The impact of the coronavirus on black people in the inner cities is compounded by long-standing racial disparities in the delivery of healthcare in the United States. Because overwhelming numbers of impoverished black people lack health insurance, they access the healthcare system largely by showing up at the emergency rooms of major hospitals.

This situation, and particularly the negative health outcomes associated with it, is exacerbated by a long history of structural racism that has produced a host of deleterious neighborhood effects, the most critical of which are persistent poverty and alienation. In this context, as a defense against white racism, an “oppositional culture” has developed that essentially devalues the “white man’s” education. Thus, the city’s leaders, whether white or black, in the local community often face powerful challenges to their authority.

These problems are intensified by widespread mistrust of the dominant white majority, whose primary relationship with the inner city is characterized by arbitrary policing and social control, and not the well-being of the community—at least this is the way black people often perceive it.

At the same time, the many black people who have been able to work and make a decent living are in the low end of the service economy, often in front-line jobs, in which they regularly interact closely with the public, as taxi, bus, and truck drivers, cashiers, baggers in grocery stores, and delivery people. These jobs place them at risk in a way that people who can work from home are not.

Heightening all these issues is the fact that black people are a sociable, empathetic people who, when necessary, often adopt and involve themselves in “hands-on” care for their sick and vulnerable. In their world view, social or physical distancing seems anathema. Hence, black people more easily pass on the virus, infecting one another at a relatively high rate.

Because of all these issues, which are worsened by social isolation and alienation, blacks of the inner-city ghettos find it harder to take the medical advice of the authorities seriously. Moreover, the social class divide within the black community between people who are educated, well-to-do, and privileged and those who are not, produces ambient suspicion within the inner-city community, which contributes to extraordinarily high death rates from COVID-19.

In terms of solutions, a vaccine is top priority, of course, but a robust regimen of testing and contact tracing is also essential, not just for black people but for the whole of society. Because this is such a contagious and lethal disease, we must understand that we truly are all in this together.

Elijah Anderson is Sterling Professor of Sociology and of African American Studies, Yale University; Charles and William L. Day Distinguished Professor Emeritus of the Social Sciences, Penn School of Arts and Sciences; and a Penn IUR Scholar.

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