Why Does NC's African American Population Have A Disproportionate Share of COVID-19 Cases?

African Americans account for a disproportionate share of COVID-19 cases across North Carolina. The question is why.  

"We've joked about this in the African American community, for years. We say, when white America gets a cold, we get pneumonia," said Ophelia Garmon-Brown, an executive with Winston-Salem-based Novant Health.

But the coronavirus is no joke, and there are actually lots of reasons. Experts say it's another sign of how the COVID-19 crisis puts a spotlight on underlying socioeconomic and public health problems. 

Statewide, 37% of COVID-19 cases are African Americans, though African Americans are only about 22% of the population. In Mecklenburg County, almost 45% of cases are among African Americans, who account for about one-third of the population. 

Mecklenburg County Public Health Director Gibbie Harris talked about the issue with state lawmakers last Thursday. 

"We're seeing more cases in our 60-plus population in our black community. And we believe part of that is because … our African Americans, especially our older African Americans, in this community are three times more likely to have chronic diseases, which puts them at risk for more severe complications from COVID-19," Harris said. 

Harris initially had been saying the spread of the coronavirus was similar to the county's overall demographics. But over the past several weeks, the African American percentage of overall cases has continued to rise in Mecklenburg, from 35% to 41% and now to 44% as of Friday - increasingly out of sync with population figures. 

We've Seen This Before 

The numbers come as no surprise to health experts. A decade ago, black people were the most susceptible to complications from H1N1, or swine flu. Over four months in 2009, 35% of people hospitalized with swine flu in 13 metropolitan areas were black, but black people were only 16% of the population.

"We have the same problem we had before COVID-19," said Garmon-Brown, who also co-chaired the Charlotte-Mecklenburg Opportunity Task Force four years ago. "One of the things I think we were very clear about in the task force report is we have a tale of two cities. And I think when we're in a crisis situation, we see that lived out even more critically than before."

Garmon-Brown said there several factors that put black people at higher risk. Many have underlying illnesses. African Americans tend to have lower rates of insurance coverage. And many have inadequate access to health care. She said a study found that in six Charlotte ZIP codes with high African American populations, there were no doctor's offices.  

Garmon-Brown also says lower-income African Americans are often essential workers least able to practice social distancing. Many work in restaurants or other low-wage jobs that you can't do at home, and many ride public transit. 

More Tests, Too? 

There may be another reason why black people are overrepresented: Because of existing health issues, some black people may be more likely to be tested for COVID-19 symptoms, Harris said in a news conference Friday.

"It makes sense that they would be individuals who are more affected by the serious complications of this disease and are more likely to be tested. So we don't think it has anything to do with increased susceptibility at this point," Harris said. 

All this means is that authorities need to pay extra attention to the trend, said Tanya Blackmon, Novant's chief diversity, inclusion and equity officer. 

"We need to focus on, as an organization and as a community, diversity inclusion now more than ever … because it's really about people on the margins, who are isolated. … We want to make sure that everyone has access to care," Blackmon said. 

Mecklenburg County is taking some steps. Harris said Friday the health department plans to work with African American churches to raise awareness about social distancing and the dangers of COVID-19.

"We're in the process of developing some materials that we'll be getting out through our African American churches as well as other churches that interact with the elderly to make sure that message is getting to them about what they need to go do take care of themselves," Harris said. 

The question is whether that education will be enough.  

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