Catherine E. Bolten | May 3, 2020
Early in March, a friend of a friend drove himself to the hospital in the throes of COVID-19-induced pneumonia. He was rendered medically unconscious and placed on a mechanical ventilator soon after. I first interacted with him through the GoFundMe page that his family set up because this young, otherwise healthy man had no medical insurance. His new job—his dream job—had delayed covering him for the first six months that he worked there. He entered the intensive care unit four days before his medical coverage would have begun, and, for the next three weeks, fought for his life.
The medical bills mounted, with no possibility that his family could cover the costs of what his insurance provider would have referred to as a “pre-existing condition”—hence how I “met” him through this desperate online plea. I am thrilled to say that he is now breathing on his own and on the road to recovery, but the dark cloud that hung over his hospital bed was comprised of two diseases: COVID-19, and the fear of insolvency that delayed him seeking medical care until it was almost too late.
In medical anthropology, the word syndemic is used to describe the interface of two diseases that often co-occur. Hypertension and type 2 diabetes are the most common non-infectious syndemics in the United States, as they are diseases that both take advantage of poverty, food insecurity, and, most importantly, lack of health insurance.
In recent news coverage sounding the alarm over the disproportionate COVID-19 mortality rates among African Americans from Milwaukee to Detroit to New Orleans, the existence of these “pre-existing conditions” is cited as one complicating factor. That the bulk of “essential workers”— public transit workers especially—are African American is also cited as a reason. However, their disproportionate infection rate does not explain their extremely high mortality rates from COVID-19. Over 70 percent of deaths in Louisiana and the city of Chicago have been African Americans, representing almost twice their actual percentages of the population in these two places. Why?
Read more here.