When the Rev. Eric Williams was asked to conduct a funeral for a young man who died from HIV because his own pastor refused, he was reluctant.
It was 1990, but Williams agreed, seeing the love that the deceased man’s family had for him during a time when HIV was heavily stigmatized. Over time, he learned about how Black people carry the highest burden of HIV. Willams also learned about how Black people are at higher risk for strokes, diabetes and heart disease. He was inspired to found the Calvary Connection Outreach Network (CCON) to care for the health of the Black faith community.
Now, at a time when Black Americans are contracting and dying from COVID-19 at disproportionately high rates, CCON is helping Black residents in Kansas City navigate the COVID-19 pandemic.
“We see so many people who are suffering,” Williams said. “And it becomes our duty and our task to want healing for the folks that we run across.”
COVID-19 is shining a light on health disparities that the Black community faces, but it isn’t the first disease to do so.
Some health disparities experienced by the Black community:
- Black people are significantly more at risk for early death than white people.
- Black people are more at risk for death by diabetes, stroke, heart disease, cancer, asthma, influenza, pneumonia, HIV/AIDS and homicide.
- There is a higher infant mortality rate among Black people. Black mothers are more likely to receive late or no prenatal care, and they are two to three times more likely to die from pregnancy-related causes than white women.
- Black people are more likely to have high blood pressure and higher rates of obesity than any other racial/ethnic group.
- Black people are more likely to experience unemployment and live in poverty than white people.
- Stress from experiencing race-based discrimination has been linked to mental health issues, higher blood pressure and increased smoking.
“We’ve seen this trend before, like when HIV became present in this country,” said Jannette Berkley-Patton, director of the University of Missouri-Kansas City Health Equity Institute.
“African Americans weren’t the first group disproportionately affected, but as transmission rates increased and with systemic issues in place, we saw similar things. We still haven’t really decreased those highly disproportionate rates of people of color who are impacted by HIV.”
In addition to higher rates of COVID-19, Black people in the Kansas City area have access to fewer permanent testing sites than the white population. The health disparities behind increased cases of COVID-19 among the Black community in Kansas City can be traced to several factors.
Black workers — especially Black women — are more likely to be front-line employees, putting them and their families at greater risk for contracting COVID-19. Black Americans have also faced the brunt of the economic fallout from the coronavirus, as more than 1 in 6 Black workers lost their jobs between February and April.
“The economic mobility and socioeconomic status of African Americans have put us at a disadvantage because we make up more of the essential workforce,” said Melissa Robinson, 3rd District councilwoman for Kansas City, Missouri. “While some of us had the privilege of being able to work from home, others of us did not, and those were mostly low-wage workers.”
Black families also are less likely to be able to social distance or quarantine due to living in multigenerational homes or crowded living quarters. They are also more likely to depend on extended family for child care while children have been out of school.
Berkley-Patton pointed out that many social determinants factor into health outcomes related to COVID-19.
“It isn’t just about whether or not you are sick,” she said. “When you are looking at the health of brown and Black people, there are chronic diseases like diabetes, high blood pressure, any kidney diseases.”
Access to affordable, quality health care is important, as well as whether patients have transportation to get to a doctor. So is mutual respect and quality communication between patients and providers. Berkley-Patton also mentions that environmental factors, such as adequate housing or the presence of hazardous particles, like lead, have an effect. So do health issues such as mental health.
“And then there is that daily thing we all face called racism and discrimination when you are a person of color,” she said.
Change from within the community
Grassroots organizations like CCON have been working for years to decrease health disparities for Kansas City’s Black residents, well before the COVID-19 pandemic. While CCON launched in 1994 in just one church, it now is a multisector organization including over 25 churches, as well as non-faith organizations. It has worked on unique ways to improve the health of Kansas Citians in the urban core, particularly within the Black faith community, such as adopting healthy food policies for church events. CCON runs the Calvary Community Wellness Center in Kansas City, which gives people a safe, affordable place to work on fitness, nutrition and health education and to receive screenings.
But when the COVID-19 pandemic began, the wellness center had to close.
Williams saw the closure as a potential opportunity to address another common health disparity affecting Black families during the pandemic: food insecurity. Before the pandemic, twelve percent of people living in the Kansas City metro area were living with food insecurity. COVID-19 is projected to cause food insecurity for up to 54 million people across the U.S., including 18 million children.
While adults and their families are affected by greater rates of unemployment during the COVID-19 pandemic, children are especially affected by the interruption of school and free breakfast and lunch programs.
To address food insecurity in Kansas City, CCON repurposed its space to distribute meals, groceries and hygiene products.
“We’re seeing new faces. I’m very pleased we have the opportunity to pivot from what we were doing to supply the need,” Williams said.
CCON also began a response network to assist clergy and congregations as they plan to move back to meeting in person.
“We have this huge problem with trust in medical institutions and folks like the CDC. We felt an obligation to try to help folks answer questions about transmissions and safety,” Williams said.
He organized a virtual town hall meeting in late May that had over 100 registrants from various congregations. Williams said that reaching out through faith is important because most of the Black community affiliates with a faith tradition.
“We believe that the power of the pulpit and the words from the trusted leader resonate in the hearts of folks,” he said.
Learning from the past
Health care workers can learn about strategies to decrease health disparities by looking at the past response to diseases around the world. Berkley-Patton points to Partners in Health, developed by Paul Farmer, which has worked in low-resource countries to battle disease and strengthen health systems.
PIH, an international nongovernmental organization, began working in Sierra Leone in 2014 as part of an emergency response to the Ebola outbreak. Rather than focus just on reducing transmission of the disease, PIH also turned attention to improving the existing health system and addressing existing challenges, such as an underfunded health care system, high rates of maternal mortality and chronic diseases and lack of sanitation access.
PIH hired hundreds of local health workers to work within their own communities to visit homes and identify cases of Ebola, check in on patients who were under quarantine, educate the community about Ebola and provide support. Because these health workers were hired from within the community, they had more local knowledge and trust.
Berkley-Patton said a similar response could be used in Kansas City to address the current pandemic.
“Our health agencies will really have to collaborate with community organizations and hire people from the communities,” she said.
Within the Black community, there is a distrust of the medical system, testing and contact tracing that a diverse set of health workers could help address.
“Many times (community organizations) have the solutions, if someone were to ask them,” she said. An example of this is the way the Black faith community, including organizations such as CCON, is able to effectively deliver messages regarding COVID-19 through telephone trees.
But Williams said the best way to begin helping the Black community in Kansas City is through activism.
“Help us to establish a fair wage, get lead out of our houses, elect people sensitive to our needs, expand Medicare and Medicaid, find solutions to policing, end redlining, fight against unfair employment” practices, he said.
Robinson said that the short-term focus to decrease health disparities within the Black population should be on grassroots strategies to employ people and lift them out of poverty.
“How do we make these bridges to employment quickly? We need to start thinking about how we can respond to the child care needs, the transportation needs and the housing needs of individuals so we can get them back to work,” she said. “How are we opening up opportunities to employment so it’s not a needle-in-the-haystack solution when you’re trying to find jobs?”
“It’s like Dr. King said. We’re talking about pulling yourself up from your boot straps, and many people don’t have any boots.”
Brittany Callan is the health and environment reporter at The Beacon and a Report for America corps member. You can reach Brittany at email@example.com. Funding for this reporting was provided in part by the Health Forward Foundation.