Over the past several weeks, the outcries over the killing of George Floyd in Minneapolis, combined with recent killings of Ahmaud Arbery in Brunswick, Georgia and Breonna Taylor in Louisville, Kentucky have grown to a dull roar, finally focusing our nation on the tremendous risk of violence and death borne on a daily basis by people of color within this country. As our broader population has begun to address the widespread and persistent violence that has plagued minority communities for generations, medical researchers in the past few weeks have expressed significant concern over another urgent threat, finding a much higher death rate from COVID-19 within our African-American communities here in California and in the country as a whole. 

We have observed over the past several weeks what we already knew, or at least should have known, that disease falls hardest on the most underprivileged and that minorities in particular, independent of their economic status, are at a higher risk of death. The non-partisan APM research lab released figures showing that African-Americans have died from COVID-19 alone at a rate of 50.3 per 100,000 people- well over twice the rates for whites (20.7), Latinos (22.9) and Asian Americans (22.7). There are several reasons for this, none of which is biological susceptibility. Most of the difficulties are direct impacts of systematic racism, so it is important we look at some of these issues to better understand why they are amplifying, rather than suppressing, the impact of disease.  

In fact, per capita public health spending (and public education spending) is measurably lower in most regions in this country with a significantly higher African-American population. While lower public health spending in your region will result in poorer outcomes all by itself, medical professionals find that they are also struggling with high levels of distrust from minorities, particularly from those in the older generations. The more privileged you are, the less likely you are to have ever been treated by, and simultaneously not trusted, your doctor. As a privileged person, you probably learned about the Hippocratic oath at a young age and always accepted that your doctor made a promise to help, not harm, in all circumstances. 

To help place you in the mindset of someone who has been given no reason to trust doctors and every reason to fear them, I have for you the story of Henrietta Lacks. Henrietta Lacks was an African-American woman born in 1920. She worked as a tobacco farmer and was a mother from an early age. When she was thirty, after giving birth and hemorrhaging severely after, she was diagnosed with cervical cancer. She was given routine (at the time) treatment for her cancer and instructed to follow up with the hospital. During followup treatment she was admitted to the hospital at her request due to severe abdominal pain and remained hospitalized until her death two months later, in 1951. 

For a very long time, that seemed to be the end of Henrietta Lacks’ story. What is both remarkable and deeply problematic is that her contributions to society did not end at her death. Henrietta Lacks’ has saved your life and my life and she is absolutely on the front-line fighting against Covid-19 right now. 

During her treatments, healthy and cancerous tissue was sampled from her body without her knowledge or consent. Those cells were cultured and displayed the unique ability to reproduce endlessly and remain alive within a culture for far longer than any previous cell lines medicine had studied. Anonymized simply as the “HeLa” cell line, they became the standard for human medical research; Henrietta’s bodyweight in cell mass being grown millions of times over (over 50 million metric tons as of 2011) to meet the insatiable needs of modern medicine. Without Henrietta Lacks, there would have been no California Stem Cell Initiative and no California Institute for Regenerative Medicine, among numerous efforts that have enabled the rise of biotechnology and life science research in the state.

Not only was Henrietta herself never able to give consent to this or any use, her family did not even know of the existence and tremendous spread of her genetic material until early in the 21st century, by which time HeLa usage was so widespread there was no ability to grant or withdraw consent. As of 2013, the only gain her family has secured from her legacy is a promise from the NIH of acknowledgement in subsequent scientific papers and two seats on a panel regulating access to her DNA sequence going forward. While Henrietta Lacks’ story is extraordinary, her treatment by the medical community is in many ways typical of the healthcare African Americans have experienced over the last 70 years, with African-American healthcare prior to that being literally the stuff of nightmares. Within the past century, there are plentiful accounts of forced sterilizations, of being placed in trials without their knowledge or consent, of being accused of lying when recounting their history or symptoms, of being lied to, and even of being straight-up experimented on as an “expendable” population. In light of this history, it becomes much clearer why many minority groups would push back when told to sacrifice their jobs to keep others healthy, to stay home when the grocery store shelves are emptying, to leave the hospital when a relative is struggling for breath with no way of knowing what will happen to their loved one inside the hospital doors once they are not there to watch over them.

When this is compounded by widespread suspicion of any African-American individual wearing a mask who walks their dog or goes to a market to shop, the significant risk of grave harm is only compounded further. While the loudest voices against masks have been those of angry white people upset at the disruption of their privilege, minorities are very aware that at the intersection of masks, profiling, and persons of color the health risks of mask wearing are very real. In recent weeks, we have already seen violence inflicted on African-Americans for looking suspicious by “being in public while following CDC guidelines”. In April, a succinct tweet circulated stating it bluntly. “I don’t want to die and on the other hand, I don’t want to die.” Jokes from the privileged about committing crimes, being nefarious, or shady need to stop. None of that does what is urgently needed, which is to normalize mask usage among all groups so that it can help slow the spread of disease. We can instead treat people of color within our communities with respect, and listen to their perspectives in navigating through this global health crisis. 

The pain and death we are inflicting on the African-American community may be far more apparent now, but we need to recognize and address the fundamental wrongs that extend far beyond policing, and even healthcare. We are not going to fix this environment overnight, but we definitely do not need to make it worse. Right now our minority communities urgently need funding. Public health funding is absolutely critical but these communities also need funding to provide masks and other desperately needed protective equipment to every individual who must spend long hours working in public spaces, funding to keep people securely housed, with ample access to healthy food, funding for widespread, low-cost (or free) internet connectivity so that the poorest children within our society can continue to be educated through distance-learning alongside their more privileged peers. Looking further ahead, we desperately need to nurture a new generation of African-American scientists and doctors by reaching out to students early, while they are still in primary school, and we need to rebuild bridges to the community with better, more accessible and trusted healthcare. We’ve already collectively inflicted plenty of harm, we can at least start to make steps towards making their situation better.