The coronavirus has disproportionately hospitalized black people in Onondaga County. The County’s population is 76.5% white, but only 54% of people hospitalized for coronavirus are white. The County’s population is 11.5% black, but 27% of people hositalized for coronavirus are black.
Looking for a possible explanation, the County Executive “speculated that the trend might be due to the fact that African-Americans have, as a whole, larger percentages of diabetes and heart disease, preexisting conditions that can make the virus much worse.”
That checks out. The overwhelming majority of black people in Onondaga County live in a few segregated neighborhoods in Syracuse, and those are the very same neighborhoods where the CDC has found the highest rates of diabetes and high blood pressure.
Population by race
Diabetes rate among adults
Hypertension rates among adults
Why though? Why is it that black people in Onondaga County are so much likelier to have been sick than white people, even before all this started?
The CDC also keeps data on factors (like lack of sleep) that contribute to health outcomes (like diabetes and high blood pressure). Here are maps of obesity, lack of sleep, and lack of exercise.
Obesity among adults
Lack of sleep among adults
Lack of exercise among adults
Put all this together, and you get a pretty stark picture. Black people are segregated into specific neighborhoods where environmental factors like polluted air and lack of access to opportunities for exercise have made it difficult for people to maintain their health, contributing to chronic conditions like diabetes and hypertension which have put them more at risk to contract coronavirus.
So it was a good thing that City Hall had announced its intention to maintain the sidewalks. Better sidewalks are the kind of positive environmental factor that would improve health outcomes by making it easier to get around on foot, making that light exercise a more prominent part of the routine of daily life. This is particularly true in those neighborhoods where people are less likely to own a car and more likely to live within walking distance of job centers like University Hill and Downtown—neighborhoods like the segregated ones where negative environmental factors have made coronavirus so much of a problem today.
But on the same day that we learned of coronavirus’ disparate racial impact, City Hall postponed that plan to maintain the sidewalks because the coronavirus has blown a hole in the municipal budget. City Hall was going to introduce a new frontage fee to pay for that maintenance, but Mayor Walsh explained that “we didn’t feel it would be fair to constituents to bear that burden now.”
But why should it take a new fee to pay for the sidewalks when DPW manages to maintain the rest of the street with money from its regular budget? Why can’t City Hall just redirect some of the road repaving money to fix the sidewalks? Why is the funding so fragile for a public resource primarily used by Syracuse’s poorest residents while the funding for the roads driven on by relatively richer City residents (and County commuters) is so resilient?
Taken together, these environmental conditions that contribute to poor health in black neighborhoods and particularly fragile funding for the mitigation of those conditions amount to an instance of structural racism—a series of seemingly neutral, unrelated, and agentless decisions that conspire to yield inequitable outcomes divided along racial lines.
Clearly, the Mayor isn’t postponing his sidewalk maintenance plan because he’s racist. And clearly, fixing the sidewalks would not, on its own, mitigate coronavirus’ disparate impact on black people in Onondaga County. And that’s the problem with structural racism—when inequity is the unintended effect of boring stuff like appropriations, when no one makes those original decisions for racist reasons, and when unmaking any one of those decisions will only have a slight and delayed effect on the enormous overall problem of racist inequality, then it’s too easy to put anti-racist action off indefinitely.
But we have to take that action now. The truth is that it’s never easy to dismantle the racist structures that hold up our municipal government. The coronavirus may make it seem like now is a particularly bad time to start, but a look at the racial disparity in infections should be enough to prove that Syracuse needs to do this work now more than ever.