Protests over the killing of George Floyd have pushed to the forefront a particular fact long known by medical professionals: Racism kills, and it may be the main cause of health disparities between whites and Blacks.
In a recent essay, Dr. Nadine Burke Harris, California's first surgeon general, wrote: "As a doctor and a policymaker, I often hear the question 'what is it about black and brown people' that makes us more vulnerable to the virus? That question infuriates me. Science makes clear how powerfully our experiences and environments shape our biology."
In her essay, Burke Harris said the images of masked protesters carrying "Black Lives Matter" signs are starkly juxtapose "the heroic efforts we are all making to protect our communities from coronavirus against our feckless efforts to curb the sickness of racism that has infected America since its birth."
"In those images is also a reminder that the disproportionate death rate of black and brown people from Covid-19 is no coincidence. It is directly related to the history of racial oppression in our nation."
Burke Harris, the mother of twin sons age 17 and sons 8 and 4, told NBC News that her entire medical training and career have been devoted to reducing health disparity.
"The way chronic stress and trauma gets under our skin and affects our biology was not being addressed. That's why it felt important to me not only to elevate the issue, but also to elevate the science," she said. "The science has been around for decades."
Research has long shown a disparity between the health of Blacks and whites. The Centers for Disease Control and Prevention reports that there is an overrepresentation of Blacks hospitalized and dying of COVID-19. Overall in the U.S., Black people are more likely to die at early ages from all causes of illnesses.
Local governments, including those of Charlotte, North Carolina; Denver; Indianapolis; and Dallas, have recently declared racism a public health crisis. Now advocates wait to see what solutions they will implement.
Burke Harris said: "We have to help health care providers understand how trauma affects people's health. It is just like lead poisoning. Doctors can do medical treatment to help reduce the impact of lead on someone's health. But the real answer is to get lead out of the paint."
Jules Harrell, a professor of psychology at Howard University, has been involved for years in research showing how stress caused by racism can affect the mental and physical health of Blacks. He said the current public acknowledgement of the issue came because of "the perfect storm. … I don't know if we could have even imagined this."
He pointed to the fact that today Blacks must contend with COVID-19 — and the disparate effects the virus has had on the Black community — while also dealing with the trauma of witnessing a string of brutal killings of Black people.
"In the 1980s at Howard, we started looking at the physiology of racism in the laboratory, looking at blood pressure and cardiovascular events," said Harrell, who said researchers had Black volunteers view films of situations like people being accused of shoplifting or refused an apartment because of race.
"Then the Rodney King incident occurred, and people saw it over and over, and it was worse than anything we were showing people," he said. "Now we see the slow-motion lynching of Mr. Floyd."
"The research we did was centered around the meanness and inconvenience of racism, but nothing like ardent cruelty," he said. "We didn't show that kind of thing because we thought of the ethics of it.
"We looked at cardiovascular effects — blood pressure and how hard the heart beats when experiencing some things such as racism. It's amazing how sensitive our systems are to this."
Harrell said that even during sleep, the brain may still process acts of racism and that blood pressure, which for many people goes down during rest, may not among Blacks.
"There's something wrong with a society that causes people to carry this even when they sleep," Harrell said.
Black people today are also suffering from experiencing racism in a way that has not been possible in the past, because of social media and the constant replay of killings.
"You don't have to be a direct target of racism for it to negatively impact your physical and emotional health," said Gail Parker, a psychologist and yoga therapist in Palm Springs, California. "People are experiencing secondary or vicarious trauma. Secondary trauma is the trauma of exposure to a racially charged event that leaves you feeling helpless and afraid and comes from seeing something overpowering. We are seeing this on top of the ongoing daily recurrences of racial events that cause us emotional pain."
Parker suggested that as society grapples with how to eradicate racism, Black people should do something in their immediate control: stop repeatedly watching and reading about these killings.
"Black people have a group consciousness, so when we see a Black person being killed or abused on television or when we read about it, we identify with that person being abused and with their family," Parker said.
Stop watching. Don't have conversations that are re-traumatizing, she said.
"Give yourself an opportunity to rest and recuperate before you re-engage," she said. "It's about self-protection. Secondary trauma is just as lethal to Black people as secondhand smoke."