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Reopening the United States: Black and Hispanic Workers Are Essential and Expendable Again.

Williams, JC ; Anderson, N ; et al.
In: American journal of public health, Jg. 110 (2020-10-01), Heft 10, S. 1506-1508
Online editorialOpinion

Reopening the United States: Black and Hispanic Workers Are Essential and Expendable Again 

By May 15, 2020, all 50 states had announced plans to reopen their economies. These plans emerged on the heels of an increasing awareness that COVID-19 had hit minority communities particularly hard, especially Black communities. Despite constituting only 13% of the US population, Blacks have made up 24% of the deaths from COVID-19 nationally, rendering them at least twice as likely to die from COVID-19 than are other groups.[1] A recent survey from Johns Hopkins University and the American Community Survey indicated that the death rate for predominantly Black counties is sixfold higher than the rate in predominantly White counties.[1]

The disproportionate impact of COVID-19 on minority communities has been partly attributed to the racial composition of the workers in economic sectors deemed essential, including home health care, nursing homes, and community food and housing services. In these sectors, where employees are likely to come into contact with COVID-19 (i.e., high-contact jobs), Blacks and Hispanics are more likely to be employed than are Whites.[2] Data from a recent McKinsey Report[2] show examples from critical economic sectors where the laborers are predominantly people of color. For example, in jobs such as psychiatric aid, nursing assistant, and orderly, Blacks make up more than twice their relative proportion of the broader US population (i.e., 13%). Because it is difficult for these jobs to be performed remotely, racial minorities have shouldered more than their share of essential labor during the COVID-19 pandemic, and their communities have been disparately endangered as a result.

The plans that states have outlined to reopen economies will likely exacerbate the racial disparities in COVID-19 infection and mortality because of the imbalance in racial and ethnic labor composition. For example, in Georgia, the first industries that are set to reopen are gyms, hair salons, tattoo parlors, movie theaters and dine-in restaurants; New York announced plans to allow manufacturing, construction, and certain retailers to reopen first; and other states have announced plans to reopen food services and department stores first.[3]

According to data from the Department of Labor Statistics,[4] Black and Hispanic workers are overrepresented in several of the industries set to reopen across the country. Figure 1 illustrates that, despite being only about 17% of the US population, Hispanic workers make up 30% of the labor force in construction, one of the first industries scheduled to reopen. In addition, Black and Hispanic workers are overrepresented in accommodation and food services and will have a greater risk of COVID-19 exposure as the summer begins and people begin to frequent restaurants and tourist attractions. It should be noted that this data set does not include all races, and because the racial composition of the labor force is highly regional, these demographic data will be exacerbated or alleviated depending on characteristics of the region (i.e., urban vs rural). However, it is clear that the national numbers reflect that Black and Hispanic workers are overrepresented in the industries slated to reopen first, which puts them at disproportionate risk for infection, illness, and death from COVID-19.

Graph: FIGURE 1— Representation in Industries Set to Reopen of (a) African Americans/Blacks and (b) Hispanics/Latinos: United States, 2020

As the corpses from COVID-19 pile up, policymakers are fully aware that certain minority groups, particularly Blacks, have been disproportionately ravaged by the pandemic. Therefore, as governors across the nation announce plans to reopen certain industries in a stepwise fashion, they do so with the knowledge that this will exacerbate COVID-19's devastation of communities of color. Their disregard for this potential outcome as they reopen industries with mostly Black laborers exemplifies the essential–expendable paradox of Black lives in the United States. This means that, although many Blacks have been designated essential laborers during COVID-19 and are celebrated in many instances, many businesses and state governments have simultaneously treated them as expendable by not providing them with proper protection or support, which shows that their lives are devalued and their suffering ignored.

This treatment of Black people as both essential and expendable dates back to the era of chattel slavery. Before slavery was abolished, enslaved Black labor was essential to the US economy.[5] But the very society that relied on enslaved Black people's toil also subjected them to unspeakably cruel living conditions, psychological terror, and backbreaking labor under the presumption that Black lives were an expendable resource to be used, discarded, and then replaced. In fact, it was only by deeming Black lives expendable that White society was able to economically extract their essential labor. Thus, enslaved Black people in the United States were simultaneously essential and expendable. Black and Hispanic people have been cast in this paradoxical role as both essential and expendable up to the present day. This paradox has been reflected in the ways that Black and Hispanic people were and are subjected to exploitive medical experiments and research, including experimental gynecological surgeries on enslaved women, the US Public Health Service's syphilis studies in both the United States and Guatemala, and more recent lead poisoning studies.[6]

Although the reopening of the economy during COVID-19 is not a formal scientific study, the plans to reopen the economy mirror a national experiment. States such as Florida, Texas, and Arizona, which were among the earliest to start reopening, currently have stark increases in COVID-19 cases. To date, there is no published data showing that racial disparities have worsened in these states that reopened first. There is much uncertainty about what will occur in the coming weeks and months as the economy tiptoes forward, and more time is needed to definitively demonstrate whether a rise in infections has occurred among Blacks and Hispanics during reopening. Because of the disproportionate representation of Black and Hispanic workers in both essential industries and the first wave of reopening industries, they will disproportionately be the subjects in an experiment administered by the state. And so, as US society looks on, working-class, vulnerable people of color will march back to the shop, office, or factory under life-threatening conditions, subjects in a national experiment to which they did not consent—an experiment that, like many before it, exploits the essential–expendable paradox of Black existence in the United States for the benefit of broader society.

To disrupt this essential–expendable paradox, there needs to be a targeted response to specifically supporting laborers of color and neighborhoods of color on state and federal levels. State and federal policymakers should swiftly implement holistic protections for essential workers. For example, the Occupational Safety and Health Administration should provide employers with resources to make COVID-19 tests freely available to workers in essential and reopening industries, especially given that data suggest that more of the testing is performed in White communities.[7] Community-based testing efforts should accommodate essential worker schedules, organize contact-tracing teams to reduce community spread, and have linguistically competent staff and materials. Additionally, there should be federal support for the expansion of "hero pay" programs—pay raises offered by some companies for essential workers—given the precarious conditions faced by essential workers and the first wave of the reopening workforce. If federal and state legislators do not systematically support and prioritize minority workers, we will see a worsening disaster in these communities and perpetuate the ongoing legacy of sacrificing Black and Hispanic lives.

CONFLICTS OF INTEREST

The authors have no conflicts of interest to declare.

REFERENCES 1 COVID Tracking Project. The COVID racial data tracker. 2020. Available at: https://covidtracking.com/race. Accessed July 25, 2020. 2 McKinsey & Company. COVID-19: investing in Black lives and neighborhoods. 2020. Available at: https://www.mckinsey.com/∼/media/mckinsey/industries/public%20sector/our%20insights/covid%2019%20investing%20in%20black%20lives%20and%20livelihoods/covid-19-investing-in-black-lives-and-livelihoods-report.ashx. Accessed May 30, 2020. 3 Lee JC, Mervosh S, Yuriria A, Harvey B, Matthews AL. See how all 50 states are reopening (and closing again). New York Times. July 24, 2020. Available at: https://www.nytimes.com/interactive/2020/us/states-reopen-map-coronavirus.html. Accessed July 25, 2020. 4 US Bureau of Labor Statistics. Labor force statistics from the Current Population Survey. 2020. Available at: https://www.bls.gov/cps/cpsaat18.htm. Accessed May 20, 2020. 5 Genovese ED. The Political Economy of Slavery: Studies in the Economy and Society of the Slave South. Middletown, CT: Wesleyan University Press; 1988. 6 Washington HA. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans From Colonial Times to the Present. New York, NY: Anchor Books; 2008. 7 Bilal U, Barber S, Diez-Roux A. Early evidence of disparities in COVID-19 testing in US cities. 2020. Available at: https://www.medrxiv.org/content/10.1101/2020.05.01.20087833v1.full.pdf. Accessed July 25, 2020.

By J. Corey Williams; Nientara Anderson; Terrell Holloway; Ezelle Samford III; Jeffrey Eugene and Jessica Isom

Reported by Author; Author; Author; Author; Author; Author

J. Corey Williams is with the Division of Child and Adolescent Psychiatry, Georgetown University Medical Center, Washington, DC. Nientara Anderson and Terrell Holloway are with the Department of Psychiatry, Yale-New Haven Hospital, New Haven, CT. Ezelle Samford III is with the Program on Race, Science, and Society, Center for Africana Studies, University of Pennsylvania, Philadelphia. Jeffrey Eugene is with the Children's Hospital of Philadelphia, Craig-Dalsimer Division of Adolescent Medicine, Philadelphia, PA. Jessica Isom is with the Department of Psychiatry, Codman Square Health Center, Boston Medical Center, Boston, MA.

J. Corey Williams is with the Division of Child and Adolescent Psychiatry, Georgetown University Medical Center, Washington, DC. Nientara Anderson and Terrell Holloway are with the Department of Psychiatry, Yale-New Haven Hospital, New Haven, CT. Ezelle Samford III is with the Program on Race, Science, and Society, Center for Africana Studies, University of Pennsylvania, Philadelphia. Jeffrey Eugene is with the Children's Hospital of Philadelphia, Craig-Dalsimer Division of Adolescent Medicine, Philadelphia, PA. Jessica Isom is with the Department of Psychiatry, Codman Square Health Center, Boston Medical Center, Boston, MA.

J. Corey Williams is with the Division of Child and Adolescent Psychiatry, Georgetown University Medical Center, Washington, DC. Nientara Anderson and Terrell Holloway are with the Department of Psychiatry, Yale-New Haven Hospital, New Haven, CT. Ezelle Samford III is with the Program on Race, Science, and Society, Center for Africana Studies, University of Pennsylvania, Philadelphia. Jeffrey Eugene is with the Children's Hospital of Philadelphia, Craig-Dalsimer Division of Adolescent Medicine, Philadelphia, PA. Jessica Isom is with the Department of Psychiatry, Codman Square Health Center, Boston Medical Center, Boston, MA.

J. Corey Williams is with the Division of Child and Adolescent Psychiatry, Georgetown University Medical Center, Washington, DC. Nientara Anderson and Terrell Holloway are with the Department of Psychiatry, Yale-New Haven Hospital, New Haven, CT. Ezelle Samford III is with the Program on Race, Science, and Society, Center for Africana Studies, University of Pennsylvania, Philadelphia. Jeffrey Eugene is with the Children's Hospital of Philadelphia, Craig-Dalsimer Division of Adolescent Medicine, Philadelphia, PA. Jessica Isom is with the Department of Psychiatry, Codman Square Health Center, Boston Medical Center, Boston, MA.

J. Corey Williams is with the Division of Child and Adolescent Psychiatry, Georgetown University Medical Center, Washington, DC. Nientara Anderson and Terrell Holloway are with the Department of Psychiatry, Yale-New Haven Hospital, New Haven, CT. Ezelle Samford III is with the Program on Race, Science, and Society, Center for Africana Studies, University of Pennsylvania, Philadelphia. Jeffrey Eugene is with the Children's Hospital of Philadelphia, Craig-Dalsimer Division of Adolescent Medicine, Philadelphia, PA. Jessica Isom is with the Department of Psychiatry, Codman Square Health Center, Boston Medical Center, Boston, MA.

J. Corey Williams is with the Division of Child and Adolescent Psychiatry, Georgetown University Medical Center, Washington, DC. Nientara Anderson and Terrell Holloway are with the Department of Psychiatry, Yale-New Haven Hospital, New Haven, CT. Ezelle Samford III is with the Program on Race, Science, and Society, Center for Africana Studies, University of Pennsylvania, Philadelphia. Jeffrey Eugene is with the Children's Hospital of Philadelphia, Craig-Dalsimer Division of Adolescent Medicine, Philadelphia, PA. Jessica Isom is with the Department of Psychiatry, Codman Square Health Center, Boston Medical Center, Boston, MA.

Titel:
Reopening the United States: Black and Hispanic Workers Are Essential and Expendable Again.
Autor/in / Beteiligte Person: Williams, JC ; Anderson, N ; Holloway, T ; Samford E 3rd ; Eugene, J ; Isom, J
Link:
Zeitschrift: American journal of public health, Jg. 110 (2020-10-01), Heft 10, S. 1506-1508
Veröffentlichung: Washington, DC : American Public Health Association ; <i>Original Publication</i>: New York [etc.], 2020
Medientyp: editorialOpinion
ISSN: 1541-0048 (electronic)
DOI: 10.2105/AJPH.2020.305879
Schlagwort:
  • Adult
  • COVID-19
  • Coronavirus Infections diagnosis
  • Coronavirus Infections transmission
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nursing Assistants statistics & numerical data
  • Pandemics
  • Pneumonia, Viral diagnosis
  • Pneumonia, Viral transmission
  • United States
  • Black or African American statistics & numerical data
  • Commerce
  • Employment statistics & numerical data
  • Hispanic or Latino statistics & numerical data
Sonstiges:
  • Nachgewiesen in: MEDLINE
  • Sprachen: English
  • Publication Type: Editorial
  • Language: English
  • [Am J Public Health] 2020 Oct; Vol. 110 (10), pp. 1506-1508.
  • MeSH Terms: Commerce* ; Black or African American / *statistics & numerical data ; Employment / *statistics & numerical data ; Hispanic or Latino / *statistics & numerical data ; Adult ; COVID-19 ; Coronavirus Infections / diagnosis ; Coronavirus Infections / transmission ; Female ; Humans ; Male ; Middle Aged ; Nursing Assistants / statistics & numerical data ; Pandemics ; Pneumonia, Viral / diagnosis ; Pneumonia, Viral / transmission ; United States
  • Comments: Erratum in: Am J Public Health. 2021 Jan;111(1):e2. (PMID: 33326294)
  • References: Mon Labor Rev. 1980 Jun;103(6):22-6. (PMID: 10309200)
  • Entry Date(s): Date Created: 20200909 Date Completed: 20201110 Latest Revision: 20221207
  • Update Code: 20231215
  • PubMed Central ID: PMC7483098

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