The CDC Shouldn’t Treat Racism as a Public-Health Crisis
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The Centers for Disease Control and Prevention was founded in 1946 as the Communicable Disease Center, with a simple goal: prevent the spread of malaria. The mission soon expanded to all communicable diseases and, more recently, to areas — such as domestic violence, gun control, and vaping — that, while related to health, seem far afield from the agency’s primary purpose. Today the CDC describes its mission as protecting the nation from health threats both foreign and domestic. Now the agency appears to have expanded its mandate into progressive politics.
In a recent statement, CDC director Rochelle Walensky asserts that there have been disproportionate numbers of COVD-19 cases and deaths in communities of color. She claims that the disparities were the result not of COVID-19 but rather of racism, which she labels a public-health crisis. Her statement echoes an American Medical Association policy recognizing racism as a public-health threat and similar declarations from 194 state and local government entities.
But the director’s statement is inconsistent with the CDC’s current data that show little or no increased incidence of black COVID-19 deaths. At best it reflects outdated data documenting disparities that no longer exist. At worst, it reflects a political agenda in search of a justification. Whichever it is, it suggests that public-health officials, in this case the CDC, have become distracted from their core job.
Currently, 60.8 percent of COVID-19 deaths are among whites, who account for 60.1 percent of the population. The ratio of percentage of deaths to population percentage is also essentially 1:1 for Hispanics. The ratio is increased for indigenous Americans (1.6) and slightly increased for black Americans (1.2), who are 14.6 percent of COVID-19 deaths and 12.5 percent of the population. Asian Americans, who have suffered racist attacks during the pandemic, account for 5.8 percent of the population but just 3.9 of COVID-19 deaths.
The picture was different back in September 2020 when blacks accounted for 20.9 percent of COVID-19 deaths, 1.7 times their 12.5 percent of the population. The increased death rate among blacks was attributable to three factors: employment (black workers are only two-thirds as likely as white workers to be able to work from home); worse baseline health (27 percent of non-elderly black adults, ages 18 to 64, have underlying medical conditions that complicate COVID-19, compared with 21 percent of non-Hispanic whites and 20 percent of Hispanics); and where black people live (blacks are a higher percentage of the population in the areas where COVID-19 initially hit). When weighted to reflect where COVID-19 outbreaks occurred through September, blacks represented 15.4 percent of the population.
What accounts for the decreased disparity and current near-parity in black and white COVID-19 deaths? Neither the types of jobs nor the underlying comorbidities of the black population have changed. What has changed is the geographic distribution of COVID-19. It has moved beyond the initial concentration in urban areas and the Northeast. Between September 2020 and now, when weighted to reflect where COVID-19 outbreaks have been occurring, the black percentage of the population dropped from 15.4 percent to just 13.1 percent. The ratio of black deaths to weighted population (14.6 / 13.1) is now just 1.1. In contrast, now that COVID-19 has spread more widely, the percentage of COVID-19 deaths among whites has risen from 51.1 percent in September to 60.8 percent today. It is whites who now appear to be disproportionately affected, with a death-to-weighted-population ratio of 1.5 — reflecting the older average age of whites when compared with that of other groups, making them more vulnerable to COVID-19, which disproportionately affects the elderly.
If blacks are no longer disproportionately impacted by COVID-19, then purported racism cannot justify the agenda of the CDC director to study how racism and other social determinants affect health and to invest in minority communities to address disparities related to COVID-19 and other health conditions. Health disparities do exist. The causes include genetics, personal choices and preferences, and differing social norms and cultural factors.
Racism, unfortunately, may play a role too, but why, in the middle of the biggest pandemic in over a hundred years, is the agency that is the nation’s primary bulwark against communicable diseases taking the lead on studying it? A multitude of other entities are better suited, especially since the CDC has already undermined its credibility by reflexively blaming racism for all health disparities, real and imagined. The CDC should stick to its primary mission.
