CoronavirusFeaturedHealthNewsThe NorthSider

Societal preconditions contribute to high infection rate among blacks

ST. LOUIS – Poverty, violence and racism have long devastated the African-American community. Now there’s another force disproportionately affecting black people: the coronavirus. And experts say its spread may be aided by those other societal preconditions. 

Both nationally and locally, African-Americans have been infected with COVID-19 and died at a greater rate than whites. 

That doesn’t surprise Keon Gilbert, an associate professor at the College for Public Health and Social Justice at St. Louis University and co-director of the university’s Institute for Healing Justice and Equity.

Keon Gilbert, Assistant Professor at the Saint Louis University School of Public Health
“It is a question of a number of factors,” said Gilbert, who holds a doctorate in public health. Some of the problem is rooted in the historical patterns of segregation, he said.

In St. Louis, as of April 24, blacks have suffered 68 percent of the confirmed infections. Seventy-two percent of those who have died in the city have been African-Americans. In 2018, the U.S. Census Bureau estimated that 47.6 percent of the city’s population was white and 45.9 percent was black.

According to the St. Louis city website, there were 1,000 reported cases of COVID-19 and 47 deaths from the disease as of April 24. A total of 676 African-Americans had been diagnosed with the ailment, and 34 had died. A total of 245 whites had tested positive; of them, 10 had died. Among other groups, there were 79 cases and three deaths. 

African-American neighborhoods have high rates of pollution, asthma, respiratory issues and lead poisoning, Gilbert said.

“You can see where African-Americans would be at a higher risk,” Gilbert said. “If you’re healthy, then your body is able to fight it off.”

Black residents, Gilbert said, are “the engines that are keeping us going” in the spread of the virus.

He noted, “Because this is a new disease and a new public health problem, all of the data is fairly new.” 

Gilbert, who is a member of the city’s Joint Board of  Health and Hospitals, noted that more COVID-19 testing centers were being opened in areas of high risk.

“We have to think about who’s susceptible, who’s at risk,” he said.

One factor may be that large families from different generations may live in the same house, Gilbert said.

“When they go home, they’re likely to expose multiple folks,” Gilbert said. “People don’t have that luxury where they can distance themselves and their family members in the same kind of way.”

The health disparities and inequities here are not unique to St. Louis, city Health Director Dr. Fredrick Echols said recently. 

“It exists across the United States and across the world and has posed a challenge for public health agencies and other governmental agencies around the world,” Echols said during a report by Mayor Lyda Krewson on the COVID-19 crisis.

Echols emphasized that the health inequalities and disparities developed long before the current pandemic.

“What we’re charged to do as health agencies is really to address those issues,” he said. Regardless of race and socioeconomic status, income or educational attainment, people will have to have access to good health care, he said. “This is a priority for us, because our community is only as strong as our weakest link.”

Often, African-Americans will not seek medical care because they don’t think they can afford it, Echols said. 

“We are rich with the resources, but the issue is, not all of the communities know about some of those resources,” Echols said.

Dr. Moyosore Onifade, an internal medicine/primary care physician at Christian Hospital.
Dr. Moyosore Onifade, an internal medicine/primary care physician at Christian Hospital, emphasized that COVID-19 doesn’t discriminate.

However, “It’s been very effective in exploiting some of the weaknesses in our public health infrastructure,” Onifade said.

“It’s transmitted in areas where there is high density,” she said. “African-American populations tend to be more in urban centers, so COVID finds who it finds.”

Further, patients with underlying health problems, such as diabetes, hypertension and lung disease, are more susceptible to COVID-19, she said.

“Some of these conditions have a higher prevalence within African-American populations,” Onifade said.

To protect them, these people need affordable health care and medications, she said. Failing that, they need to work on prevention, including social distancing.

Jim Merkel Born and raised in the St. Louis area, Jim Merkel covered communities throughout the area from 1991 to 2013 for the old Suburban Journals of Greater St. Louis. He is the author of five books about the Gateway City published by Reedy Press. The latest is Growing Up St. Louis: Looking Back Through the Decades. He and his wife, Lorraine, live in the Bevo Mill neighborhood of south St. Louis with Miss Jenny the Cat. For more about Jim, visit

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