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Coronavirus risk for African Americans tied to more than race

Racial disparities around the virus are impossible to ignore, with African Americans seeing higher rates of hospitalization and of deaths.
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WASHINGTON — Last week the racial disparities that have accompanied the coronavirus outbreak in the U.S. became a major story. Officials in St. Louis, Detroit and a large swath of states reported that African American populations had been hit especially hard by the virus.

A look at the data helps explain why. Behind the well-known daily numbers of the pandemic — the cases, hospitalizations and deaths — a mix of geography, socioeconomics and health factors make COVID-19, the disease associated with the virus, particularly dangerous for some minority groups.

At this point, the racial disparities around the virus are impossible to ignore, with African Americans seeing higher rates of hospitalization and of deaths.

A Centers for Disease Control and Prevention study of the virus found that 33 percent of those who have been hospitalized are African American — even though that racial group makes up only 13 percent of the general population. Meanwhile, 45 percent of those in hospitals for the virus are white and non-Hispanic, even though that group makes up more than 60 percent of the overall population.

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Those are significant and damning figures, to be sure, but comparing hospitalizations to national population figures ignores the way the virus has spread. The footprint of COVID-19 has grown over the last few weeks and reached into more rural locales, but the biggest hot spots have been big urban areas.

Among the top 20 counties for cases are 10 that are home to some of the nation's biggest cities, places with racially and ethnically diverse populations.

The list includes New York, Philadelphia, Miami, Detroit, Chicago and New Orleans. Those cities and counties are all above the national average for their African American populations. And together, they held 27 percent of all confirmed cases of the virus in the U.S. as of Friday night.

That concentration of hot spots is most likely behind some of the disparities in the COVID-19 impacts so far, but that explains only a small part of the difference.

Another crucial factor is the socioeconomic challenges minority populations face. Minority groups tend to have higher rates of poverty and higher percentages of people without health insurance.

In 2018, 11.8 percent of the U.S. population lived in poverty, but the figures were 20.8 percent for African Americans, 17.6 percent for Hispanics and 25.4 percent for Native Americans. Those numbers mean minority populations are less likely to live healthy lifestyles; healthy foods and daily exercise are less likely to be part of daily routines.

Those economic challenges often translate into a lack of health insurance, as well. Among the non-elderly population, only 8 percent of white, non-Hispanic Americans lack health insurance, according to the Kaiser Family Foundation. But the figures are 11 percent for African Americans, 19 percent for Hispanics and 22 percent for Native Americans.

Add those socioeconomic impacts together and you get another challenge for minority groups. They are more likely to suffer from the underlying health issues that can lead to severe cases of the virus.

African Americans, in particular, are more likely to suffer from health problems that are some of the main triggers for COVID-19 hospitalization, including asthma, diabetes and obesity. For each of those conditions, African Americans are above the national average by a percentage point or more — and further above the numbers for white, non-Hispanic Americans.

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Native Americans are also above the national average in all three measures. So far, some Native Americans have benefited from living in more rural areas where the virus has been slower to arrive.

Hispanics are above the national averages for obesity and diabetes. As the virus grows in Western and Southern states, they could face more challenges.

The far-reaching impacts of COVID-19 have become more apparent as the pandemic grows, but the figures concerning racial disparities and the virus shine a light on broader health inequities and challenges in the U.S.

Even after the virus is gone, those larger systemwide differences will remain. And don't be surprised if the figures end up part of the broader presidential campaign conversation.