One of the best predictors of life expectancy is your ZIP code. That was one of the outcomes relayed to the audience of a Harvard Biostatistics summer program back in 2014 by Dr. Melody Goodman. Dr. Goodman, an African American female who herself was a Ph.D graduate of the Harvard School of Public Health, was sharing her research on what was known as the “Delmar Divide,” a prominent socioeconomic division within the city of St. Louis, MO.
In the 2015 edition of the State of Black Kansas City, Rex Archer, M.D., provided similar data of clear socioeconomic segmentation in neighborhoods east of Troost and the resulting impact on the overall health and wellbeing of those communities. The plea from Dr. Archer more than six years ago was that if we have already identified gaps in life expectancy in certain ZIP codes, then it is beholden upon us to implement the transformative programs and partnerships that will address the racial, social and economic disparities that led to these identified gaps in health outcomes.
While progress has been made, you can see from the map that Dr. Archer used in 2015 compared with the Health Department’s COVID cases by ZIP code from April of 2020, there is still much work to be done.
In Physics, principles of motion are summed up in Newton’s Law of Inertia which states that an object in motion will stay in motion. This fundamental principle of inertia applies not only to physics but to human behavior as well. While neighborhoods and ZIP codes east of Troost are freed from the impediments of policies and covenants that led to these hyper-segregated communities, the inertia from those policies is still very much in motion. The same ZIP codes identified as having a lower life expectancy in Dr. Archer’s 2015 submission are the same ZIP codes seeing some of the highest concentration of infections from COVID-19. How does one counteract this inertia?
There is a second but equally important component to Newton’s Law of Inertia and it states that objects will stay in motion unless acted upon by an outside force. In a society impacted by centuries of policies and laws intentionally hostile towards people of color, there is no question that in order to achieve progress, we will need new policies, laws and programs to reverse that damage. But that’s only one component of the “outside force” needed. The other is you, the reader, consumer, resident and communities mentioned here within.
A foundational principle within behaviorism is that there is a hierarchy of human needs. Maslow’s hierarchy of needs range from physiological needs at the bottom to self-fulfillment at the top. Needs like achieving wealth, success and reaching your full potential cannot be realized until foundational needs like your health, food, water, shelter and safety are secured first. Simply put, without health, there is no wealth.
This pandemic has given us many lessons on how we see and care for one another. Now that we have tools available to each of us that have been proven effective at mitigating the personal and communal impacts of COVID, the pandemic has also solidified these two core principles of physics and behaviorism mentioned above. While there are many things that have buoyed the inertia of disparate impact on communities of color and there is still a need for multiple outside forces to reverse that inertia, one thing is clear. One of the key forces needed to reverse the disparate impact of COVID on communities of color is us, the people of color living inside and outside of those communities. In many ways, we have to be our own outside force erected in defense of the inertia that has crashed upon us for so long eroding the bedrock of our communities. Yes, we need connections and champions outside of our communities developing new policies and providing funding for new programs. But the inflection point we are at now is one where we must not waver from and that is in realizing and acting on the notion that we can be our own inertia as well. Right now, that begins with ensuring we are getting and encouraging others to get the COVID-19 vaccine.
The cost of an ICU stay per day is over $7,000. The cost of illness for many in our community can and has become a lifetime sentence in a prison of financial instability. Aside from the direct financial impact, the pandemic has slowed progress, diminished our ability to connect, and added instability to an already unstable setting. And now, now we have a choice as to whether or not we want the inertia of these disparate health outcomes to continue. As for that stifling inertia that has hindered so much of the progress our communities so desperately yearn for, today, you could choose to be the opposing force that our communities so desperately need.
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