How American discrimination has hindered the way we've handled disease outbreaks

Barbara Alper/Getty ImagesMarchers on a Gay Pride parade through Manhattan, New York City, carry a banner which reads ‘A.I.D.S.: We need research, not hysteria!’, June 1983.
  • A long history of discrimination has led to government inaction and mishandling of outbreaks throughout American history.
  • During the Civil War, an outbreak of smallpox among African Americans was left ignored.
  • When the AIDS epidemic occured in the 1980s, government reluctance to help gay populations resulted in countless deaths and a slow response to mitigate the virus.
  • Now, discrimination can be felt amid the coronavirus pandemic. A disproportionate number of black people have gotten sick and died, and reports of racism against minority groups have risen.
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The coronavirus pandemic isn’t the first disease outbreak that America has blundered. The US has a history of mishandling epidemic diseases by assessing the worth of those who are sick – and choosing to mitigate care accordingly.

A long history of racial discrimination, homophobia, and class division has led to government inaction during previous epidemics. In the 1980s, the AIDS crisis was met with backlash from homophobic American leaders, and misled research even prompted some doctors to refer to the virus as “gay cancer.”

The inaccurate idea that HIV/AIDS only affected a marginalised community – gay men – led to a slow government response, and a general sense of apathy. Officials within the Reagan administration were even recorded laughing about the epidemic.

During the Civil War, an outbreak of smallpox among newly freed slaves was largely ignored, despite the fact that a vaccine existed and preventative protocols were put in place to slow the spread of the disease.

Rather than addressing the outbreak, officials wrongly argued that the virus was spreading due to unsanitary habits and black inferiority.

Today’s pandemic is no exception to this history – a disproportionate number of black Americans have gotten sick from COVID-19, and an increase in racial tensions have become stark since the beginning of the outbreak.

A history of racism has impacted the way the US responded to past diseases

In 1863, the mortality rate from a smallpox outbreak nearly doubled in one night in Alexandria, Virginia, The Atlantic reported. By March, hundreds of people had died, and by the time an official record was released in 1867, the fatalities had reached nearly 50,000.

But the explosion of a smallpox epidemic should have never gone that far. By the late 18th century, physicians had developed a vaccine and quarantining protocols to prevent the spread of the virus. But when it hit formerly enslaved people harder than whites, those protocols were largely absent.

While white victims of smallpox were given care and placed under hospital quarantine, black victims were shoved into flea-infested tents without beds or proper care, and left in a vulnerable position for the spread of disease.

There was no infrastructure put in place to help freed people, and the black population was left to suffer without government aid. Ideas spread among racist whites that black people were disease-ridden, unsanitary, and dangerous to live around.

Nearly a century before that epidemic, an outbreak of Yellow Fever led to a false rumour that black people were immune to the disease, the New Yorker reported.

Benjamin Rush, a signer of the Declaration of Independence and a leading physician in Philadelphia, published theories on African-American immunity and thus convinced prominent black individuals to act as caretakers for those who had fallen ill.

Near the end of the epidemic, a newspaper editor published a story claiming African American caretakers had been using their so-called “immunity” to steal from white people who were sick.

The false notion that black people were protected from the virus ultimately led to unnecessary deaths, increased racism, and the bigoted idea that black and white bodies are innately different.

This theory of difference could be felt within the 1918 flu pandemic, when white populations falsely predicted that African Americans would be hit disproportionately higher because of a perceived increased susceptibility of disease. In reality, African Americans happened to be less susceptible to the 1918 influenza outbreak, even though they largely received inferior care in segregated hospitals.

Widespread homophobia resulted in a slow response to the HIV/AIDS epidemic

ACT UP AIDS Michael Abramson/The LIFE Images Collection via Getty Images/Getty ImagesACT UP members carrying huge banner that reads THE AIDS CRISIS IS NOT OVER as they walk down the street during Gay & Lesbian Pride march.

Media conferences in 1982 and 1983 showed President Ronald Reagan’s press secretary, Larry Speakes, mocking the AIDS epidemic after references were made to it being “the gay plague.”

“I don’t know a thing about it,” Speakes said. As the crowd erupted in laughter, Speakes told one reporter, “I don’t have it, do you?”

This was just one example of blatant disregard for HIV victims who many viewed as on the fringe of society as either gay men or intravenous drug users. Because at first it affected non-mainstream populations, the majority of American’s didn’t even know about the epidemic early on.

In the early 1980s, false diagnosis of the virus as a cancer, and a shift away from virology research, led to a slow response to mitigate the illness.

Reagan himself didn’t publicly address the country about AIDS until 1985, when more than 12,000 people in the US had died from the epidemic, NBC News reported. Though the government made the promise that a vaccine would be developed by 1986, no such efforts were made.

The following year, more government inaction and the development of a failed drug called azidothymidine, or AZT, led to the formation of AIDS activist groups across the country. One of the most prominent, ACT UP in New York City, called on the FDA to allow patients to use experimental drug treatments and access to better healthcare.

Only then – years after the epidemic had taken the lives of thousands of people in the US – did the government begin to initiate a more comprehensive response.

Today’s coronavirus pandemic has disproportionately hit minority populations and led to racial discrimination

Coronavirus racismJohn Tlumacki/The Boston Globe via Getty ImagesMembers of the Asian American Commission hold a press conference on the steps of the Massachusetts State House to condemn racism towards the Asian American community because of coronavirus on March 12, 2020 in Boston.

Today’s coronavirus pandemic is no exception to a vast history of structural inequality within the US. Studies have shown that a disproportionate number of black people have contracted COVID-19, been hospitalized for the disease, and died from it.

A recent report by researchers at amfAR, a non-profit focused on AIDS research, found that counties in which at least 13% of the population is black account for 58% of COVID-19 deaths and 52% of cases nationwide.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has previously said that this is partly attributed to an underlying set of health risks including diabetes, hypertension, obesity, and asthma, which are more prevalent among black communities.

But Evelynn Hammonds, a chair on Harvard’s department of the history of science, who has spent her career studying race and disease, has noted the importance in researching why these underlying health conditions exist.

“It’s the social conditions that continue to produce these vulnerabilities in certain populations, not that the people somehow are inherently biologically different,” Hammonds told the New Yorker.

Without noting why black communities are more vulnerable to underlying health conditions, Americans may make the unfair assumption that black people and other minorities are simply more susceptible to disease – echoing the ways Americans have responded to disease outbreaks in the past.

“A narrative of black bodies being different, and deficits in black people’s behaviour being responsible for them being more vulnerable to disease, harkens back to some of the themes of the earlier epidemics,” Hammonds said.

Additionally, reports of discrimination among Asian Americans have been rampant since the outbreak was first reported in Wuhan, China.

This is because new diseases often lead to public fear, stigma, and the notion of blame, Josue David Cisneros, professor at University of Illinois at Urbana-Champaign previously told Business Insider’s Marguerite Ward.

“Some of the US’ first immigration laws were targeting Chinese immigrants because they were seen as racial, cultural, and biological threats, for example the Chinese Exclusion Act,” Cisneros said. “Perceived biological threat is tied to a perceived cultural threat.”

Racism has also persisted in regard to social distancing. In New York City, there have been numerous reports of the NYPD disproportionately arresting black and Latino citizens accused of breaking social distancing rules.

“It is not surprising that a new disease leads to public fear, stigma, and the scapegoating of certain kinds of people because we tend to understand these events through our past disease rhetoric, which is rooted in fear, stigma, scapegoating,” Cisneros previously told Business Insider.

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