Covid-19 Unmasking Racial Inequalities in Brazil
Note from BW of Brazil: It often amazes me how things can dramatically change in what seems tom be a bat of the eye. The headlines I came across just a few days ago are a great, but depressing example of this. In the oast few months, I had already posted a number of articles addressing how the so-called Covid-19 pandemic is affecting Brazil. I watched as the numbers in the United States were exploding while in Brazil, even with the numbers of cases and deaths attributed to the coronavirus growing, the rates in Brazil were significantly smaller. But in an incredible twist, in a matter of weeks, Brazil has risen from number 16 in the world, to number 8 to now number 4 and, according to some sources, number 3, trailing only the United States and Russia.
As I often say here, I can’t claim that I’m surprised because just a few weeks ago, reports coming out of Brazil suggested that the number of coronavirus cases and deaths could be as high as 12 times underestimated! According to a report from National Public Radio, Brazil is now the new “hotspot” for cases of Covid-19 and, according to the mayor of the largest city and with the most cases in the country, the health care system is on the verge of collapse. This is clearly alarming news and I can personally speak on this coming live from north zone São Paulo where, at one point, the city was considering mounting road blocks on certain avenues (Inajar de Souza and Freguesia de Ó) of this section of the city to diminish traffic and perhaps curtail to growth in this region.
Hold’dup! Stop the press! This just in. Since I began writing this material, I have learned that Brazil has just moved into the number two position in the world in terms of total number of cases of Covid-19! There are still many countries that have reported more deaths than Brazil supposedly due to the coronavirus, but I don’t know that that can even be considered good news. 1) Regardless of the country, nearly 340,000 people have died, 2) with the explosion in cases of late, the difficult question is, how many people may eventually die from the virus?
The other issue that I’m not seeing being covered in the international media is the question of what we know about the racial breakdown of Covid-19 cases and deaths. While CNN is reporting that “Brazil hits record high for new coronavirus cases“, and Reuters is reporting that “Brazil coronavirus outbreak worsens as country could soon be No. 2 in cases“, neither of the news outlets is reporting how the pandemic seems to be deadlier within the preto/pardo (black/brown) population than the branco (white) population.
Given how the virus has been devastating to the African-American population in the US, it would seem that the international media would be more apt to reporting what seems to be a similar trend in Brazil. Why? The warning signs have been there for some time.
For example, in April, we learned that, while whites are more likely to contract coronavirus, blacks are more likely to die from the disease. Because of living conditions in the slums known as favelas, there has been fear of how such a pandemic could be far worse in this areas. Favelas are mostly populated by black and brown people. We know that cuts in the national health care system would be more detrimental to the non-white population as pretos and pardos are the majority of people who depend on this form of health care. It is also true that in São Paulo, the epicenter of the virus in Brazil, blacks have a 62% higher risk of dying from Covid-19 than whites. And all of this doesn’t even consider early fears that Covid-19 cases could be 12 times higher than officially reported.
Well, wouldn’t you know it, coronavirus cases have exploded as of late and right in the middle of this rise, we learn than, opposite to original reports in terms of the racial data on the pandemic, pretos and pardos are now the majority of the deaths from the virus. A startling chain of events and it seems that the worst is still yet to come. More on that next time.
In two weeks, the number of blacks killed by coronavirus is five times higher in Brazil
Courtesy of Agência Pública
Study by the Agência Pública shows that deaths and hospitalizations of pretos e pardos (blacks and browns) has risen more than in whites
In two weeks, the number of black people dying for Covid-19 in Brazil has increased fivefold. From April 11 to 26, deaths of black patients confirmed by the Federal Government went from just over 180 to more than 930. In addition, the number of black Brazilians hospitalized for Severe Acute Respiratory Syndrome (SARS) caused by coronavirus increased 5.5 times.
The increase in deaths of white patients was much lower: in the same two weeks, the number reached just over three times. And the number of hospitalized white Brazilians has increased in a similar proportion.
The explosion of cases of blacks who are hospitalized or die because of Covid-19 has unmasked racial inequalities in Brazil: among blacks, there is one death for every three hospitalized for SARS caused by the coronavirus; among whites, there is one death for every 4.4 hospitalizations.
The data are the result of an analysis carried out by the Agência Pública based on epidemiological bulletins from the Ministry of Health that have information on race and color of hospitalizations and deaths from coronavirus. The Federal Government released these updated figures only up to April 26.
For every death in Moema, four die in Brasilândia (Covid-19 Unmasking Racial Inequalities)
In São Paulo, the largest city in the country and the one with the highest number of deaths from Covid-19, it is the neighborhoods where the black population is most concentrated that bring the greatest number of deaths from the disease. According to Pública, of the ten neighborhoods with the highest absolute number of deaths caused by the coronavirus, eight have more blacks than the São Paulo average.
The neighborhood with the highest absolute number of deaths is Brasilândia, with 103 cases. The region has about 50% of the black population – the average for São Paulo is 37%. At the opposite end, the city’s least black neighborhood, Moema, had 26 deaths. The average number of blacks in the region is less than 6%.
Even adjusting deaths to the population, the two neighborhoods have different realities: compared to the number of residents in Moema, Brasilândia has about 25% more deaths. Pública considered the data from the last Census (2010) for calculating population and race/color of residents.
Periphery neighborhoods with more black residents than the average in São Paulo have seen Covid-19 cases soar – and with them, deaths. Jardim Ângela, the neighborhood with the highest percentage of blacks in the entire city, saw coronavirus deaths almost triple in about two weeks. Grajaú, Parelheiros, Itaim Paulista, Jardim Helena, Capão Redondo and Pedreira, all neighborhoods with a majority of the black population, more than doubled the deaths by Covid-19 in the same period.
The advance of the coronavirus in the periphery of São Paulo has shortened the distance of deaths between richer neighborhoods, where the first cases of Covid-19 emerged. On April 17, neighborhoods with smaller black populations than the city average had 13% more deaths than regions where more blacks live. Two weeks later, that difference dropped to 3%. If the trend continues, neighborhoods where blacks live more than the city average will outnumber neighborhoods where less blacks live.
The journalist Lucas Veloso, co-founder of the Agência Mural de Jornalismo das Periferias, lives in one of the main avenues of Guaianases, a neighborhood located in the east end of the city of São Paulo. He notes that the movement of passersby at the site has increased in recent weeks, compared to the week of March 24, when Governor João Doria (PSDB) instituted quarantine in the state. “In the first two weeks [after the decree was announced], the streets were indeed more deserted. The movement of the fair (of fruits and vegetables) that happens on Wednesdays, for example, had dropped a lot. There were few tents, few vendors. But after the third and fourth weeks, I realized that this has changed,” he reports.
According to him, part of the local population was unable to stop due to issues of income. “Many of those who live on the outskirts are part of essential services. So, public transport in the morning, at the train station, has not decreased so much. They are couriers, nurses, security guards. So, as it’s a poor neighborhood, on the periphery, in which many people are subject to underemployment, the neighborhood can’t stop completely,”analyzes the journalist.
Now, he notes that even people who managed to stay at home relaxed the quarantine restrictions. “People had the hope, in the beginning, of getting emergency aid from the government and not having to leave home. But there are all these bureaucracies that people were unable to solve, many people don’t have quality internet and were unable to download the application, so the aid money doesn’t come. This is also a factor that puts people back on the streets.”
The places where blacks live are precisely those with the lowest Municipal Human Development Index (MHDI). The ten neighborhoods with the worst MHDI in São Paulo have more blacks than the city average. The ten with the best MHDI have fewer blacks than the average. In the ten neighborhoods with the highest absolute number of deaths, eight have MHDI considered average, below 0.8. It is precisely these eight neighborhoods where the average number of black residents is above the city average.
In Rio, neighborhoods with more blacks than the city average have already accumulated more deaths
In the capital of Rio, neighborhoods with more blacks than the city average already have more deaths in absolute numbers than neighborhoods with fewer blacks.
The growth of cases in the periphery and in the slums has led these regions to register more and more deaths. Currently, Campo Grande, with more than 50% of black residents, is the neighborhood with the most deaths. The region passed Copacabana, which was previously the location with the highest absolute number of deaths by Covid-19. After Copacabana, Bangu and Realengo, two neighborhoods with a majority of the black population, occupy the 3rd and 4th place with more deaths in the city.
Rocinha, the largest slum in the city, already counts nine deaths in official data. Doctors who serve the community dispute the number and point out that there would already be 22 deaths in the favela.
The relationship between the number of confirmed cases and deaths is also quite different between wealthy and poor neighborhoods in Rio de Janeiro, which may point to difficulties for residents of the favelas and the periphery to undergo examinations. In Rocinha, for example, there are more than twice as many deaths in relation to confirmed cases as in Leblon. The neighborhoods with the most confirmed cases are Copacabana and Barra da Tijuca.
In Amazonas, with the collapse of the SUS (national health care system), whites survive longer than blacks
In Amazonas, among people who develop severe conditions in Covid-19, deaths of blacks are more frequent than whites. According to Pública, of every 2.4 blacks in serious condition, there’s one death. Among whites, one death was recorded for every 3.2 severely ill patients.
The state, which was the first to have a maximum capacity of intensive care units for patients with Covid-19, has registered a more significant increase among blacks in serious condition than among whites. By the end of April, in less than a week, the number of seriously ill black patients more than doubled.
The absolute majority of deaths in Amazonas are black: more than 13 blacks died for each white death. The health department has already registered about 850 black patients in serious condition and more than 340 deaths. Among whites, there were 81 serious cases and 25 deaths. Race and color data were updated on April 29.
Ministry of Health says there are no studies that point to race as a risk factor
Despite the data showing that blacks had a greater increase in deaths and registered more deaths among hospitalized patients, the Federal Government does not disclose this information in detail. There is, for example, no information on how many cases were confirmed by race / color or the number of tests on blacks, whites and other groups.
As Rita Borret, of the Brazilian Society of Family and Community Medicine, explains, not disclosing these data prevents health professionals, the press, researchers and even the population from monitoring whether underreporting in blacks is greater than in whites. The doctor explains that blacks depend more on the Unified Health System (SUS) – a survey by the Institute of Applied Economic Research (Ipea) indicated that, in
2008, the black population represented 67% of SUS users.
“If access to the exam is difficult in the public system, how do you know if a black patient has confirmed the disease or not? And if there are people who are not even having the chance to be served, including for hospitalization, we know that Covid-19 is underreported in the black population, but we don’t know how much,”he analyzes.
It was the health working group of the black population, of which Borret is a member, that asked the Ministry of Health to publish race/color data of those killed by coronavirus. The government only started to disclose the data in the April 11 bulletin, without detailing data from confirmed cases or tests. Asked about the lack of more complete data, the ministry, already under the management of Nelson Teich, went on to state that there are no “technical or scientific studies that point to color or race as a risk factor for the disease”.
“We know that the problem is not race, but racism, which makes it difficult for blacks to access health care. Access to health care for the black population is much worse than for the white population in the country. And we don’t have time, the coronavirus doesn’t have time to do a pedagogical work on the National Policy for the Comprehensive Health of the Black Population. We need the Ministry to be aware of these issues at all times, as written in the Law,” criticizes Borret.
For Fernanda Campagnucci, executive director of Open Knowledge Brasil (OKBR), the absence of data on race and color is a problem for the analysis of the impact that Covid-19 has on different groups. “In some places they have started to analyze how the black population has been affected disproportionately, as in the United States, for example. This may be related to several other factors, but it is important to have the data to start doing this type of analysis here in Brazil.”
The latest Transparency Covid-19 newsletter, a weekly publication organized by OKBR that assesses the transparency of states and the Federal Government in the dissemination of pandemic data, pointed out that 32% of states disclose their microdata. Of the states that make their microdata available, only Espírito Santo provides the database including data on race/color; however, this information is not filled in all registered cases (of the 3208 records collected until May 3, 1094 had the race/color field ignored).
On May 5th, the Federal Court of Rio de Janeiro determined that registration and disclosure of coronavirus cases in the country must have information on the race/color of those infected.
Lack of data on the black population is a historical problem in Brazil
The lack of official race data is historical in the country, says lawyer Daniel Teixeira. He is director of the Center for the Study of Labor Relations and Inequalities (Ceert), a non-governmental organization focused on promoting race and gender equality.
“There are several factors that can explain this high lethality [of Covid-19 among the black population]. Precisely, having better information means that we even confirm or even exclude the importance or relevance of each of these factors, as the case may be. Because there is the wealth that the data can make,” defends Teixeira, who says that the lack of this data can be “disastrous”. The researcher considers that the gap doesn’t occur only in the area of health and is common in the country. “The lack of this type of slant can be an impediment for people to have public policies that take account of this situation that, historically, disregards the dimensions of structural inequalities in Brazil,” says Teixeira.
Covid-19 Unmasking Racial Inequalities:
Journalist Christiane Gomes, project coordinator for the Rosa Luxemburg Foundation in São Paulo, and a member of the black collective Ilú Obá de Min, says that the pandemic opens up racial inequality in Brazil, “the fruit of a colonial past that persists today”. “At the beginning of the pandemic, it was often said that the virus does not choose social class or race. But this is a fallacy and the numbers that compare the number of deaths in neighborhoods like Morumbi and Brasilândia exemplify this,” she says.
She points out that the problem is not only a reflection of poverty, but that the discussion must also consider gender and race. “For example, who works more in domestic work? It’s black women. Who works more in the services of structure, security? Finally, what is the base of the Brazilian social pyramid? It is the black population. So, it’s this population that is most vulnerable and the least able to achieve social isolation. We are talking about a macro problem, Brazil is a country that has racism in its structure,” analyzes Gomes, who defends greater data transparency of the pandemic caused by the new coronavirus, with the objective of guiding public management.
In the US, coronavirus lethality is also higher among blacks
The lawyer Daniel Teixeira, director of Ceert, recalls that the lack of transparency about the racial data of the pandemic also occurred in other countries, such as the USA, which officially leads the number of cases of infections by the new coronavirus in the world. “At the CDC, Centers for Disease Control and Prevention, the body that monitors data on Covid-19 and other diseases, we have not had a broad reading of the data either,” the expert said.
The limited availability of racial data has led Johns Hopkins University, an institution that is a reference in the area of health in the country, to release a map showing which American states have produced racial breakdowns about the new pandemic. According to the university’s mapping, only two of the 50 US states, Illinois and Kansas, have complete racial statistics on confirmed cases, deaths and tests for the new coronavirus.
Since the survey was published, there has been an improvement in transparency: the number of states that provide racial data on confirmed cases has risen from 34 to 42; the number of states that also provide racial data on deaths caused by Covid-19 rose from 26 to 38.
“They are monitoring and talking about the importance for them to do so. It’s an appeal from the university, for this to be considered, given the disproportionate impact that already exists in the states and cities that already do this monitoring with breakdown,” says Teixeira.
With the data, it was possible to attest to the higher lethality of the disease among black communities in the country, as shown by Reuters reports, about the greater likelihood of blacks dying when contracting Covid-19 and the Washington Post that reflected a study in Georgia, which revealed disproportionality of hospitalization of black people by Covid-19 in the state.
Teixeira warns that the available figures, in the US and Brazil, highlight “the constant disease of structural racism that reproduces itself. “This is a central issue of racism. No wonder that one of the strongest movements in the US today is the Black Lives Matter, vidas negras importam (in Portuguese). This statement is because the death [of the black population] has always been seen more and more as part of the social landscape. To the point that there is little revolt with regard to these deaths, in so much greater numbers of the black population.”
Source: Carta Capital