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Commentary: How COVID-19 is a symptom of structural racism

(Wong Maye-E | AP photo) Women wearing face masks leave after a church service at the New Horizon International Church, Sunday, Oct. 4, 2020, in Jackson, Miss. Across the country, racial minorities, especially Black people, have been hit hard by COVID-19.

Loss of smell and taste are well known symptoms of COVID-19 but what if COVID itself is a symptom of a bigger problem?

As of this month, more than 2 million people have died from COVID. This pales in comparison to the 3 million newborns and 300,000 mothers dying from preventable childbirth complications that are further compounded by poor access to health care services.

Unfortunately, these existing issues are exponentially worsening due to COVID, which has placed enormous strains on our healthcare system and further intensified social and health disparities. What happens when COVID, high rates of maternal-fetal mortality, and structural inequities converge here in Salt Lake City?

To begin to answer this complex question, we interviewed OB/gyn specialist Dr. Michelle Debbink, who has been investigating COVID’s impact on prenatal health care access in the Salt Lake Valley. Debbink emphasizes that disparities in both COVID infections/deaths and maternal-fetal mortality rates are manifestations of systemic racism, of which COVID outcomes have unmasked the consequences of intersectional risk factors.

For example, Black and Hispanic women are more likely than white women to be breadwinners in their families, which necessitates continuing to work while pregnant even in the time of COVID. Due to lack of access to higher-paying jobs, minority women are more likely to work essential, minimum-wage jobs with fewer protection policies that facilitate the spread of COVID.

In Hispanic communities, a higher number of multigenerational households with limited isolation options increases pandemic spread. As a result, a disproportionate number of Hispanic patients are admitted to the hospital and ICU with COVID.

So how do we begin to fix the problem? Well, like the problem itself, the solution will be complicated and multifactorial. In addition to the standard public health approaches such as vaccination, contact tracing and personal protection steps (masking, hand washing and physical distancing) there are large social-structural changes that could also help.

For instance, Debbink sees income support (raising the minimum wage) and employment protections (sick leave and paid maternity leave) as clear first steps. While these might not be obvious solutions to a pandemic crisis, they would accomplish multiple things that could mitigate pandemic spread.

First, they would decrease the financial burden on families, thereby allowing pregnant individuals more flexibility to take time off work to attend to their own health and that of their unborn child. Additionally, financial security would allow pregnant individuals better access to healthcare, as well as decreasing stress surrounding finances, health, and COVID exposure.

While this is by no means an end all solution, it is a first step to addressing a deeper problem and providing some relief to individuals. As Debbink states, “The disparities in COVID are a symptom of a problem, not a problem themselves. Structural racism and structural classism are actually the problems … the solutions are in dismantling the structures that lead to differential access to health opportunities.”

Let us learn a lesson from COVID, which has divided society into many different dichotomies — sick vs. healthy, rich vs. poor, work-from-home vs. essential worker — and address these solutions beginning today. Begin to address your own racial biases, begin to recognize the classist system that has created these disparities in the first place, and remember that race itself is not a risk factor, but rather the racist systems.

Call your elected representatives to ask for policy change, and take the necessary steps to begin to dismantle this system. It is necessary not only for our pregnant population, but for many others who face these stratifications daily.

Sarmishta Diraviam Kannan


Merodean Huntsman


Heather Cummins

Sarmishta Diraviam Kannan, Merodean Huntsman and Heather Cummins are first-year medical students at the University of Utah School of Medicine.