Black Americans Can’t Breathe: How Environmental Racism Has Intersected with COVID-19

How could that be? Top medical officials have offered little guidance, blaming preexisting conditions faced by Black people without further inquiry or consideration. What’s being overlooked, or even ignored, is the fact that health outcomes are often influenced by levers of systemic racism.

These disparate effects don’t just happen; they are tied to policy. Poor air quality, which has been linked to more severe COVID-19 symptoms and is also disproportionately imposed on Black people in the US, offers a compelling example of racist policy leading to racist health outcomes.

A new study from Harvard public health experts reveals two important findings: First, exposure to toxic air pollution (PM 2.5) increases vulnerability to death and the most severe symptoms of the novel virus. Researchers considered data from 3,000 counties, accounting for 98 percent of the population, and found that long-term exposure to air pollution increases vulnerability to the most severe COVID-19 outcomes; an increase of 1 microgram per cubic meter of long-term PM2.5 exposure is associated with an 8 to 15 percent increase in the COVID-19 mortality rate.

This is supported by similar analysis of hard-hit European countries that have already turned the corner. In Spain, Italy, France, and Germany, 78 percent of deaths occurred in only five regions, which are also the most polluted, according to German researchers who studied the effects of nitrogen dioxide.

The second key finding is a 45 percent increase in COVID-19 mortality rate associated with a 1 standard deviation increase in percent Black residents. This trend is supported by research from Johns Hopkins University and the American Community Survey that shows that the infection rate in predominantly Black counties is more than three times that of white counties. The death rate in Black counties is six times that of white counties.

Harvard researchers do not draw explicit links between these two key findings, but another recent study finds that Black Americans endure 56 percent more toxic air pollution than they create in the US, while white people are exposed to 17 percent less pollution than they create. The compounded lifetime effect of this exposure is elevated levels of asthma, high blood pressure, and cancer—the same conditions that now predict how severely individuals are affected by COVID-19.

Taken together, this research suggests that Black people’s disproportionate death rates from COVID-19—a virus that attacks the lungs—could be associated with the lifetime exposure to toxic air pollution they disproportionately endure. The potential link deserves further inquiry, especially as we head into a second wave of COVID-19 cases that will endanger even more Black Americans.

Top health officials should be scrambling for answers. But they’re not. They have largely brushed off the fact that Black people are dying at alarming rates and use sanitizing language like “underlying conditions” and “comorbidities” to explain the drastic disparity Black people are facing. Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, has said this disparity in death rates is due to preexisting conditions that Black people are more likely to have. His solution: “It’s very sad. There’s nothing we can do about it right now, except to try and give them the best possible care to avoid those complications.”

As Secretary of Health and Human Services Alex Azar, a former pharmaceutical lobbyist, said, “Unfortunately the American population is very diverse . . . It is a population with significant unhealthy comorbidities that do make many individuals in our communities, in particular African American, minority communities, particularly at risk here because of significant underlying disease health disparities and disease comorbidities.”

These careless and callous statements do not address the root of the problem, and they effectively absolve policymakers of the choices they’ve made—and in many cases, their inaction—that led to the racialized effects of COVID-19. In this case, naming and investigating the environmental determinants of COVID-19 death, such as air pollution, underscores the already dire need to implement Black-centered climate policies as we combat the climate crisis.

Ultimately, enacting environmental justice policies that aim to reduce pollution endured by Black communities would be essential not only to mitigating climate change and improving health overall but also to preventing unequal effects of major public health crises like COVID-19.