From Harvard Medical School:
Anti-Racist Epidemiology
Research suggests reparations for slavery could have reduced COVID-19 infections and deaths in U.S.
By JAKE MILLER February 10, 2021 ResearchThis article is part of Harvard Medical School’s continuing coverage of medicine, biomedical research, medical education and policy related to the SARS-CoV-2 pandemic and the disease COVID-19.
Civil rights activists have long called for monetary reparations to the Black descendants of Africans enslaved in the United States as a financial, moral, and ethical form of restitution for the injustices of slavery.
Now, a study led by Harvard Medical School researchers suggests reparations could also have surprising public health benefits for Black individuals and the entire nation.
To estimate the impact of structural inequities between Black and white individuals, the researchers set out to capture the effect of reparation payments on the Black-white wealth gap in the state of Louisiana.
Their analysis, published online on Feb. 9 in Social Science & Medicine, suggests that if reparations had been made before the COVID-19 pandemic, transmission of SARS-CoV-2 in the state’s overall population could have been reduced by anywhere from 31 percent to 68 percent.
The work was done in collaboration with the Lancet Commission on Reparations and Redistributive Justice.
“While there are compelling moral and historical arguments for racial-injustice interventions such as reparations, our study demonstrates that repairing the damage caused by the legacy of slavery and Jim Crow racism would have enormous benefits to the entire population of the United States,” said study senior author Eugene Richardson, assistant professor of global health and social medicine in the Blavatnik Institute at Harvard Medical School.
The disproportionate effects of COVID-19 on racial minorities—Black individuals in particular—have been well documented. Black people get COVID-19 at a rate nearly one and a half times higher than that of white people, are hospitalized at a rate nearly four times higher, and are three times as likely to die from the disease, according to the latest estimates from the U.S. Centers for Disease Control.
Actually, that disparity declined during each of the three Covid waves of 2020, with the last wave showing virtually no difference in excess deaths between whites and blacks. The black excess death rate fell sharply from the first to the third wave, while white death rate went up in the third wave. From the CDC:
During the third wave, the excess death rate among whites was running worse than among blacks until suddenly dropping in the last week of 2020.
In contrast to the much more recounted troubles of blacks, Hispanics were hit very hard by all three waves. Asians were hit hard in the first wave and then surprisingly hard by the third wave, much worse than blacks were slammed.
For their analysis, the researchers paired sophisticated data analytics and computational tools with commonly used epidemiologic modeling methods to calculate the impact of structural racism on infection rates among Black and white populations in Louisiana. They chose Louisiana as an exemplar of the impacts of structural racism in the U.S. because it was one of the few states that reported infection rates by race in the early stages of the pandemic. For a control group, the researchers chose the relatively egalitarian population of South Korea.
Comparing Louisiana versus South Korea, why didn’t anybody ever think of that before? It’s the perfect ceteris paribus comparison, better than Vermont vs. New Hampshire. Louisiana and South Korea are alike in all things except Louisiana is infected with the disease of White Racism.
… The study examined the initial period of the outbreak, before infection control measures were implemented, so any differences in infection rates between populations at that time would have been driven mainly by differences in the social structures, the researchers said.
For example, Louisiana has a population heavily segregated by race, with Black people having higher levels of overcrowded housing and working jobs that are more likely to expose them to SARS-CoV-2 than white people. In comparison, South Korea has a more homogenous population with far less segregation.
To probe how such structural inequities impact transmission of SARS-CoV-2, the researchers examined infection rates over time for the first two months of the epidemic in each location. During the initial phase of the outbreak in Louisiana, each infected person spread the virus to 1.3 to 2.5 more people than an infected individual during the same phase of the outbreak in South Korea, the analysis showed.
And yet, South Koreans are just as gregarious and rule-respecting as Louisiana blacks. So this is a perfect comparison.
The study also showed it took Louisiana more than twice as long to bring the early wave of the epidemic under control as South Korea.
Next, the researchers used next-generation matrices to gauge how overcrowding, segregation, and the wealth gap between Blacks and whites in Louisiana could have driven higher infection rates and how monetary reparations would affect viral transmission.
Do African Americans tend to live in overcrowded housing really all that much? My impression is that Mexicans tend to have a higher number of residents per room on average, but do blacks? Or do blacks tend to empty out neighborhoods over the years, leading to a lot of square footage per person? Detroit, for example, has one-third of the population that it used to. The population of the Austin neighborhood in Chicago has dropped from 128,000 when my in-laws moved out in 1970 to 98,000 today. On the other hand, increasing numbers of houses in Austin are being abandoned, so the decline in average number of persons per room isn’t as steep.
Conversely, I don’t know what the population density per room is in South Korea at present. I imagine it was extremely high in the past, but they’ve built a lot of housing since. In Japan, the average family of four had about 600 square feet in 1980, if I recall correctly, but that has more than doubled since then.
In any case, I suspect that South Korea’s success against covid stems from it being largely an island, with ocean on three sides and mine fields on the fourth, along with a competent society.
The model showed that greater equity between Blacks and whites might have reduced infection transmission rates by anywhere from 31 percent to 68 percent for every person in the state.
Because racism is the reason Louisiana blacks tend to have sociable face-to-face jobs while whites tend to have unsociable jobs that they can do hidden away at home. It’s simple logic: it’s because blacks are hated that they get paid to do more sociable work.
This research comes at a time when many Americans are already thinking about the larger societal costs of structural racism, the researchers said. They noted, for example, that the nationwide movement to protest police brutality against Black people has been fueled by many of the inequitable outcomes exemplified so painfully by the coronavirus pandemic in the U.S.
… Richardson said that the research was designed to explore how reparations payments might have altered the trajectory of the coronavirus pandemic in the U.S. and how a different response to the disease could have helped mitigate the disparities fueled by social conditions that are vestiges of slavery.
Fortunately, the Chappelle Show in 2003 modeled the impact of how reparations would cause blacks to shelter in place and socially distance:
… Richardson said that historian and anti-racist scholar Ibram X. Kendi’s description of the differences between racism and anti-racism were helpful in designing the study. According to Kendi, a racist policy is any policy that produces or sustains inequality or promotes the power of one racial group over another, whereas an anti-racist policy is any measure that produces or sustains equity between racial groups.
Anti-racism is where the government takes your equity in your home, because you are white, and gives it to Ibram X. Kendi, because he is black.
… To assess the effect of reparation payments on the trajectory of the pandemic, the researchers based their calculations on a model that would pay $250,000 per person or $800,000 per household to descendants of enslaved individuals—one of several proposed reparation models.
That’s a mere ten trillion dollars. Money printer go brrrrrr … and then all our racial disparities are over forever, or at least until the next credit card bill is due.
Meanwhile, as I pointed out last year:
Strikingly, it’s not even true anymore that whites live longer than nonwhites. White Americans now live slightly less long than the national average. While white life expectancy in 2018 was 3.6 years longer than black expectancy and 1.2 years longer than American Indians, Hispanics outlive whites by 2.3 years and Asians live 7.7 years longer.
Why do Hispanics out live whites by so much? Nobody really knows. I wouldn’t be surprised if it has something to do with why Hispanics are dying of Covid so much: perhaps Hispanics live longer because they socialize with their extended families so much, which in general is good for their well-being, except during this perverse pandemic, which punishes the normally healthiest things in life.
From US News and World Report:
When it comes to mortality rates, the lower you are on the graph, the better. By 2015, after 15 years of Deaths of Despair, U.S. whites died at higher rates (age-adjusted) than not only U.S. Latinos but also Peruvians in Peru and a few other Latin American countries.
The Latino Health Paradox Goes Beyond U.S. Borders
Latin Americans are less likely to suffer an early death than whites in the U.S.By Gaby Galvin, Staff Writer Feb. 12, 2020, at 2:38 p.m.
LATIN AMERICANS ARE less likely to die prematurely than non-Hispanic whites in the U.S. – whether they live in the country or not, a new study suggests.
Researchers have long theorized that a longer life expectancy among Latinos in the U.S. – despite often facing socioeconomic disadvantages – could be driven in part by a “healthy immigrant effect,” meaning healthier people may be more likely to immigrate to the U.S. than those in poorer health. But the new study, published Wednesday in JAMA Network Open, suggests “there may be a broader Latin American paradox” that extends far beyond U.S. borders.
Researchers from the National Institutes of Health analyzed some 22 million deaths among people 20 to 64 years old between 2001 and 2015 in the U.S., Argentina, Belize, Brazil, Chile, Colombia, Cuba, Ecuador, Mexico, Nicaragua, Panama, Peru and Uruguay. They split people in the U.S. into four groups: whites, Africans Americans, Latinos and Puerto Ricans.
Researchers found the rate of premature death among women from six major causes – circulatory, respiratory or digestive diseases; endocrine disorders such as diabetes; tumors; and external causes like assaults and accidental deaths – was lower in most of the Latin American countries and among U.S. Latinas than among white and African American women in the U.S.
The results were similar among men: Only Peruvians had a lower premature mortality rate than Latino men in the U.S., while white men in the U.S. landed in the middle of the pack and African American men had the second-highest rate, ahead of only Belize.
Belize is a highly black country, although apparently it’s getting less so as black Belizeans move to the US and mestizo Central Americans move into Belize. It looks roughly as if more Amerindian countries like Peru have long life expectancies while blacker countries like Belize have shorter, much the same pattern as seen in the US.
On the other hand, male life expectancies in Mexico didn’t grow as much from 2000 to 2015 as in other Latin American countries, perhaps due to all the murders from the immense drug war that began in 2007. My impression is that Latinos in the US, however, have been getting less homicidal over the same period.
Premature mortality rates fell for most groups overall between 2001 and 2015, including U.S. Latinos, African Americans and in most of the Latin American countries, which account for about 80% of the population in the region, the study found. Among U.S. whites, the premature death rate plateaued for both men and women, increased among people 20 to 34 years old and stayed relatively flat among older groups.
Much of the progress in Latin America was tied to a decline in deaths from heart disease and cancer, the study found. Yet cancer still was a major cause of premature death among women in the Latin American countries, and “external causes” like violence and accidents have been a major driver of these deaths among men.
For example, Belize saw the highest premature death rate for men among the countries studied in 2015, with 702 deaths per 100,000, driven largely by homicides and other external deaths. The Central American country had an unemployment rate of 9.5% in 2019, and has become mired in the global drug trade.
In general, immigration can hardly be rationalized anymore on the grounds that immigration is the only way for Latin Americans to escape early death.
