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It's typical of the intellectual/moral bankruptcy of so many American
academics that they were confused by her viewpoint.


Why African-Americans are disproportionately dying of the Covid-19 virus –
It’s not obesity, it’s slavery

https://www.nytimes.com/2020/05/25/opinion/coronavirus-race-obesity.html

By Sabrina Strings

Dr. Strings is an associate professor of sociology at the University of
California at Irvine

·         May 25, 2020



About five years ago, I was invited to sit in on a meeting about health in
the African-American community. Several important figures in the fields of
public health and economics were present. A freshly minted Ph.D., I felt
strangely like an interloper. I was also the only black person in the room.



One of the facilitators introduced me to the other participants and said
something to the effect of “Sabrina, what do you think? Why are black
people sick?”



It was a question asked in earnest. Some of the experts had devoted their
entire careers to addressing questions surrounding racial health
inequities. Years of research, and in some instances failed interventions,
had left them baffled. *Why are black people so sick?*



My answer was swift and unequivocal.

“Slavery.”



My colleagues looked befuddled as they tried to come to terms with my reply.

I meant what I said: The era of slavery was when white Americans determined
that black Americans needed only the bare necessities, not enough to keep
them optimally safe and healthy. It set in motion black people’s diminished
access to healthy foods, safe working conditions, medical treatment and a
host of other social inequities that negatively impact health.



This message is particularly important in a moment when African-Americans
have experienced the highest rates of severe complications and death from
the coronavirus and “obesity” has surfaced as an explanation. The cultural
narrative that black people’s weight is a harbinger of disease and death
has long served as a dangerous distraction from the real sources of
inequality, and it’s happening again.



Reliable data are hard to come by, but available analyses show that on
average, the rate of black fatalities is 2.4 times that of whites with
Covid-19. In states including Michigan, Kansas and Wisconsin and in
Washington, D.C., that ratio jumps
<https://www.apmresearchlab.org/covid/deaths-by-race> to five to seven
black people dying of Covid-19 complications for every one white death.

Despite the lack of clarity surrounding these findings, one interpretation
of these disparities that has gained traction is the idea that black people
are unduly obese
<https://www.nbcnews.com/health/health-news/african-americans-disproportionately-affected-coronavirus-cdc-report-finds-n1179306>(currently
defined as a body mass index greater than 30) which is seen as a driver of
other chronic illnesses and is believed to put black people at high risk
for serious complications from Covid-19.



These claims have received intense media attention, despite the fact that
scientists haven’t been able to sufficiently explain the link between
obesity and Covid-19. According to the Centers for Disease Control and
Prevention, 42.2 <https://www.cdc.gov/obesity/data/adult.html> percent of
white Americans and 49.6 percent of African-Americans are obese.
Researchers have yet to clarify how a 7 percentage-point disparity in
obesity prevalence translates to a 240 percent-700 percent disparity in
fatalities <https://www.apmresearchlab.org/covid/deaths-by-race>.



Experts have raised questions about the rush to implicate obesity, and
especially “severe obesity” (B.M.I. greater than 40), as a factor in
coronavirus complications. An article in the medical journal The Lancet
<https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30156-X/fulltext>
evaluated
Britain’s inclusion of obesity as a risk factor for coronavirus
complications and retorted, “To date, no available data show adverse
Covid-19 outcomes specifically in people with a BMI of 40 kg/m2.” The
authors concluded, “The scarcity of information regarding the increased
risk of illness for people with a BMI higher than 40 kg/m2 has led to
ambiguity and might increase anxiety, given that these individuals have now
been categorised as vulnerable to severe illness if they contract Covid-19.”



Promoting strained associations between race, body size, and complications
from this little-understood disease has served to reinforce an image of
black people as wholly swept up in sensuous pleasures like eating and
drinking, which supposedly makes our unruly bodies repositories of
preventable weight-related illnesses. The attitudes I see today have echoes
of what I described in “Fearing the Black Body: The Racial Origins of Fat
Phobia <https://nyupress.org/9781479886753/fearing-the-black-body/>.” My
research showed that anti-fat attitudes originated not with medical
findings, but with Enlightenment-era belief that overfeeding and fatness
were evidence of “savagery” and racial inferiority.



Today, the stakes of these discussions could not be higher. When I learned
about guidelines suggesting that doctors may use existing health
conditions, including obesity, to deny or limit eligibility to lifesaving
coronavirus treatments
<https://www.nytimes.com/2020/03/31/us/coronavirus-covid-triage-rationing-ventilators.html>,
I couldn’t help thinking of the slavery-era debates I’ve studied about
whether or not so-called “constitutionally weak” African-Americans should
receive medical care.



Fortunately, since that event I attended five years ago, experts focused on
the health of African-Americans have continued to work to direct the
nation’s attention away from individual-level factors.



The New York Times’ 1619 Project featured essays detailing how the legacy
of slavery impacted health
<https://www.nytimes.com/interactive/2019/08/14/magazine/racial-differences-doctors.html>
and
health care for African-Americans and explaining how, since the era of
slavery, black people’s bodies have been labeled congenitally diseased
<https://www.journals.uchicago.edu/doi/abs/10.1086/681773> and undeserving
of access to lifesaving treatments
<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258045/>.



In a recent essay addressing Covid-19 specifically, Rashawn Ray underscored the
legacy of redlining that pushed black people into poor, densely populated
communities often with limited access to
<https://www.brookings.edu/blog/fixgov/2020/04/09/why-are-blacks-dying-at-higher-rates-from-covid-19/>health
care. And he pointed out that black people are overrepresented in service
positions and as essential workers who have greater exposure than those
with the luxury of sheltering in place. Ibram X. Kendi
<https://www.theatlantic.com/ideas/archive/2020/04/stop-looking-away-race-covid-19-victims/609250/>
has
written that the “irresponsible behavior of disproportionately poor people
of color” — often cited as an important factor in health disparities — is a
scapegoat directing American’s attention from the centrality of systemic
racism in current racial health inequities.

Evaluating the inadequate and questionable data about race, weight and
Covid-19 complications with these insights in mind makes it clear that
obesity — and its affiliated, if incorrect implication of poor lifestyle
choices — should not be front and center when it comes to understanding how
this pandemic has affected African-Americans. Even before Covid-19, black
Americans had higher rates of multiple chronic illnesses
<https://www.usnews.com/opinion/blogs/policy-dose/articles/2016-04-14/theres-a-huge-health-equity-gap-between-whites-and-minorities>
and
a lower life expectancy than white Americans
<https://www.healthaffairs.org/doi/full/10.1377/hlthaff.24.2.459>,
regardless of weight. This is an indication that our social structures are
failing us. These failings — and the accompanying embrace of the belief
that black bodies are uniquely flawed — are rooted in a shameful era of
American history that took place hundreds of years before this pandemic.

Sabrina Strings is an associate professor of sociology at the University of
California at Irvine and the author of “Fearing the Black Body: The Racial
Origins of Fat Phobia
<https://nyupress.org/9781479886753/fearing-the-black-body/>.”
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