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Black People In San Antonio Are Dying From COVID-19 At A Disproportionate Rate. Why?

A hearse is parked outside of a funeral home in San Antonio early April 2020.
Dominic Anthony Walsh | Texas Public Radio
A hearse is parked outside of a funeral home in San Antonio early April 2020.

Of the 104 people who have died from COVID-19 in San Antonio so far, 61 are Hispanic, 22 are white and 17 are Black. That’s according to data from the San Antonio Metropolitan Health District as of June 24.

Black people represent 16% of all COVID-19-related deaths in the city, even though they only make up 8.5% of the population. This trend is similar across the U.S. According to the Centers for Disease Control and Prevention (CDC), nearly 25% of all COVID-19-related deaths are Black people, even though they only make up 13% of the nation’s population. Neither Hispanic nor white people in San Antonio were overrepresented in deaths from COVID-19 compared to their populations.

One reason for the overrepresentation in Black deaths is an outbreak at the Southeast Nursing and Rehabilitation Center. Five of the center’s 18 deaths were Black people. But the disparity is much deeper than that. 

Made with Flourish

Junda Woo is the medical director of Metro Health. She described several factors that would predispose Black people to be more likely to die from COVID-19.

“Black and brown people are more often diagnosed with underlying health conditions that are associated with death from COVID-19,” Woo said. “For example, high blood pressure; for example, kidney problems; for example, chronic lung diseases.”

In San Antonio, Black people represent 7.6% of all COVID-19 cases while making up 16% of total deaths — a disparity not seen in the Hispanic and white populations. However, while people who are Hispanic aren't overrepresented in COVID-19 deaths, they do make up a disproportionate number of positive cases.

Woo said research shows many underlying health conditions in Black people can be traced to health inequities that they face across the country. 

"Even when you strip out education and income, Black people are more likely to have high blood pressure,” Woo said. “The term that’s used is ‘weathering.’ It’s a kind of chronic stress from experiencing everyday racism that can also wear down your health.”

Woo also explained other ways racism can predispose Black people to be more likely to have negative health outcomes.

“The old standby of access to healthcare, which could include not only having health insurance but even wanting to go to a healthcare provider after experiences of systemic racism (in healthcare),” Woo said. “We have residential racial segregation, especially in San Antonio, and that is in itself is associated with some bad health outcomes such as COVID-19, but just bad health outcomes in general.”

San Antonio has been recognized as one of the most economically segregated cities in the nation, and has a deep history of residential segregation and redlining, a 1930s practice of denying the possibility of home ownership to minority communities by the federal government. 

Woo said two of the most effective ways to limit deaths from COVID-19 involve increased testing and outreach efforts in marginalized communities. Metro-Health has been ramping up those efforts in recent weeks. 

“Our community health workers and our Stand Up S.A. workers have done a lot of community education — specifically in the West Side, the East Side [and] the South Side — so that people understand their risks [and] understand how to protect themselves,” Woo said.

Between April 1 and May 2, the Metro Health Community Health & Prevention (CHP) team went to 106 census tracts in marginalized communities and visited more than 5,900 locations as part of the outreach effort, according to Woo. CHP determined which census tracts to visit in collaboration with the San Antonio Office of Equity to ensure that the outreach efforts would go to the communities in the city that needed it most. 

Woo said one positive sign is that there has been a decrease in the COVID-19 disparity in deaths for San Antonio’s Black population over the last few months, down more than 10% from a high of around 30% in April. But Woo says it's still too high. 

Josh Peck can be reached at josh@tpr.org or on Twitter at @Joshua_Peck_.

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