It was only a few short weeks ago that a tweet from Madonna labeling COVID-19 “the great equalizer” went viral. Echoing high-profile elected officials such New York Governor Andrew Cuomo, this framing of the global pandemic quickly drew sharp criticism. With overwhelming evidence regarding racial and class disparities in terms of both lost lives and lost livelihoods as a result of the virus, any assertion of equity of impact ignores painful yet blaring truths about deeply entrenched inequality along multiple fault lines in the U.S.
As more data pours in regarding COVID-19–related fatalities as well as rising unemployment, the individual and compounded effects of racism, poverty, ageism, and ableism become undeniable. Even President Trump’s surgeon general, Jerome Adams, recently confirmed that African Americans, in particular, were at greater risk of contracting the potentially deadly virus. Adams’ comments on the disparate effects of COVID-19 on African Americans nevertheless leaned into racist stereotypes about consumption of drugs and alcohol. He also trumpeted personal responsibility in the face of a crisis even as he acknowledged grave structural realities such as comorbidities, which leave African Americans more vulnerable.
Adams’ statements thus far, however, fall short of detailing the fullness of why certain communities are more at risk than others. Identifying the existence of comorbidities is simply not enough. This pandemic requires a clear, full-throated assessment of how longstanding structural barriers, institutionalized discrimination, and interconnected oppressions lead to stark outcomes for marginalized communities.
From how ventilators are rationed to the disproportionate number of African Americans with existing conditions such as asthma, diabetes, high blood pressure, and hypertension to the overrepresentation of people of color in low-wage, essential work, the story to be told is one of gross, systemic inequality that positions far too many people as disposable. Merely pointing out, for example, that African Americans are more likely to die from COVID-19 than their white counterparts doesn’t explain how or why we experience a higher mortality rate.
To grasp how and why this pandemic has been particularly devastating for African Americans, Latinx, Indigenous, and undocumented communities, poor people, incarcerated populations, the houseless, the elderly, and disabled people, scholars, public health officials, journalists from within one or more these hyper-exposed communities, and many others have been at the forefront of pushing mainstream media as well as elected officials to dig deeper. Whether calling out medical racism, ableism, or fatphobia or problems in medical ethics, those vocalizing the intricacies of COVID-19’s disparate impact illuminate inglorious histories of exclusion, discrimination, and neglect.
Even with more coverage about and discussion of COVID-19 and inequality, gender hasn’t been at the forefront of the way we talk about unequal outcomes. A few notable exceptions exist, but gender has been primarily covered as an afterthought to a more complex and interconnected understanding of the virus. While research indicates that more cisgender men are dying from COVID-19 than cisgender women, the compilation of data on the specific impact on women of color — from the perspectives of fatality rates, exposure through low-wage essential work, and caretaking — remains uncharted territory.
Black women are uniquely situated within overlapping systems of oppression to sustain disproportionate losses of both life and livelihood during this pandemic. Whether they experience symptoms associated with the coronavirus, seek medical assistance, and are denied life-saving care like Rushia Johnson Stephens of Dekalb County, Georgia, or they put their lives at risk in low-wage, caretaking jobs like Leilani Jordan of Prince George’s County, Maryland, COVID-19 is hitting Black women from numerous directions. Black women confront the reality of not being believed by medical practitioners as well as being in professions in which they are simultaneously essential and undervalued. Not working puts their livelihoods in limbo; working puts their lives in jeopardy. The choice between potential death and unlivable living is one far too many Black women are already making and will continue to make in the coming months.
Among Black women, decisions about seeking medical attention or continuing to work in unsafe environments, coupled with gendered racism, are further complicated by factors such as disability and socioeconomic status. If and when shortages of ventilators or hospital beds occur, ableist ideas about who receives treatment will negatively affect Black women with disabilities. Poorer and houseless Black women may face substantial barriers in seeking care or may not be able to stop working in high-risk jobs like caretaking in assisted living facilities, in custodial and clerical work at hospitals, or as cashiers/clerks in grocery stores.
A recent report points to a rise in the number of pregnant, cisgender women testing positive for COVID-19. Given pre-coronavirus Black maternal morbidity rates, it is difficult to imagine Black people with gestational capacity now being at an even greater risk for death. Stress derived from medical, gendered racism during childbirth will more than likely intensify during this pandemic and may also result in even worse outcomes for Black childbearing people — especially Black women.
COVID-19 changes the broader medical landscape for Black women seeking health care for other illnesses and ailments as well. For instance, many people living with lupus, an autoimmune disorder, will not be able to access Plaquenil, a drug used to treat some of effects of lupus, because President Trump has spoken of it as a potential treatment for the novel coronavirus. Pharmacies are running out of the medication and lupus patients are not able to access this medication because of the largely untested possibility of it serving as an effective treatment for COVID-19. Black women are disproportionately burdened by lupus and will be unduly harmed by the inaccessibility of this drug.
We are still in the early stages of this global pandemic, and yet we are already in danger of relegating Black women’s unique experiences to a footnote. As studies of this virus move forward and more data is captured and reported, those on the margins and the reasons why they are on the margins can’t be forgotten. Just like so many other pressing social justice issues such as climate change or food insecurity, comprehending and combating COVID-19 requires an intersectional approach. We can’t address this virus if we don’t acknowledge the range of experiences upon which it sheds light. The novel coronavirus is not the great equalizer, it is the great magnifier.
