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Pandemic, systemic racism deal brutal blows to Black well-being

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Doctors have known it for a long time, well before the resounding cries of “Black Lives Matter”: Black people suffer disproportionately. They face countless challenges…
Doctors have known it for a long time, well before the resounding cries of “Black Lives Matter”: Black people suffer disproportionately.
They face countless challenges to good health, among them food, transportation and income. The stress of living with racism has very real, physical effects. And they are especially prone to diabetes, hypertension and other chronic diseases that can be tricky to manage even in normal times.
Then came COVID-19 and George Floyd – one killing Black people in alarming numbers, the other shining a harsh light on systemic racism. In a matter of months and nearly 8 minutes, it became clear that institutions designed to ensure the two most important things in life – health and safety – had converged to turn against one segment of the population in stark, horrific ways.
It’s a brutal blow to Black people’s well-being and renewed calls for racial justice in all realms including health care. Doctors and their patients are reeling from the impact.
“We are exhausted and we are not OK,” said Dr. Patrice Harris, a psychiatrist who just ended her yearlong term as president of the American Medical Association. She was speaking not so much for herself as for her community.
Police violence is always an injustice, “but its harm is elevated amid the remarkable stress people are facing amid the COVID-19 pandemic,” Harris and AMA Trustee Dr. Jesse Ehrenfeld said in a recent online opinion article.
Floyd’s death is the most extreme example of over-policing that has long plagued Black and brown communities. It has been linked with elevated stress, high blood pressure and other chronic illness that contribute to the high virus death rates in Black people.
As their offices start reopening for regular appointments, doctors are bracing for the fallout: a wave of sicker, shell-shocked patients.
As a physician, Harris knows she has a certain privilege. But she also knows firsthand the weariness of Black lives in America.
Harris was only the second Black physician to lead the AMA in its 173-year history. She gets “those looks” when walking into stores. She’s been asked to fetch coffee while wearing scrubs and a stethoscope.
“It’s not that we don’t have any more to give,” Harris said. But there’s a feeling among many that if Floyd’s death can’t spark meaningful change for Black Americans, nothing will.
Dr. Brittani James is a primary-care doctor. Most of her patients on Chicago’s South Side are Black.
Her neighborhood was one of the last in the city to get a COVID-19 testing site. They opened first in wealthier, whiter North Side areas.
“When I talk about institutional racism, this is happening in real time,” James said.
She has seen the virus hit many of her patients, while others grow sicker from chronic disease, and it’s heartbreaking, James said. “As a Black doctor, I feel like I’m failing my patients every day,” she said.
While her clinic has remained open, many patients are too terrified of COVID-19 to come in. That means trying to treat complaints without physical exams or blood tests. She has tried sending patients prescriptions for blood pressure cuffs but some can’t afford the cost. The options are “have their blood pressure uncontrolled or adjust their medications blind,” she said.
For every patient who has called for an appointment, there are 10 others she hasn’t heard from in months.
“There is no way that all of a sudden overnight there’s no more heart attacks, no more strokes, no more patients having poorly controlled diabetes,” she said.

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