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
SA MLK DAY 2021
The legacy and homage to Dr. Martin Luther King, Jr. lived on, however, the traditional celebrations and one of the largest marches in the country was reimagined this year due to COVID concerns. San Antonio city officials and the MLK, Jr., Commission had the public’s best interest in hand and held a commemorative virtual march.
This year marked the 53rd anniversary of the first March for Justice in San Antonio. The march that San Antonio participants know and observer well was organized by the late Rev. Dr. Raymond “R.A.” Callies, Sr., a San Antonio teacher and pastor. He began the March in 1968 as a call to bring awareness to the need for basic infrastructure on the east side. His efforts have resulted in what has became one of if not the largest MLK march in the US, hosting over 300,000 participants of all ages, ethnic backgrounds, and creed.
The commemorative virtual march kicked-off with a premiere of native San Antonian and accomplished filmmaker Ya’ke Smith’s Dream: Rising Up For Justice film. The film celebrated organizers, community leaders, past marches, and featured musical performances. The premiere aired on News4SA, and the city’s TVSA.
Around town caravans, neighborhood marches, and a few community block parties took place with COVID safety measures in order. Many still wanted to honor Dr. King’s legacy by celebrating with family, friends, and neighbors to carry out his message of unity and building better communities while echoing the continued push for justice and equality for all.
MLK Day 2021 was not shuttered. One march didn’t stop the show. As the opening words of the film read and reminded us… “The Dream Continues!”
City Seeks Applicants For SA: Ready To Work Advisory Board
The City of San Antonio is accepting applications for the SA: Ready to Work Advisory Board.
In November, San Antonio voters overwhelmingly approved SA: Ready to Work, a training and education initiative to assist San Antonio residents impacted by the Covid-19 pandemic. Last week, City Council approved the creation of a nine-member SA: Ready to Work Advisory Board to provide feedback on program objectives.
“During the campaign this fall, voters asked how this initiative would incorporate diverse community feedback and remain aligned with business and resident needs. The timely creation of this board establishes a transparent and inclusive process from the start as City Council considers the various policies associated with this workforce and training initiative,” said Mayor Ron Nirenberg. “I encourage employers, participants and stakeholder organizations interested in playing a role in this important initiative to apply to serve.”
This Board will consist of representatives from four local employers with in-demand occupations, two current/previous participants in the City of San Antonio workforce development programs, one trade or labor organization, one community organization, and one workforce training provider. In additional, two City Council members appointed by the Mayor will serve as liaisons to this Advisory Board.
Applications for the Advisory Board positions can be found at the City of San Antonio’s Board and Commissions website (https://www.sanantonio.gov/Clerk/Legislative/BoardsCommissions#13319780-apply-for-a-board). Applications will be reviewed for eligibility beginning in mid-January and forward to City Council for review and potential appointment. Potential applicants are asked to consider that no appointed members of this Advisory Board may have direct relationships with entities that contract with the City for implementation of the SA Ready to Work program.
SA: Ready to Work will be tax supported through a 1/8th cent sales tax. This education and workforce program would begin serving San Antonio residents in fall 2021 and extend through December 2025. Each year of the initiative, up to 10,000 residents will be served with a total of up to 40,000 residents served over the four years.
Open Call: Calling All Artists
The City of San Antonio’s Department of Arts & Culture’s Public Art Division is seeking applicants for the 2021 Public Art Pre-Qualified List for Artists and Support Services.
The Pre-Qualified List works as a roster of emerging and experienced individuals and organizations who are pre-qualified by City Council to work on designing, building, and promoting future projects within the Department of Arts & Culture’s Public Art Program.
We are seeking professional qualifications from area, state, national, and international artists and arts organizations as well as individuals and businesses that provide support services including, but not limited to, consulting, curating, writing, project management, art history, art handling and shipping, art appraising, restoring and conserving art, art fabrication and installation, photo and video documentation, graphic and web-based design, and technical design.
· Deadline to Apply: January 18, 2021 at 4:30 p.m. CT
· Optional Virtual Informational Workshop: December 8, 2020 at 5:30 p.m. CT.
All Open Call details and application instructions can be found at http://www.sanantonio.gov/arts/open
Applying for the Pre-Qualified List allows applicants to be selected for future projects, inclusion does not guarantee selection for a public art contract.
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