As expected, Blacks and other minorities have borne the brunt of the COVID pandemic.
The National Center for Health Statistics is releasing up-to-date death data for COVID-19-related deaths in response to the pandemic. These estimates of the excess deaths-the number of deaths exceeding the normal average in recent years include counts of deaths by race and Hispanic Origin.
The total number of excess COVID deaths in the United States from February 1, 2020, to May 27, 2023, was 1,349,559. Non-Hispanic Blacks accounted for 155,979 (14%) of these deaths. But these rates have been higher.
While disparities in cases and deaths have widened and narrowed throughout the COVID-19 pandemic, data show that AIAN, Black, and Hispanic people have had higher rates of cases and death compared with White people over most of the course of the pandemic and that they have experienced overall higher rates of infection, hospitalization, and death.
The use of the excess death measurement became prominent under Margaret Heckler during her short tenure as Secretary of Health and Human Services. Heckler was a Republican congressperson from Massachusetts until she lost her seat in 1982 because of redistricting.
President Ronald Reagan, perceived a need to have high-ranking females in his administration and had very little interest in having an agency like the Department of Health and Human Services (HHS) succeed in its work of “enhancing the health and well-being of all Americans,” appointed her Secretary of HHS. She later admitted that she had known nothing about health and medicine.
However, she quickly took to the role, as she was astonished at the racial and ethnic health and medical care disparities in major reports produced by her department. The HHS annual report, Health, United States, 1983, documented racial health disparities, including life expectancy, which she called “an affront to our ideals and to the genius of American medicine.”
After meeting with various leaders and groups in health and medical care, she created the Task Force on Black and Minority Health in 1984 to address these disparities.
In 1985 Secretary Heckler released the landmark Report of the Secretary’s Task Force on Black and Minority Health, comprising seven volumes, which incidentally occupied a prominent space on my bookshelf and in my work for many years. This was the first time that the U.S. government had comprehensively studied the health status of racial and ethnic minorities and elevated minority health onto the national stage.
And for this, she was fired after only 31 months on the job. She was quickly forced out of that position and made ambassador to Ireland, a far less critical role than Secretary of HHS. The White House said she was not working on Reagan’s agenda.
But her good deeds had already been done. The so-called Heckler Report concluded that health disparities accounted for 60,000 excess deaths each year. It also put forth several recommendations to reduce health disparities.
The Heckler Report led to the creation of the HHS Office of Minority Health in 1986. It influenced many issues in minority health and health equity. It led to the establishment of offices of minority health in NIH, CDC, and the Health Resources and Services Administration.
We still have racial and ethnic disparities in health and a related issue, medical care. And we use some of the terms that became more widely used under Secretary Margaret Heckler–“excess deaths” and “years of life loss.” In one study, researchers concluded that the gap in health outcomes translated into 80 million years of life lost — years of life that could have been preserved if the gap between Black and White Mortality rates had been eliminated.
Blacks do not have a predisposition to die more often. They die more readily because of how society treats them, i.e., racism. Racism determines how well and how long one lives. Heckler started us in the right direction; however, her work just bit off a part of the “large elephant.”
