‘This has been going on for years’: A look at the health crisis that has already hit the black community long before COVID-19.

DALLAS COUNTY, Texas. When COVID-19 forced life around the world to change in March 2020, there were more questions than answers. Initially, many believed that young people were not vulnerable, and children could not understand this. There has been confusion about how it spread. There were those who did not even believe that it was real.

As the weeks went by, the number of cases and, unfortunately, the number of people dying from the disease continued to rise. Businesses are closed. Schools sent students home. Scientists and researchers have begun gathering information to build a more complete picture of what the world is really facing.

One of the first headlines was data showing that the virus, while devastating everywhere, had a disproportionate impact on black and Hispanic communities.

Nearly three years later, this is still the case.

As of the end of 2022, the CDC reported that people of color are still more likely to contract, be hospitalized with, and die from COVID than white people.

But the impact of COVID-19 on the black community has not led to inequality; it just shed light on a gap that had existed for decades. Dr. Caroly Estelle, deputy director of infection prevention at the Parkland Health and Hospital System, said the pandemic’s impact on black communities is not surprising.

“Chronic disease differences are not new,” Estelle said. “This has been going on for many years.”

This is a story that has already been told in disease data that has been normalized and often underestimated. We started calling them “underlying conditions” because they created complications for COVID-19, but even before we knew about the new coronavirus, chronic diseases like hypertension, heart disease, obesity, and diabetes were already killing hundreds of thousands of people. Every year. year.

They also disproportionately killed blacks.

“Chronic diseases such as diabetes, high blood pressure, and coronary heart disease cause mortality among patients in our community,” Estel said. “They represent a huge burden on our community as a whole, but especially on our black and brown communities.”

Late last year, Parkland partnered with the Dallas County Department of Health and Human Services to publish its Public Health Needs Assessment, which is a comprehensive report on the health problems that exist in Dallas County and in Parkland patients.

The 128-page report outlines community survey results, hospital data, and county health data. This report, which includes a lot of information from 2020, contains the obvious truth that blacks were already dying faster than other ethnic groups from a range of chronic diseases, which in turn caused more devastation from COVID-19. .

“It’s the same every flu season,” Estel said. “They [people with chronic illnesses] with an increased risk of getting sick with a heavy fly, as well as getting sick with a severe flu, and this happens every season.

In fiscal year 2021, Parkland treated 113,623 patients suffering from high blood pressure who visited almost 800,000 times.

High blood pressure, or hypertension, was the chronic condition that caused the hospital system to receive the most visits, and 84% of those patients were black and Hispanic.

“High blood pressure has been called the silent killer. Why do they call it the silent killer? Because you don’t feel anything, but it can go on,” Estelle said.

It is also the biggest risk factor for cardiovascular disease, which has been the leading cause of death in the United States, Texas, and Dallas County for decades.

The report states that African Americans have the highest death rate from heart disease, a trend that has continued for many years.

In fact, when looking at the death rate from some of the most common causes of death in Dallas County, blacks outperform other ethnic groups.

In 2020, the leading causes of death in Dallas County were heart disease, cancer, COVID-19, accidents, Alzheimer’s disease, cerebrovascular disease, chronic lower respiratory disease, diabetes, nephritis/nephrosis, and chronic liver disease.

Blacks had higher death rates for six of them: heart disease, cancer, accidents, cerebrovascular disease, diabetes, and nephritis/nephrosis.

All of these conditions, with the exception of accidents, are chronic diseases.

When you look at the five most vulnerable versus the five least vulnerable zip codes in Dallas County, you can see a pattern. Despite their close proximity, the zip codes with the highest chronic disease vulnerability index were also the zip codes with the lowest life expectancy in the county and the zip codes where COVID hospitalizations and deaths were disproportionately higher than in counties with similar populations but less vulnerability to chronic diseases. illness.

These are also counties with higher concentrations of blacks and Hispanics.

For example, the postal code 75204 has one of the lowest vulnerability indexes. It includes areas such as Uptown and Oak Lawn. About 32,032 people live here. There have been 10,199 cases of COVID-19 in the area, according to DCHHS: 284 of these residents were hospitalized with the virus, 57 were admitted to the intensive care unit, and 29 people died.

The Dallas County Zip Code 75241 has approximately 30,864 residents. Despite fewer people, 10,418 COVID cases have been reported in the area: 936 residents were hospitalized as COVID patients, 201 of them were admitted to the intensive care unit, and 125 of them died.

There is an undeniable link between chronic illness and the impact of COVID-19 on these communities, with serious illness and death being the most worrisome outcome.

While some of these conditions are genetic, most are lifestyle related.

In fact, for most of these conditions, the CDC offers three top tips for preventing them: avoid smoking, eat a healthy diet, and exercise. The health organization has even cited physical inactivity as a risk factor for COVID-19.

“They don’t always prevent it in everyone and they don’t always stop the progression of these diseases, but they can certainly reduce the risk,” Estel said.

Estelle said a healthier lifestyle could also reduce the amount of medication people with chronic conditions need to take to treat these conditions.

While there are safety barriers to outdoor sports in some neighborhoods and areas of North Texas that are food deserts where there are no grocery stores selling fresh produce, there are a number of socioeconomic factors that contribute to this disparity. There is also an opportunity for people who cannot move from one area to another to take charge of their health and improve their performance.

There are also groups working to break down these barriers.

Theo Murdo created the Zone Fitness Training Run in Dallas in March 2020. The group meets Wednesday nights in Los Colinas and Saturday and Sunday mornings at White Rock Lake for what she calls a “social run.”

“We have a goal and we make sure that every time someone comes out here, we start with a 5k and, hell, they end up working their way to a marathon, so it was just awesome.” Murdo said.

The running club is made up almost entirely of black runners, making them unique in the North Texas running community.

“When we show up at these races, people look at us like, ‘Oh, we’ve never seen this before. It’s different,” Murdo said.

In 2022, 22 ZFT runners ran their first full marathon and 15 ran their first half marathon.

“We have people who two years ago probably couldn’t run a quarter mile, and now they are running their second … third marathon,” Murdo.

He said his group is “inspiring” as he watches people of all shapes and sizes dedicate time and hard work towards goals they never knew existed. He said he also sees a ripple effect in how his participants feel about their health.

“They are doing their own research,” Murdo said. “They learn how their body works. We’ve had people with weight problems… heart problems… stuff like that. They want to run so much. and get checked out to make sure they are healthy enough to run. It really empowered people to take their health very, very seriously, especially black men.”

And as the group grows each week, with some meetups reaching over 100 runners, so does the feeling of a healthy community.

“This is public health,” Estelle said. “They’re doing an extension of what the Dallas County Department of Health and all of our peers in public health are doing, and they’re doing it at the grassroots level in society.”

Estelle said she hopes the group will continue to grow as research shows that public health initiatives are most successful when they are created by and for their own communities.

The pandemic has shed light on a number of health issues that already existed in North Texas, and while they will likely require significant social change to fully resolve, there are things everyone can do to get healthier and live longer.

“What you do matters,” Estelle said. “Your choice matters and it matters. Start small. Pick one.”