COVID-19 and the color green

The world is still learning lessons from the pandemic virus known as COVID-19. Having said this, there have been some pearls of wisdom kneaded out of the different countries and cultures that have come into contact with the virus. In America, current data has shown that 1 in 2,000 African Americans have been infected by the virus and, though this demographic is not unusually likely to contract the disease, they are 2.4 times more likely to die from the virus than white Americans, and 2.2 likelier than Asians and Hispanics. Is this a genetic anomaly associated with African Americans? No, but that would be an even easier fix than the true cause.

Recently, the Journal of the American Medical Association (JAMA) published an article outlining research that suggests the virus known as COVID-19 carries with it the innate ability to recognize and attack proteins located on a substance produced by the human body known as Angiotensin-Converting Enzyme 2, or ACE2. This substance is critically important in regulating blood pressure in the human body. This makes substantial sense when you look at some of the symptoms and aftereffects of a COVID-19 infection in the body. Those who suffer the worst cases are typically those with high blood pressure, diabetes, and morbid obesity. Without the aid of ACE2 in their bodies, their blood vessels remain constricted as the natural anti-inflammatory response compounds issues leading to shortness of breath, organ failure, and blood clots.

So why are African Americans entering this cascade of death at higher rates? Again, the evidence does not show that African Americans are more susceptible to contracting the disease than other demographics, rather they are more likely to die. What is the connection then? Socioeconomics. African Americans on a national level remain the poorest, poorest-housed, and unhealthiest group with higher rates of asthma, high blood pressure, diabetes, cancer, and obesity. They live in situations of crowded housing and food deserts at a higher incidence than any other demographic. These social determinants of health leave African Americans more vulnerable to death due to the virus. The point here is that those in poverty who do not have access to consistent housing and nutritious food are more susceptible to the chronic diseases mentioned above. These folks are the ones who are more likely to die post COVID-19 infection than any others.

In Miami County, the estimated percentage of the population that are African American is 4.4 percent, however, an estimated 8 percent of Miami County residents currently live in poverty. That accounts for 8,590 lives. Now, not all these individuals are given a death sentence upon contraction of the virus. Health Partners Free Clinic has treated poverty-stricken survivors like mentioned in this article, but they are more likely to see a ventilator and come out the other end with worsening blood pressure and blood clots that we continue to treat. The medical irony of all this is that many individuals with high blood pressure and/or diabetes are placed on medications to treat these chronic conditions which act to increase the ACE2 substance in their bodies. From what we know now, these medications could be placing them in harm’s way.

Social disparities rear their ugly heads in times of economic turmoil, and we expect this to increase the percentage of poverty in Miami County. The systemic poverty that all communities face has confronted us in the food lines already. Regardless of race, gender, or ethnicity the color we are most concerned about in decreasing the magnitude of death teeters on the green. Those with money are more likely to survive, and those without are not.