As coronavirus spreads in Minnesota, it exposes racial inequalities

When on his evening walk Minneapolis City Council Member Jeremiah Ellison got the call confirming his beloved grandmother had died from coronavirus, all he could do was sit on a park bench and weep.

He had recently returned from attending her funeral in Detroit. Knowing that "even at 82" his "Nana" — an independent, hilarious, gardening-loving, "work until I drop dead" kind of woman — died from COVID-19 angered him.

He thought about how her death and the lives of other people of color nationwide struck down in the pandemic underscored deeply entrenched racial health and economic gaps.

"If you're someone who thought you had more time to solve these inequities, like maybe we could get it right in a generation or two, I think maybe this pandemic is proving that we don't have that much time," Ellison said. "Folks who deserve a remedy to systemic racism are going to die faster than the pace we're currently working at."

He pointed out that the north Minneapolis residents he represents are often from or have family still in Chicago, Detroit, Milwaukee and Gary, Ind., where racial inequalities in income, health, housing and unemployment are being mirrored in how the virus is affecting minorities. He fears more coronavirus deaths are coming among communities of color.

As COVID-19 continues to take thousands of lives each day in the United States, minorities in particular are being ravaged out of proportion, public health officials say.

In New York City, early data showed Hispanics accounting for 34% of COVID-19 deaths while making up 29% of the city's population.

In Michigan, blacks have accounted for a third of COVID-19 cases and four in 10 deaths, even though they represent 14% of the population.

In Chicago, 72% of the deaths have been among the city's black residents, though they make up 29% of the population.

While the official number of people of color dying from COVID-19 in the Twin Cities is more proportional to their share of the population, the pandemic is forcing Minnesotans to reckon with longtime disparities.

Minnesota Gov. Tim Walz said at a recent news conference that COVID-19 is "exacerbating" other issues that disproportionately affected communities of color before the pandemic. He announced the formation of a Community Resilience and Recovery work group to look at policymaking and other opportunities to help communities of color.

Statewide, blacks comprise about 7% of the population. So far, they make up 13% of Minnesotans confirmed to be infected and 3% of those killed; Asians, 4% and less than 1%, respectively. People of Hispanic ethnicity comprise 6% of people known to have contracted COVID-19 and 3% of those who have been killed by it.

But officials say the actual numbers of people hit by the disease in Minnesota's minority communities is likely higher. One reason is because race and ethnic data is often self-reported and the state doesn't know the race or ethnicity of about 20% of those who have contracted the virus.

The other reason: Much of the testing to date has taken place in southeastern Minnesota, where the Mayo Clinic is located, or in nursing homes and other congregate-living facilities, where most residents are white. Without comprehensive testing in communities of color, many victims of the virus who are not hospitalized might never be counted.

Statewide, only about 1,500 people are tested each day, said Luisa Pessoa-Brandão, manager of Epidemiology, Research, and Evaluation at the Minneapolis Health Department. That means officials likely are missing the more mild cases that nonetheless help spread the virus.

Minneapolis Health Commissioner Gretchen Musicant said she doesn't expect the official minority numbers to stay where they are for long. As in other cities, blacks and others with lower-paying, service jobs in the Twin Cities are less able to work from home. Social distancing can be tougher to achieve in higher density, low-income neighborhoods.

"I think we are fairly early in our outbreak compared to other communities [in the East and West]," Musicant said. "But we have similarities in terms of [economic and health] disparities, so I would not be surprised if COVID results are similar here, too … but it hasn't been documented yet."

Those differences may be slowly starting to show in Ramsey County. Blacks there make up 18% of known coronavirus cases and Asians comprise 9%. Still, the race of those afflicted is unknown in 18% of cases, according to reports.

St. Paul Mayor Melvin Carter said there should be a sense of urgency to fill in the blanks regarding the virus' impact on the inner city.

"We have a shortage of tests, and the fact is, we can't say for certain what the virus is doing other than it's moving fast," he said. "We shouldn't wait to take action until after people get sick and die."

The heavy COVID-19 toll being paid by communities of color across the country reflects similar disparities in housing, health care and economic well-being that have existed for generations. Multigenerational distrust of doctors, hospitals and medical research has also made people in communities of color more likely to be wary of seeking care.

When Elie Farhat died this month at 92 from COVID-19, he left the world alone, according to Elianne Farhat, his granddaughter.

The Lebanese immigrant spent much of his life rising above trying circumstances — he was orphaned at a young age and survived war and conflict in Lebanon before starting a new life in America. He was "a good grandpa who wanted the best for his family," known in the local Lebanese community for his quiet demeanor, comedic timing during a conversation and the backgammon games he set up in garages around their northeast Minneapolis neighborhood.

But for him "to die with none of them around you" has been hard for the family to wrestle with, his granddaughter said.

"One of the biggest challenges in front of us is that there are no simple answers, and the reason that we continue to have disparate outcomes across race in our state is because it's complicated and compounding layers of injustice that people are experiencing," said Farhat, executive director of TakeAction Minnesota, which describes itself as a progressive political organization. "I don't know another path forward that isn't hard and complicated and that doesn't really force us to confront the set of assumptions we have about the world and how it operates."

Kelsey Dawson, who coordinates strategic engagement for Hennepin County, and Jillian Kyles, a county Human Services program manager, are working to reach the county's immigrant and minority communities to help them navigate the coronavirus crisis and connect with services.

From distributing literature and setting up helpline messages in up to 19 languages to teams of workers going into inner city neighborhoods, outreach efforts are reinforcing social distancing among folks whose cultures value just the opposite. There are even videos coming soon about the importance of wearing masks.

"Social distancing is difficult for people who go to school together, whose community life is filled with summer gatherings in a park," Dawson said.

Communities of color are also vulnerable to the COVID-19 outbreak because of higher rates of chronic health issues including obesity, high blood pressure, diabetes and heart disease. Health experts say those chronic issues can make it harder for the immune system to fight off viral infection.

It's important to remember that communities of color are not predisposed to COVID-19 or any other diseases and they "haven't done anything wrong" to be more vulnerable, said Julie Nielsen, innovation group director with Northpoint Health & Wellness Center, a community health center in Minneapolis. She said the illness is a reminder of how health issues in white communities can be amplified in the black community due to longtime inequities.

"It's not like they're not taking care of themselves," Nielsen said. "We need to remember that there are generations of systemic marginalization in the communities where they haven't for generations been able to access health care at the same rate or access housing and all of the other things we need to thrive. … We need to remember that giving the same or equal amount of care and service to various groups won't result in the same outcomes."

Farhat noted that conversations on how race intersects with other aspects of life can be mistaken as personal attacks.

"Talking about people having that opportunity doesn't mean that a white person was intentionally crafting systems that made these negative impacts, it doesn't mean a white person isn't entitled to the same level of opportunity and joy that everyone else is," Farhat said. "I think when we're talking about institutional racism, structural racism, it's really important to be very clear that everybody, regardless of race, has the same ability to live joyful, healthy and abundant lives."