The fact that African Americans have suffered and died disproportionately during the COVID-19 pandemic has been widely discussed in the popular press. Less discussed, and more surprising, is the fact that Black mortality in the best of times is worse than white mortality even in the worst of times. “Excess Black mortality,” as demographers call it, is a normal feature of capitalism in the United States. But what if we treated it as a crisis on par with COVID-19? What if, overwhelmed by the enormity and urgency of the problem, we said, Everything must stop—schools, restaurants, businesses, church, public transportation—until we find a way for things to continue without prolonging, and so worsening, the crisis? What if we put ourselves on a war footing. That is, what if we did not think of ourselves as acting in normal times, or as bound by familiar assumptions about how things have to work. What if we were prepared to do whatever it takes to end the crisis, even to the point of upending our lives, as our lives have all been upended by the COVID-19 pandemic? That is the question raised by recent study published in the Proceedings of the National Academy of Sciences. Anton Ford of Rampant interviews the the author of that study, Elizabeth Wrigley-Field.
Your study asks how the scale of the COVID-19 pandemic compares to that of racial inequality in the United States. Could you tell us what you found?
I set out to answer the question, how many white people would have to die from the COVID-19 pandemic—through whatever pathways: COVID itself, delayed medical care, economic deprivation—for white mortality in 2020 to look like Black mortality in a normal year?
And, in fact, instead of asking about a typical year, I took the best ever Black mortality as my basis of comparison. That was in 2014, before the worst of the opioid crisis pushed mortality higher for the next several years (for Black people and white people).
And the other thing I should say is that I’m talking about age-adjusted mortality. In any given year, white people die at a higher rate than Black people overall—because the white population is about a decade older. But when you compare people who are the same ages, in general, Black mortality is substantially higher.
So I asked, how many extra white deaths would there have to be this year for age-adjusted white mortality to spike up to these best-ever, 2014 Black mortality rates?
The answer I found was, about 400,000. To come to that answer, I actually did two versions of the thought experiment, because it matters what age we imagine these extra deaths are happening at. Since it’s hard to know what the age pattern of excess mortality in 2020 will be, I tried imagining that these excess deaths follow the age pattern of direct COVID-19 deaths and that they follow the overall age pattern of mortality in a typical year. These two versions of the thought experiment gave me similar estimates, about 400,000 to 420,000.
I also asked how many extra white deaths there would have to be for white life expectancy—the average lifespan, or, on average, how old people are when they die—to plummet down to the best-ever Black level, also from 2014. This would take more deaths because deaths at relatively old ages don’t affect life expectancy all that much. And here, it makes more difference which particular thought experiment you choose about how old people are when they die from the pandemic. For white life expectancy in 2020 to fall to the best recorded Black life expectancy, I estimated that the pandemic would need to kill between about 700,000 and 1 million white people.
To put that in perspective, the most recent CDC estimate as I’m answering this uses data up to November 7. It shows almost 120,000 COVID deaths among non-Hispanic whites so far. These numbers are very likely to skyrocket over the next several weeks, but it would still be truly shocking if they reached 400,000.
And that tells you that, even if the Black population had somehow been immune to the coronavirus in 2020, we would expect white mortality in 2020 to still be lower than Black mortality this year—in fact, lower than Black mortality has ever been.
Meanwhile, as we all know, the pandemic actually has hit people of color hardest—the gulf between Black, Indigenous, and immigrant populations on one hand and the white population on the other will be much starker this year.
The comparison between the lethality of COVID-19 and racial inequality is in many ways surprising. These might seem like apples and oranges. What prompted you to draw the comparison?
There’s a literal answer to this (what path led me to construct this comparison?) and a substantive answer (why do I think this comparison is meaningful?).
The literal answer stems with some research I did a few years ago with two great social scientists, Chris Muller and James Feigenbaum. We were looking at infectious disease mortality in US cities in the early twentieth century, when infectious disease spread wantonly—people died all the time of things like tuberculosis, flu; lots of babies died of diarrhea.
We ended up discovering that the infectious disease mortality that urban whites had during the 1918 flu pandemic—which was really, really high, like, almost literally off-the-charts mortality compared to every other year—was still less than the infectious disease mortality that all other urban residents experienced every single year in that era.
This stunned us. We actually didn’t believe it. We checked the data a million different ways: changing around what counts as an infectious disease when some of the records were ambiguous; changing which cities we looked at; adjusting for age or not adjusting for age—whatever we did, we found the same thing. That result is real.
This really affected how I think about the scale of racial inequality in that era. In my line of work, as a mortality demographer, we talk all the time about the 1918 flu as this unique, unprecedented event. Realizing that the same mortality level was just the typical, year-in, year-out experience for people of color in that era was shocking to me.
And the substantive answer?
The reason this comparison is so important to me is that pandemics are intimately connected with social action. We do an awful lot to stop them.
It can seem strange to say that when we are living through the horror of completely inadequate action to stop the pandemic. We’re up to 185,000 confirmed COVID deaths, which means a much higher number in reality, and in a phase where the deaths are accelerating. And, more than nine months in, we still have PPE shortages for essential workers; indoor dining, bars, gyms, and weddings are seeding super-spreader events all over; there’s no national agreement about masks; there’s no national data infrastructure to guide decision-making on a local level; there’s no infusion of resources to schools and other essential buildings to improve their ventilation; there’s no transfers of wealth to make it livable for people to stay home safely rather than return to unsafe workplaces. So it seems strange to say that we do a lot to stop pandemics. And yet.
The speed with which we have changed our basic assumptions about how we should live right now—it’s really incredible. For me, it was about ten days in March that upended all of my assumptions about the next, let’s say, two years of my life. My workplace transformed how we do our work. Kids in my city are in school remotely. From the perspective of today, with the reality of the pandemic, it’s astonishing how little we’ve done—but from the perspective of February, it’s astonishing how much we’ve changed.
And, actually, a lot of polls, especially relatively early on, showed that people generally wanted more restrictions and worried that things would open up too quickly. The polarization around COVID control is dramatic, but it shouldn’t obscure how high the level of agreement actually is that we should be living really differently right now.
So the question that poses for me is: what if we took racism as seriously as we take the pandemic?
My study is telling us that racism is associated with more deaths every year than white people are likely to experience from the pandemic this year. What if we reacted with the same level of urgency, the same willingness to let go of expectations about how things work, or doing things the way we’ve always done them, and instead had the starting point: what do we need to do to stop this?
Were you surprised by the results of your study?
Oh yes. Even with the hindsight of having been so surprised when I found the same thing about the 1918 flu. Even then, I really did not expect this. It’s staggering to me.
To a layperson, the data may seem abstract. But what you are talking about—what your graphs represent—are people whose lives have been cut short. What are the consequences of “excess Black mortality” in human terms?
Something I’ve been thinking a lot about is how much of the meaning we make from our lives depends on how our lives unfurl in time. Getting the time to pursue our own projects, to see ourselves change and grow, getting to see the people we love change—the things that make for a meaningful life really get their meaning from how they extend over our lives and our loved ones’ lives. Cutting someone’s life short robs them and the people they love of that meaning. And when we do it so disproportionately to a population that we also intensively segregate, we’re concentrating that theft and the experience of grief in a devastating way. It’s a really horrific thing.
And the losses aren’t just to that person, or even just to their loved ones. Because we’re social creatures and we’re creatures who learn so well, aging gives us different kinds of perspectives on the world. It’s not just a cliché to talk about aging bringing the possibility of wisdom. I think it’s actually something deep about what kind of organisms we are. So cutting all these lives short is also a huge cultural loss. I feel a little ambivalent about talking about it that way, to be honest, because I never want to distract from the fact that the biggest, most profound loss is to the person whose life was taken. But I think it can also be important to name the harm fully. These early deaths are robbing all of us of the effects that the people killed too soon should have had on the world.
Mortality is one index of well-being, but there are others. Would you expect the results to be similar if you looked at other indices, such as wealth?
Yeah. The comparison would have to be different, but the idea that a massive disaster for the white population might still not be as bad as the typical experience for the Black population—that will show up for a lot of outcomes. White unemployment and underemployment, at its Great Recession peak, was similar to historically low Black levels shortly before the recession.
Wealth is actually where you see the starkest gaps. Black family wealth at its peak, right before the Great Recession, was less than half of what white family wealth was decades earlier. White family wealth fell during the recession, certainly—and the value it fell to was larger than Black family wealth at its peak, by a factor of around 4.5. That’s an incredible difference that affects every aspect of your life—where you can live, what kind of education you and your kids can get, what kind of health care you can access in an emergency, whether you can retire.
What kind of criticism have you received—from those on right and from those on the left?
From the right, the main critique is that I assume that the excessive death rates of African Americans compared to white Americans reflect racism. They will typically note that Asian American and Latinx populations in the United States live longer on average than whites do and ask rhetorically, does that mean that relatively high white mortality shows that there is racism against whites?
These critics are correct that population disparities are complex and can reflect many different things. In the case of populations with a lot of immigrants (and children of immigrants), one thing they reflect is that immigrants tend to be a healthy group of people on average, because immigrating is often really hard and not everyone can manage it. And another thing they reflect is that there are some key ways that US culture is distinctly unhealthy, and coming from another culture might protect you from some of that.
But when you’re making a Black/white comparison, you’re looking at a disparity in a very distinct context. If your society takes one group of people and confines them to the worst jobs, won’t sell or rent them housing in safer neighborhoods with better funded schools and more opportunities, puts its most toxic pollution in the neighborhoods where they do live, has a state apparatus that directs routine violence against them and behaves as though that’s normal, has many of its medical and social service workers treat them with hostility and contempt, and has, over many generations, locked them out of accumulating wealth that gives a cushion against economic insecurity . . . if your society does all that and then you turn around and see that the same group of people doesn’t live very long, your starting assumption should be that those choices are why. It’s specifically when we look at the Black/white disparity that our starting assumption should be: this gap reflects racism. And that’s because everything we know about health maps onto some way that Black people have been disadvantaged in the United States.
From the left, I get a different objection. A lot of people have a really visceral reaction against the idea that we’ve done a lot to shut down COVID. And, like I said, I get it—it’s jarring in the context that we have done so little, relative to what’s needed.
But the question I want to put back to those critics (all of whom, so far, have been white) is this: Take stock of how different your life is right now compared to, let’s say, February because of efforts to stop COVID spread. Your efforts, your loved ones’ efforts, your employer’s and your local government’s efforts. Your list is going to look really different depending on your class position and the specific nature of your job, but even if you’re, say, a school worker working in person, I suspect there is a lot on your list.
Now take stock of how different your life is compared with what you imagine it would be if you, your loved ones, and your government made no effort to stop racism—due to whatever efforts you, and they, have taken.
For most people who ask me this, there’s no comparison. And I don’t mean that as a criticism of the people asking. But it’s a way to put in perspective what I mean that we have embraced disruption to stop COVID while we, as a society, have been absolutely unwilling to embrace disruption to fight racism. We try to fit antiracist initiatives into the margins of how things work (“Let’s do an antiracist training at work!”) instead of asking, what do we need to change to stop this?
The last thing I want to say about this particular critique is that I do think there is a danger of letting the intense polarization around COVID containment keep us from recognizing how much has changed. And one thing I think is helpful about the comparison to the 1918 pandemic, actually, is that you can see both sides of this. Virus control was intensely polarizing then, too. People rebelled against supposedly authoritarian mask mandates and lockdowns then, too, and a lot of lives were lost because governments let businesses like theaters open up earlier than they should have. Yet that pandemic also introduced profound changes in daily life at the time and enduring changes in medicine, architecture, all kinds of things. Both are true. Polarization and hostility isn’t a sign that nothing has changed—not in 1918, not in the Civil Rights Movement, not in 2020.
And the reason it’s dangerous to only see the hostility is that it exaggerates our sense of continuity in the status quo. But if you’re on the left, one of the biggest lessons of this year should be that the limits of the possibilities people will entertain can change very fast sometimes. New contexts will upend our assumptions about what’s reasonable the way COVID changed an awful lot of assumptions about, for example, what kinds of education are good enough for now or what kind of travel is expendable. And social movements will change what seems reasonable, too. I live in Minneapolis, so the embrace of defunding the police, broadly, and police abolition among a smaller group, really stands out to me.
It matters to know that basic assumptions can change for a big part of the populace very fast, because otherwise we develop tunnel vision; we limit our own imaginations before we start. Something I keep thinking about is that we’re on a path of accelerating climate change, just as much as an accelerating pandemic. I think some years ahead will feel more like the past than 2020 did, but I also think it’s quite possible that we will look back on 2019 as the last year of a former version of normal. I don’t know. But it seems like one of core tasks of the left in this context is to articulate some compelling visions of what things could look like. And it seems to me that having a good imagination requires you to see both sides, to imagine the pandemic response we could have had that wouldn’t be treating us all as so brutally expendable, but also to recognize that we’ve already seen a mass embrace of some real sacrifices to keep each other safe.
You live in Minneapolis, where George Floyd was murdered by the police, and where protests have sparked the most widespread and sustained series of demonstrations in US history. Did this have an impact on how you were thinking about inequality in mortality?
I actually did the first, very rough draft of my analysis on May 25, the day Floyd was killed. I learned of his death the next morning, and I put aside my analysis for a while because I was taken up with protesting. And then because of the protests I dropped everything for a couple of weeks to do a fast analysis of lifetime lost to police violence in the United States. I came back to this project comparing racism to COVID in early June and finished the final version in early August, so the whole thing was written in this context where my city, and specifically my neighborhood, Seward, were having a lot of conversations about the alternative to policing and the long-term organizing strategy to get there. I think that influenced what I wanted to do with what I found—not just say, “Look how bad racism is,” but say, “We could do something about this, and we must.”
You conclude by expressing the hope that the results of your study might help reframe debates about things like reparations, defunding the police, universal social programs, desegregation of schools and neighborhoods, increased wages and workplace democracy. You write that you hope to move “away from which transformations will be politically tenable to, simply, which transformations will be effective in preventing harms associated with racism.” Could you say more about the hoped-for reframing?
If our starting point is “how do we keep society operating basically the way it has been, but tweak it to reduce racism,” we will still have profound inequality in how long we get to live. We will probably still have Black people experiencing a level of early death that matches white people’s COVID experience, every year because the racial inequality is built too deeply into how our economy, our state, and our culture work for that to be effective.
What I was thinking when I wrote that conclusion was that sometimes we talk ourselves out of even dreaming of what we should have. But what if our starting assumption was not that things will be roughly as they are, and most people will never accept any different, and we have to fit our goals into that box, but instead, we just asked: what will it take to prevent these deaths?
Then we would be having a conversation about mass redistribution of wealth, about reorganizing workplaces, about intense environmental cleanups, about mass training of a new generation of health workers who are embedded in the communities they serve. And we would face intense opposition to all those things. But we would be honest about what’s required, and we would pose the same question we ask, aghast, about the COVID protections we should have, but don’t: how can this not be worth it?