Black People, Post-Traumatic Stress Disorder (PTSD) and the Risk of Death From Coronavirus (COVID-19)
Nationwide —Here are some facts: Black people have been found to be more likely to die from COVID-19 infection than white people, both in the United Kingdom and the United States of America. Black people also have a higher rate of PTSD diagnosis than white people. PTSD can result in suppression of the immune system. Immunosuppression is associated with a higher risk of death from COVID-19. It is thus not unreasonable to question whether PTSD-induced immunosuppression is contributing to the elevated risk of dying from COVID-19 amongst black people.
Data reveals that Black people are more than four times more likely to die from COVID-19 than white people in England and Wales and that even after adjusting for age, socioeconomic conditions and prior health, the figures show that Black people remain twice as likely to die from COVID-19 than white people in England and Wales, according to the Office for National Statistics.1 Some suggest sickle cell disease is the explanation, however this is unlikely, being already in a shielded group they are likely to have little or no ongoing expo-sure to COVID-19. Other contributary factors which have been highlighted are obesity, over-crowding and frontline working, however these are likely to be already adjusted for within socioeconomic status.
This article proposes that PTSD-induced immunosuppression contributes to raised mortality from COVID-19. PTSD is a condition which occurs after a traumatic experience where symptoms persist of reliving the distressing event and there is hypervigilance, numbing, mood changes including negativity about the self, the world and the future. There is avoidance of people and situations that act as reminders of the event and sleep and concentration disturbance. Physical symptoms including Neurological, Respiratory and Cardiovascular symptoms also occur in PTSD.2
What is the evidence that Black people have higher rates of PTSD?
The Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2014 found doubling of the rate of PTSD amongst black adults at 8.3 per compared to white adults at 4.2 though assumed that the differences could not be relied on because of the small sizes involved.3
One study found that when PTSD affects US race/ethnic minorities, it is usually untreated and likely to become chronic and persistent and suggested that the large disparities in treatment indicate a need for investment in accessible and culturally sensitive treatment options.4 A separate two year follow up study found that African Americans with PTSD experience high number of traumas and most do not receive treatment.5
Findings from large-scale national studies suggest African Americans have a 9.1% prevalence rate for PTSD.6 This suggests that almost one in ten Black people becomes traumatized. This is an underestimate due to known under-diagnosis of PTSD in black people.7 Studies of racial discrimination and race-related stress have shown that when an individual reports psychological distress from racism, trauma was often not considered.8
Why would Black people be at increased risk of PTSD?
In addition to traumatic experiences that a person of any race or ethnicity might face, race-specific traumas include micro-aggressions and the erosion of a fundamental requirement for human beings – a sense of belonging. A striking example of that undermining of belonging was witnessed by the Windrush generation in the UK. Black people face challenges to a sense of belonging to desirable social, housing, occupational groups and on a wider scale there are challenges to the black person’s right to belong in a country such as the UK, a crude example being the ‘go back to where you came from’ statement. A sense of belonging is an intrinsic human need. The psychologist Maslow’s hierarchy of human needs defined self-actualization and self-esteem as requiring the secure foundations created by a sense of belonging.
Another often overlooked contributory factor to the large prevalence of traumas affecting Black people is Intergenerational transmission of trauma. Parent-child attachment patterns are known to replicate through generations within families. Going back to slavery and post-slavery eras, forced black familial disruption was part of the mechanism that enabled forced labour and enrichment of slave owners and others and this involved brutal disregard for the integrity of the black family unit by white oppressors. Yet another overlooked factor is vicarious trauma and witnessing shootings of unarmed black people can give rise to a sense of threat to the black viewer’s sense of their own safety.
What is the evidence that PTSD suppresses the immune system?
A study of 1,550 male workers with a previous history of PTSD concluded that PTSD produces immunosuppression and has long-term implications for health.9 This finding is now widely accepted amongst mental health professionals and a questionnaire commonly used as a tool to diagnose PTSD is the IES-r.10 A cut-off point of 37 and above in the IES-r is commonly accepted by mental health workers as associated with immunosuppression.
Treatment of PTSD
PTSD in Black people is treatable with a growing number of psychotherapies including prolonged exposure therapy, EMDR, cognitive processing therapy, somatic experiencing, if delivered by psychotherapists with training and knowledge of diversity matters. Medication is sometimes but not always required.
There now exists evidence for higher death rates of Black people from COVID-19 compared to White people as well as evidence that Black people have a higher rate of PTSD diagnosis than White people and furthermore that PTSD is associated with immunosuppression and we know that immunosuppression is associated with a higher risk of death from COVID-19. The proposed association described here between PTSD-induced immunosuppression and increased risk of death from COVID-19 needs to be explored further and in addition, high PTSD rates in black people need to be recognised and treated as both a mental and physical health priority.
1. Office of National Statistics. Release date: 7 May 2020. Coronavirus (COVID-19) related deaths by ethnic group, England and Wales: 2 March 2020 to 10 April 2020 obtained on 12 May 2020
2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Publishing
3. Adult Psychiatric Morbidity Survey. (2014) retrieved on 11 May 2020 from https://www.ethnicity-facts-figures.service.gov.uk/health/mental-health/adults-with-post-traumatic-stress-disorder-ptsd-in-the-month-prior-to-survey/latest
4. Roberts, A.L., Gilman, S.E., Breslau, J.N., Breslau, N., & Koenen, K.C. (2011). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychol Med.
5. Pérez Benítez, C., Sibrava, N., Kohn-Wood, L., Bjornsson, A., Zlotnick, C., Weisberg, R. & Keller, M. (2014). Posttraumatic stress disorder in African Americans: A two year follow-up study. Psychiatry Research-neuroimaging Volume: 220, Issue: 1, pp 376-383
6. Himle, J.A., Baser, R.E., Taylor, R.J., Campbell, R. D. & Jackson J.S. (2009). Anxiety disorders among African Americans, blacks of Caribbean descent, and non-Hispanic whites in the United States, Journal of Anxiety Disorders, 23(5): 578-590.
7. Williams M., Malcoun E. & Bahojb Nouri L. (2015) Assessment of Posttraumatic Stress Disorder with African Americans. In: Benuto L., Leany B. (eds) Guide to Psychological Assessment with African Americans. Springer, New York, NY
8. Carter, R. (2007). Racism and Psychological and Emotional Injury: Recognizing and Assessing Race-Based Traumatic Stress. The counselling psychologist Volume: 35 issue: 1, page(s): 13-105
9. Noriyuki Kawamura, Yoshiharu Kim & Nozomu Asukai (2001) Suppression of Cellular Immunity in Men with a past history of Posttraumatic stress disorder. Retrieved on 11 May 2020 from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.158.3.484
10. Weiss, D.S., & Marmar, C.R. (1997). The Impact of Event Scale-Revised. In J.P. Wilson, & T.M. Keane (Eds.), Assessing Psychological Trauma and PTSD: A Practitioner’s Handbook (pp. 399-411). New York: Guilford Press
Source: Anne Coker
Be Counted and Be Heard Comedy Show
Be Counted and Be Heard Comedy Show to encourage African Americans in our community to get counted in the 2020 Census
The Dream Big Scholarship Fund, in collaboration with the San Antonio/Bexar County Complete Count Committee, will host the Be Counted and Be Heard Comedy Show this Sunday, Sept. 27, from 6 to 10 p.m. at the AT&T Center parking lot. The goal of the comedy show will be to encourage African American residents of San Antonio and Bexar County to respond to the 2020 Census before next week’s deadline on Sept. 30.
“It’s imperative that the African American community understand the impact that they can make by letting their voices be heard and getting counted in the 2020 census is one way to be heard,” stated Michele Thomas founder of the Dream Big Scholarship Fund.
The show’s program will be hosted by 25-year United States Army Combat veteran and aspiring gospel singer Thomas B. Bryant. The program will feature “Funniest Person in South Texas” finalist, Comedian Clifton Simmons. Headlining the comedy show will be Comedian Marcus D. Wiley from the Yolanda Adams Morning Show. While providing entertainment, these trusted voices will share information about why completing the 2020 Census is important to our communities.
Multiple organizations such as The 100 Black Men of San Antonio, Psi Alpha Chapter of Omega Psi Phi and Kappa Alpha Psi Fraternity Inc. have pledged their support and resources to the event to ensure a complete count of the community.
The open-air event will be held in Parking Lot 3 at the AT&T Center. To ensure physical distancing and prevent the spread of COVID-19, all activities will allow participants to stay in their vehicles. Attendees can enjoy the comedy show from the comfort and safety of their cars, as well as fill out the census form on their own mobile device or on tablets which volunteers will bring to each vehicle.
The event will be live-streamed on Dream Big Scholarship Fund’s Facebook Page (https://www.facebook.com/dreambigscholarshipfund) and participants can complete the questionnaire at home and register to win gift card prizes. The census can be completed online at my2020census.gov or by calling 1.844.330.2020. Time is running out, be heard and get counted now!
Sickle Cell Awareness Month
September is National Sickle Cell Awareness Month, designated by Congress to help focus attention on the need for research and treatment of sickle cell disease.
SCD is a group of inherited red blood cell disorders. Healthy red blood cells are round, and they move through small blood vessels to carry oxygen to all parts of the body. In someone who has Sickle Cell Disease (SCD), the red blood cells become hard and sticky and look like a C-shaped farm tool called a “sickle”. The sickle cells die early, which causes a constant shortage of red blood cells. Also, when they travel through small blood vessels, they get stuck and clog the blood flow. This can cause pain and other serious problems such as infection, acute chest syndrome and stroke.
In the United States
The exact number of people living with SCD in the U.S. is unknown. Working with partners, the CDC supports projects to learn about the number of people living with SCD to better understand how the disease impacts their health.
It is estimated that:
- SCD affects approximately 100,000 Americans.
- SCD occurs among about 1 out of every 365 Black or African-American births.
- SCD occurs among about 1 out of every 16,300 Hispanic-American births.
- About 1 in 13 Black or African-American babies is born with sickle cell trait (SCT)
SCDAA’s theme for this year is Sickle Cell Matters. Sickle Cell Awareness Month Flyers, Myths & Facts Sheet, Calendar of Events as well as other vital information can be found by visiting https://www.sicklecelldisease.org/ People can share in awareness efforts or join SCDAA at one of the many great events to support sickle cell awareness!
Everyone is encouraged to be a part of this national effort to increase awareness about sickle cell disease and sickle cell trait during the month of September. Individuals and organizations can join the efforts to bring attention to sickle cell disease by engaging elected officials for proclamations, hosting awareness events, distributing educational information to dispel the myths about sickle cell disease, and lighting public spaces, buildings and landmarks red (burgundy)!
Another Blow Dealt: Charges Not Directly Linked To Victim Breonna Taylor
Residents of Louisville, Kentucky along with spectators across the world have waited for more than six months with anticipation for the verdict in the Breonna Taylor case. Anticipation has been boiling so much so that city and state officials began preparing days ago for uncertainty in the event that protests and riots could potentially break out once the verdict was read. The Kentucky National Guard and state police were called in and a 72-hour countywide curfew has been enacted. Once again there is further division, unrest, and lack of trust in another American city as clashes have already began to erupt in the streets of Louisville.
The verdict is in and the long-awaited grand jury charges are as follows. Only one former police officer, Brett Hankinson, was indicted on three felony counts of first-degree wanton endangerment. In a nutshell, the other two officers will face no charges and the charges Hankinson faces are not directly related to the wrongful death of Breonna Taylor, but rather his reckless action of “wantonly shooting a gun” into an apartment (not Breonna’s). First-degree wanton endangerment is a Class D felony, the lowest of four classes of felonies, the maximum sentence is five years; the minimum is one year.
Last week an announcement was made by the city of Louisville that a $12 million settlement had been reached with the family of Breonna Taylor. Continued prayers for the family of Breonna Taylor and the city of Louisville.
Be Counted and Be Heard Comedy Show
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Another Blow Dealt: Charges Not Directly Linked To Victim Breonna Taylor
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