KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show on WAMU 88.5, where I'm broadcasting from home so welcome. Later in the broadcast we'll discuss how isolation is particularly difficult for recovering alcoholics, who cannot now attend AA meetings. Then the current availability of medical marijuana in this region.

KOJO NNAMDIBut first, we've all felt the effects of the Coronavirus pandemic, but recent data reported by the District and the State of Maryland show that the virus is not affecting all of us equally. Communities of color specifically those in the black community have disproportionately high rates of infection and fatality from COVID-19. What's causing this disparity, and what can be done to protect these vulnerable communities? Joining me now is Dr. Hugh Mighty, Dean of Howard University's Medical School and the Clinical Care Vice President for Howard University Hospital. Dr. Mighty, thank you for joining us.

HUGH MIGHTYIt's my pleasure. Thank you for having me.

NNAMDIDr. Mighty, what are the data coming out of D.C., Maryland and Virginia telling us about the ways that different communities are being affected by Coronavirus around the region?

MIGHTYWell, it would seem that the data is really consistent here as it is across the nation in that it seems that communities that are sort of underserved or poor communities, minority communities tend to see a larger impact of the virus than -- across even the DMV we're starting to see that especially if you look at Prince George's County in Maryland. And now we're starting to see that same surge within the District.

NNAMDIAlso joining us is Danyelle Solomon, Vice President of Race and Ethnicity Policy at the Center for American Progress. Danyelle Solomon, thank you for joining us.

DANYELLE SOLOMONHi. Thank you for having me.

NNAMDIWhat may I ask do you think is causing these disparities in Coronavirus cases along racial lines?

SOLOMONYes. I think what we're seeing today is that any time we have a pandemic, an epidemic or a national emergency what happens is you see a light shined on inequality. And this is exactly what we're seeing with COVID-19. COVID-19 is showing exacerbation of racial disparities that have been present across communities in America for decades and quite frankly centuries.

NNAMDIDr. Mighty, why is it that communities of color have higher rates of preexisting conditions?

MIGHTYWell, I think across time we know that, you know, the inequities for around both care and housing, nutrition, certain job classifications lend the communities to be at a higher risk for underlying diseases especially as you would see in high blood pressure, diabetes. Certain minority populations are more prone to have diseases like connective tissue disorders, lupus and so forth. All of these things create a physical clinical burden that is then uncovered by an additional stressor or a newly introduced pathogen like the virus that we're facing now.

MIGHTYSo again it comes because we've had years and years of underlying what we call core morbidities or physical conditions that have not necessarily been addressed in poorer communities. And along comes a new challenge that uncovers the fact that this has been there for a very long time.

NNAMDIHow is this affected, Dr. Mighty, by access to healthcare in communities of color or simply nutrition?

MIGHTYBoth things are impactful. Access to care is a matter of being able to treat and take care of let's say, let's pick one condition for a moment. Diabetes, so if you've got diabetes and it's not controlled it leads to other impactful things such as heart disease such as blood pressure issues. And then the control of diabetes is largely dependent on not only medication as in insulin by also largely driven by your access to proper nutrition. So one singular disease that needs to be managed carries with it, you know, the ability to -- A, you have to be able to get the care, and B, you also have to be able to follow the care plan, which in many cases might be nutrition.

MIGHTYSo those things many times in communities of color -- either just because of jobs, many people have service jobs. They're hourly workers, for them to come to the doctor they have to take off work to do that and they can't necessarily afford to do that. Or there are issues of child care, which drives access points. And so you can't simply go to the doctor if, you know, work and you work all day. And then you end up going home and you have to take care of your child. Just taking off the things that people normally would take for granted when we say it are just simply not necessarily available in many communities.

NNAMDIDanyelle Solomon, how does the use of public transit factor into the spread of Coronavirus?

SOLOMONYeah, that's a great question. It definitely factors into the spread of Coronavirus. As the doctor was saying, you know, for communities of color it's very likely that they are more likely to use public transportation than instead of having their own car. And so any time that you're in a highly dense area whether that's your house or the transportation you use you're more likely to come into contact with Coronavirus.

SOLOMONThe idea that individuals can participate in social distancing is also much harder for communities of color, because of the jobs that they hold. So for example, we know that people of color overrepresented in service sector jobs. Those are jobs like bus drivers, grocery store workers or child care workers or restaurants or salons and barbers those are jobs that make it really hard for you to work from home. They require you to interact with individuals. We know that less than one in five African Americans can actually work from home. And one in six Latinos can actually work from home.

SOLOMONSo whether it's transportation or the job you hold social distancing is much harder for these communities, which makes them more likely to come in contact with COVID-19.

NNAMDIHere's Ron in Washington D.C. Ron, you're on the air. Go ahead, please.

RONHi, Kojo. Thank you to Dr. Mighty and your other guest for kind of raising the issue of -- you know, I'm lucky as an African American to be able to stay home from work and take precautions to prevent the spread of COVID-19. But I have my mother, my father, a sister and a brother who all are essential workers and are continuing to work. My brother, Bobby, used public transit to get to and from work. And so, you know, for them, I'm sure that they're taking precautions when I check in on them.

RONBut for them and many folks you know in the community that I live in and family members' work continues. And so, you know, I don't think people understand how hard it is to take precautions as a person of color when you are working in the service industry and other essential fields. We're using the public transit, and all of the historic inequities that are community has faced are front and center right now. And it's, you know, I don't think we're talking enough about that as folks prepare to say should we reopen the economy.

NNAMDIWell, that's why we're talking about it now, and you make all of the points -- you underscore all of the points that our guests are making. So Ron thank you very much for sharing that personal experience with us. Danyelle Solomon, although D.C., Maryland and Virginia have all made some effort to release racial disparity data on Coronavirus patients much of the data is incomplete. Why is that?

SOLOMONYeah. That's right. D.C. is kind of no different than the rest of the country. The data that is available including the data that was recently released by the CDC is incomplete and spotty. However, the data that we do have does show us that COVID-19 is having a disproportionately negative impact on the black community in particular as well as tribal communities. In D.C. in particular black residents make up almost half of the population about 46 percent, but they represent 76 percent of the deaths in comparison to white residents, who make up only 10 percent of the COVID-19 deaths.

SOLOMONSo the data is spotty, but the data we do have shows that it is hitting black residents much harsher than their white counterparts. There's been a lot of work done by advocates and lawmakers to ensure that we get better more comprehensive demographic data, which is essential so we can make sure that we are targeting our resources and interventions into the communities that most need it. And there's no doubt that the black community needs more interventions in order to combat this virus.

NNAMDIDr. Mighty, why is it important that this race based data be collected?

MIGHTYWell, I think it's very important not only for now. I mean, the virus is here now. It's going to run through its course as we see it. But not only do we have to deal with it now. We're going to have to deal with it going forward. And understanding who is affected and what the factors are that drive that are going to be very important in the future to one, you know, diminish the spread of the virus, but also in order to make sure that our communities are well-informed in terms of things such as what should we have to do in the future is contact tracing.

MIGHTYWe have to know who is infected so that, again, if we know who's infected we can at least be able to spread that out and to prevent the more people coming in contact with us. So I think it's very important to do that. One -- two it's important to also look at what disorders there are that we can actually tackle. So we think about and we talk about people having, you know, high blood pressure, diabetes, etcetera.

MIGHTYBut it's important that especially now that we are on distancing or we have fewer people who can travel and so forth that we actually find a way to reach out to those communities so that we can keep tabs on them. That we can make sure that they're being informed. We can make sure that's somebody with a medical disorder doesn't stay home, because we know that if they get infected that that virus is more likely to stress their systems beyond which, you know, normally people who don't have a disease would be. So I think it's important we have the data. The more informed we are the better prepared we are to be able to provide interventions to those communities to help keep them healthier and safer.

NNAMDIDanyelle Solomon, you mentioned native populations. Here is Jeffrey in Michigan. Jeffrey, you're on the air. Go ahead, please.

JEFFREYYeah, my name is Dr. Jeffrey Mazek and I'm a Physician originally from Washington D.C. But I'm working on the Sault Ste. Marie Reservation in upstate New York. And, again, is that all the data we're having and the data I'm seeing and where I work every day is that it's pretty much ravaging the Native American community. And like everywhere else we're short of PPE. We're short of the testing and the whole bit. So like some of your authorities to kind of address COVID in the Native American communities.

NNAMDIOf course, Mazek is a well-known name in the health care community here in Washington D.C. Care to address that, Dr. Mighty. We only have about 30 seconds left in this segment.

MIGHTYYeah. It's, you know, the problem we've got and one of the biggest things we face especially as you get to more rural communities it's two things. One is getting the information out, but it's also important to have things like you're saying PPEs. Information getting out is expressing to people the importance of the few things that we can do. Distancing, the ability to at least use masks to try to prevent rapid spread among communities. PPEs and access for healthcare workers, you know, we don't have enough. That's just the bottom line. There's not enough and what we do have is not well distributed. So the challenges are real in both rural communities as well as in underserved communities.

NNAMDIGot to take a short break. When we come back we'll continue this conversation. You can still give us a call 800-433-8850. Do you think enough is being done to protect your community? I'm Kojo Nnamdi.

NNAMDIWelcome back. We're talking about the racial disparities and the effect of the Coronavirus pandemic across the U.S., but in particular in this region. Danyelle Solomon, some people have contended that the racial disparities during this pandemic are the result of individual choices. How would you respond to that?

SOLOMONThat is absolutely incorrect, completely incorrect. What we're seeing in this moment has nothing to do with individual choices that the African American community or individuals have made. What we are seeing is the result of decades, centuries long of structural racism. We are seeing the impact of federal, state and local policy playing out in real time right now on health outcomes as well as economic outcomes.

SOLOMONAnd I can give a quick example in regards to D.C. for example. So in D.C. African Americans are eight times more likely to have diabetes than their white counterparts. Part of that is because of food deserts. So in D.C. there are only three grocery stores that serve predominantly African American residents in Wards 7 and 8. That's over 130,000 residents. In comparison, in Ward 3 where there are mostly white residents there are nine grocery stores.

SOLOMONSo that is not the result of individual choices that black people are making in D.C. around the access to food. That is the result of policy and where grocery stores reside in the District of Columbia. And that's just one example, there are many examples of public policy that plays out at the federal level, the state level and the local level that has an impact on outcomes for people of color, and that's really what we're seeing right now.

NNAMDIYou mentioned Ward 7, well, I see on the phone right now is one Vince Gray. I'm pretty sure that's our Ward 7 councilmember and former mayor. Vincent Gray, you're on the air. Thank you for joining us. Go ahead, please.

VINCENT GREYThank you so much, Kojo. I appreciate you having me on for this hugely important discussion. I mean, it's was interesting to listen to the last person who was talking about the situation with grocery stores, which is a huge issue of course on the east side of the city. And then it's just amazing to me, Kojo, that we have so many people, who seemingly are astounded that we have such large health disparities being evident among people who are African American in the District of Columbia, and the fact that we have had health disparities among African Americans in huge numbers for such a long time in the District of Columbia.

VINCENT GREYYou know, Kojo, in coming back to work on policy in the city one of the reasons why I did this was to be able to work on health and the fact that we have such huge health disparities.

NNAMDIYou chair or you certainly used to chair the Council's committee on health, don't you?

GREYI chair the Health Committee. That is exactly right. And that's what I wanted to do when I came back to the Council. And when I was mayor, Kojo, you may well remember that I had sufficient of amount of money in the budget to be build a new hospital to replace the antiquated building at the United Medical Center. And by the time I got back all that money had disappeared. We had $336 million in the budget to do that, more than enough to build a new hospital and more than enough to build a first class healthcare system. So when I came back the $336 million was gone. What was left was $96 million, which is really being used as a way to try to maintain what was then at the United Medical Center.

NNAMDIAllow me to interrupt because I don't have a lot of time left. But you seem to be explaining that that is simply one of the reasons why these disparities continue to exist east of the river in Washington D.C.

GREYWell, that's right. And, you know, we need to recognize the health disparities among African Americans have been huge in the District of Columbia. And we need a real healthcare system where there's so many African Americans, who live especially in Ward 7 and 8. And that's exactly what we're trying to build. It's amazing, Kojo, that we have a situation in which there is not even an urgent care center in either Ward 7 or Ward 8.

NNAMDIOkay.

GREYYou know, that seems obvious to me that that should be in place. And that's exactly what we're trying to do now.

NNAMDIMayor Gray, thank you for making that call. Danyelle Solomon and Dr. Hugh Mighty since the former mayor is in politics, let's talk about politics for a second because a few days ago Charlene Drew Jarvis, the Former NI8 Scientist and longtime D.C. councilmember tweeted something that caught my attention. She said, as soon as it became clear that African Americans suffered the greatest loss from COVID-19, Republican leaders considered that opening up businesses became more important than saving lives. As a matter of fact, Tom Sherwood first passed that tweet on to me. I'd like to hear both of your thoughts on that statement. Dr. Mighty, let's start with you.

MIGHTYWell, as always, the thing that we should do and the thing we've depended on through our whole lives with epidemics, pandemics and whatever is to follow the science. There's no question that the economy in the country is very very much under pressure is an understatement, but it's also just as important to understand that the economy is driven by people in the end. And in the end if we don't have the people to provide the services and work the economy is not going to turn and go in any other direction. So I think that the thing that we must do at all times is to follow the science. I think that's the sound approach to all of this.

NNAMDIDanyelle Solomon.

SOLOMONYes. I couldn't agree more with the doctor. We should follow the science. I think what's also most important here is to remember that black residents and communities of color are the backbone of American economic systems. And you can see that in the jobs that they're more likely to hold. And so I think it's really important to make sure folks not only follow the science and provide the healthcare and resources that are needed. But also understand whether or not you feel it's impacting you or your family. It is because the people that drive our buses, run our restaurants, cut our hair, take care of our children are being impacted by it. And so we need to ensure we're getting resources out to these communities immediately.

NNAMDISpeaking of following the science, here's a question from Olivia in Reston, Virginia. Olivia, you're on the air. Go ahead, please.

OLIVIAHi. So actually I had a question about the role of the G6PD gene and its potential impact on the significantly -- on the negative outcome that you guys are seeing within the African American population specifically. And so I wanted the doctor to touch on that. And just a little aside thing was I got this information from an ER doctor who was a really good family friend, who had noticed that 85 percent of the mortalities from COVID-19 in his hospital were actually African Americans with this specific gene.

NNAMDIDr. Mighty, know anything about that?

MIGHTYSo, again, we're going to use -- enlighten it a little bit. So the G6PD gene has impacts on red blood cells and hemoglobin and such. So if you could lighten that to a more common disorder that we have with sickle cell. It's really a matter of there's so many small genetic variants in things that render people less able to fight off the virus. So the at risk population are going to be numerous. And certainly folks with anything that affects hemoglobin and -- hemoglobin is the thing that, you know, lends you to your oxygen carrying capacity. If we lower that oxygen carrying capacity it places the system more at risk. So again when you look at the different the profiles and variants around hemoglobin and those blood carrying disorders, those people are going to be more at risk.

MIGHTYSo I don't have any particular statistic on what that person is seeing. I haven't seen anything really published around that. But there is clearly a risk to anyone who has a disorder that involves the ability to carry oxygen, sickle cell being one of the largest of those.

NNAMDIAnd finally, Danyelle Solomon, how do language barriers factor into a lack of access to healthcare for some communities of color?

SOLOMONYeah, that's a great question. I would say two things. First it's about just getting the information out there. When this first broke what we found is that a lot of the information trying to inform the public about COVID-19 was only in English. But we know that there are hundreds of different languages being spoken every day and making sure that those materials are translated accordingly is really essential so the public actually knows what is going on and what steps they should take. The second piece of this is improving translations skills inside hospitals and urgent care facilities to make sure that folks who are going in to seek care actually can talk about the systems that they are having and get the care that they need.

NNAMDIDanyelle Solomon, Dr. Hugh Mighty, thank you both for joining us. We're going to take a short break. When we come back -- when we return we'll discuss how isolation is particularly difficult for recovering alcoholics who cannot now attend AA meetings. I'm Kojo Nnamdi.