Customers walked around her, coughing.
Rubbing alcohol and gloves were in short supply. The masks she wore, she made herself. Some of her coworkers, scared, had stopped coming to work. But not her.
Beyond five sick days a year, she said, “everything is up in the air” as far as paid leave if she becomes ill with COVID-19.
Deemed essential, however, the retail store worker — who requested anonymity out of fear of losing her job — has to help make ends meet for her family of three, even when that means she needs to gamble with her health during a pandemic that has killed tens of thousands nationwide.
“Basically, either you work or you could lose your job,” she told The Dispatch. “So I feel like I have to go. … I’m scared every day.”
She is one of many black Mississippians who must work front-line jobs to make a living amid the coronavirus outbreak. In the store where she works, she said, all of her coworkers are black.
The prevalence of contact-intensive work among black Americans helped lead to a disproportionately heavy impact the pandemic has on the state’s black communities, said experts and community leaders. State-level statistics show black Mississippians account for a higher rate of confirmed coronavirus cases and deaths compared to whites.
A combination of factors appears to contribute to those numbers — economic disadvantage, mistrust of institutions, a higher rate of underlying health conditions and limited access to health care.
‘Whopping, lopsided mortality’
As of Wednesday evening, African Americans made up 56 percent of confirmed COVID-19 cases in the state and 66 percent of the state’s COVID-19 deaths, data from the Mississippi State Department of Health shows.
But the ethnic group accounts for only 38 percent of Mississippi’s population, according to the latest estimate from the U.S. Census Bureau. In Columbus, they accounted for 63.5 percent of the city’s population in 2018.
“It’s been a whopping, lopsided mortality when we look at African-American folks,” said state health officer Dr. Thomas Dobbs during a conference with the Mississippi Legislative Black Caucus (MLBC) last week.
So far, MSDH has yet to publish county-level data on the racial breakdown of coronavirus cases. Department spokeswoman Liz Sharlot told The Dispatch the data sample size is too small for a local data release.
The racial disparity is emerging not only in Mississippi but also among other southern states and across the nation. Similar racial gaps have been found in several cities like Chicago and Milwaukee, as well as in the state of Louisiana.
A recent study by the Centers for Disease Control and Prevention also concluded the disease might disproportionately affect black citizens.
‘We can’t afford to be off’
Working as “front-line workers” — such as grocery clerks, postal workers, sanitation or fast-food workers — during the pandemic increases chances of exposure to the coronavirus, said Dr. Sandra Melvin, who chairs the Health Committee of the Mississippi Conference of the NAACP.
Many African Americans who work those jobs, however, do not have a choice.
“We’ve got to work, that’s how we are going to take care of our family. We have to be out there,” said Lavonne Latham-Harris, president of the Columbus-Lowndes branch of the NAACP. “By being at the front line, we are also at the low end of the pay scale.”
African Americans in the state are at an economic disadvantage compared to whites, Melvin said.
Roughly 22 percent of the state’s population lived below the poverty line in 2017, the latest year data available from the American Community Survey five-year estimate, a survey conducted by the U.S. Census Bureau. About 57 percent of those who live in poverty were black, whereas 36 percent were white, data shows.
Rep. Kabir Karriem (D-Columbus), vice chair of the MLBC, said the financial burden is too hard to bear for a lot of black Mississippians.
“We can’t afford to be off,” he said.
Additionally, African Americans who live in “crowded” households with children and extended family may not even have a place to self-quarantine if they start showing symptoms, said Chris Taylor, former president of the Oktibbeha County NAACP chapter.
“If they have five or 10 (people) in the house they are living in,” he said, “how can you self-isolate?”
High rate of health conditions, limited access to care
Patients with underlying health issues are more vulnerable to the coronavirus than healthy individuals, Dobbs said.
Compared to whites, blacks have much higher rates of hypertension, immunocompromised conditions, cardiovascular diseases, lung diseases and diabetes, he said. The rate of diabetes for blacks is about seven times higher than in whites, he said.
Behind the high rate of health problems, community leaders say, is the hardship for blacks to access affordable health care.
Roughly 12 percent of Mississippians were not insured as of 2018.
“If we break that down by race, 13.9 percent (of African Americans) are without insurance in Mississippi … compared to 10.6 percent of whites,” Melvin said.
The lack of health insurance coverage, Taylor said, is leaving a lot of black citizens helpless when they need medical attention.
Mobile coronavirus testing sites require a doctor’s referral, for example.
“The people not getting the care, they don’t have a personal doctor,” Taylor said. “The majority of the whites do have a health care provider, but blacks have to depend on the (emergency rooms). And when they go to the ER, if it’s not life and death, they are going to send you home.
“They can be tested,” he added, “but they’ll almost be dying by the time they do get tested.”
Exacerbating these problems is a mistrust among African Americans of institutions, said David Buys, state health specialist at Mississippi State University.
“(That) maybe leads African Americans to … wait until they are further along in the disease process before they show up for testing and for treatment,” Buys said.
The retail store worker echoed that point.
“We’ve been taught to not trust the government,” she said. “We’ve been taught by different things that have happened to people over the course of time.”
Some African Americans in her community believe in conspiracy theories, she said, and that the pandemic is “not real.”
“(They think) it’s just something the media is putting out,” she said. “They felt that if it was that time the Lord wanted to (spread) the coronavirus, they were going to get it no matter what.”
That spread of misinformation puts those communities more at risk, Karriem said.
“There was a plethora of misinformation … that African Americans couldn’t get it, that we were immune to the coronavirus,” he said. “All of that has been debunked. We see now that anybody can get it. It is a serious disease and is something that cannot be taken lightly.”
What can be done?
To raise awareness among Mississippians, Buys said community leaders and local officials can help “put the word out.”
Trusted local leaders matter, and using the network of those “local champions” may help dispel rumors and spread accurate, useful information, Buys said. Specifically, faith groups can help, too.
“I think ministers, particularly in African-American communities, carry a lot of weight,” he said.
Some local leaders also pointed to the need to offer more tests to Mississippians in need, particularly in the black communities.
“I wish testing had been more available to people in the African-American community and the virus wouldn’t have hit so disproportionately,” Karriem said. “We have to set up testing shops inside the African-American communities … and make it more accessible.”
District Attorney Scott Colom said there should be a targeted approach to reach those who are vulnerable to the virus and offer them mobile testing.
“If a person in … public housing has the coronavirus, it can more easily spread because they are living more condensed,” he said.
Help is already available in Mississippi, with free, mobile testing sites across the state. The long-term solution, Karriem said, would be to expand Medicaid to cover more uninsured populations. But for now, chances are slim.
Even with the measures that are already in place, misinformation and lack means will continue to be a challenge, Buys said.
“It’s hard to undo decades of mistrust and concern about cost,” Buys said.
Yue Stella Yu was previously a reporter for The Dispatch.