In Brazil, most of the 190,000 dead from COVID are of one particular skin color and social class: they are Black and poor. While the president and the No Vax movements are denying the need and urgency for mass vaccination, pre-existing racial and social inequalities are deepening as infections are rising, highlighting regional, social, gender, income, educational, and healthcare access disparities.
This is evidenced by several studies that have focused on the topic, such as that of the Pólis Institute. According to a survey by the institute conducted in the city of São Paulo, the mortality rate due to COVID of Black and mestizo people between March and July of this year was 172 deaths per 100,000 inhabitants, while the mortality rate of the white population was 115 deaths per 100,000.
The first case of a person dead from COVID-19 in Brazil was emblematic: on March 17, a 63-year-old Black waitress, previously suffering from diabetes and hypertension, died from the virus after being infected by her employer, who had just arrived from a trip to Italy.
“It was the middle and upper class, tourists or business people who came from Europe, who introduced the virus to Brazil. Then, the pandemic reached the periphery, where remote work, social distancing and even sanitation are not a reality for many people,” explains Eliseu Alves Waldman, a professor in the department of epidemiology at the University of São Paulo (USP).
Another aggravating factor, according to Waldman, is the previous health complications correlated with lower socioeconomic status, such as obesity, heart disease, respiratory disease and smoking, which are more prevalent among Black and suburban populations.
According to AFRO, a research center on racial issues linked to the Brazilian Center for Analysis and Planning (CEBRAP), right at the beginning of the pandemic, researchers and representatives of social movements had already noted the vulnerability of Black, poor and indigenous populations. Pressure from these groups led to the publication of the first infection, hospitalization and lethality data for COVID-19 organized by ethnicity.
“It’s a historical inequality that is always replicated, even when you have important outcomes like the universalization of public health. Following the introduction of SUS (the Brazilian federal government’s public health platform), the health conditions of peripheral populations have improved, but the disparity between Blacks and whites continues,” says Jaciane Milanezi, a sociologist and researcher at AFRO-CEBRAP.
Milanezi explains that the Black population is the one that makes the most use of the SUS infrastructure, which offers primary care, considered exemplary and with high local availability in Brazilian municipalities and territories. However, due to a lack of coordinated national policy, this service has not been used to its full potential. In addition, the time it takes to access hospitals with specialized services is another risk factor: for example, it takes residents of the São Paulo suburbs, on average, 71 minutes to reach a hospital with an intensive care unit.
The research by AFRO-CEBRAP also highlights the economic fragility of the unemployed and informal workers, most of whom are Black. In the early months of the pandemic, 70 percent of jobs lost were informal. “Remote work is associated with some occupational and educational attainment. And the percentage of whites graduating from college is twice that of Blacks,” says the researcher.
Among the unemployed, Black women make up the group that looked for the least amount of work in 2020, because they do more of the care work in their homes, with most daycare centers, preschools and educational institutions having closed since March.
“All the precautions—staying home, wearing a mask, washing one’s hands—are only possible for a part of the population. Many social movements have brought food, soap, water and disinfectant gels to communities that did not have access to these items,” Milanezi tells us. The sociologist argues that the absence of national coordination to address the pandemic, coupled with the dismantling of specialized policies for the needs of these populations, leads to persistent inequality.
“Decisions about how to manage the pandemic are made at the local level. Some work, some don’t, such as in cities that have reduced public transport circulation, thus generating more crowding on the available buses. There are many important initiatives from social movements and the private sector that are doing the work not done by the state. We will only reduce racial inequality when the state recognizes its existence,” Milanezi concludes.
