot of interaction between the cashier and buyer. Are usually done in small stores which are the only stores located in poor neighborhoods. Lottery sales usually require a lot of time to transact leading to long exposure rates with customers. Are done by people who are addicted lottery players and will ignore their symptoms to play. If you want to contact trace, trace the people getting sick in Detroit and identify the common vectors. I bet small liquor and party stores are common in the picture. Why isn't Whitmer banning lottery sales? They maybe the biggest reason why the cases in Detroit and Wayne county are exploding. Is there anybody in the news media who will put aside their partisanship and start saving lives? Hold Whitmer responsible and close the lottery.

Gloria
Wed, 04/15/2020 - 5:36pm

Not my governor! Socialism at its finest!!!