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
A Call for Conservation
City of San Antonio opens cooling centers as ERCOT calls for conservation through the week
The Electric Reliability Council of Texas (ERCOT) has called on the state to conserve power through Friday, June 18, 2021.
“With ERCOT calling for conservation and higher temperatures approaching, I want to encourage our residents to utilize these cooling centers if they need to seek safety from the heat. If you need assistance, please call 311,” said City Manager Erik Walsh.
To conserve energy at home, CPS Energy recommends that customers:
- Set thermostats 2 to 3 degrees higher from 2 – 7 p.m.; set programmable thermostats to higher temperatures when no one is home. The optimum energy-saving temperature is 78 degrees.
- Avoid using large appliances (i.e. ovens, washing machines, etc.), especially during peak demand hours.
- Use fans to feel 4 to 6 degrees cooler. Remember: fans cool people by moving air across the skin. They don’t cool rooms and should be turned off in empty rooms.
- Set pool pumps to run early morning or overnight; shutoff from 4 – 6 p.m.
- Turn off and unplug non-essential lights and appliances.
- Close shades and blinds on windows exposed to direct sunlight.
- Charge electric vehicles after 9 p.m.
The City of San Antonio has opened the following locations as cooling centers. The City of San Antonio has opened the following locations as cooling centers. Service animals (as defined by the Americans with Disabilities Act) are allowed in City Cooling Centers. As required by law, residents should always provide pets with protection from the sun, a shelter that includes three walls, a raised floor and roof as well as food and fresh water daily.
Residents in need of transportation assistance can contact 311 for assistance. Those with medical needs and in need of assistance should also call 311 for arrangements.
Locations and hours of operation are below:
|Bazan Library||2200 W Commerce St||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm||1pm-6pm|
|Brook Hollow Library||530 Heimer Rd||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Carver Library||3350 E Commerce St||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Cody Library||11441 Vance Jackson Rd||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Collins Garden Library||200 N Park Blvd||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm||1pm-6pm|
|Cortez Library||2803 Hunter Blvd||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm||1pm-6pm|
|Encino Library||2515 E Evans Rd||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Great Northwest Library||9050 Wellwood St||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Guerra Library||7978 Military Drive West||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm||1pm-6pm|
|Igo Library||13330 Kyle Seale Pkwy||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Johnston Library||6307 Sun Valley Dr||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Landa Library||233 Bushnell Ave||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Las Palmas Library||515 Castroville Rd||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm||1pm-6pm|
|Maverick Library||8700 Mystic Park||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Mission Library||3134 Roosevelt Ave||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm||1pm-6pm|
|Pan American Library||1122 W. Pyron Ave||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm||1pm-6pm|
|Parman Library at Stone Oak||20735 Wilderness Oak||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|San Pedro Library||1315 San Pedro Ave||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Schaefer Library||6322 US HWY 87 E||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Semmes Library||15060 Judson Rd||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Thousand Oaks Library||4618 Thousand Oaks Dr||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Tobin Library at Oakwell||4134 Harry Wurzbach||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm|
|Westfall Library||6111 Rosedale Ct||Closed||12pm-8pm||10am-6pm||10am-6pm||10am-6pm||10am-6pm||1pm-6pm|
|James Bode Community Center||901 Rigsby Ave||3pm-9pm||3pm-9pm||3pm-9pm||3pm-9pm||3pm-7pm||1pm-5pm|
|Commanders House Adult and Senior Center||622 S Flores||8am-5pm||8am-5pm||8am-5pm||8am-5pm||8am-5pm||Closed|
|Copernicus Community Center||5003 Lord Rd||7:30 am-7:00 pm||7:30 am-7:00 pm||7:30 am-7:00 pm||7:30 am-7:00 pm||7:30 am-7:00 pm||10am-4pm|
|Dawson Community Center||2500 E Commerce||Closed||2pm-9pm||2pm-9pm||2pm-9pm||2pm-7pm||9am-5pm|
|Denver Heights Community Center||300 Porter St||Closed||Closed||Closed||Closed||Closed||Closed|
|Dorie Miller Community Center||2802 Martin Luther King Dr||Closed||Closed||Closed||Closed||Closed||Closed|
|Fairchild Recreation Center||1214 E Crockett St||3:30pm-8:00pm||3:30 pm-8:30 pm||9am-12pm & 3:30pm-8:00pm||3:30 pm-8:30 pm||9am-12pm & 3:30pm-8pm||9am-3pm|
|Father Roman Community Center||11030 Ruidosa St||Closed||Closed||Closed||Closed||Closed||Closed|
|Garza Community Center||5627 Mira Vista||7:30 am-7:00 pm||7:30 am-7:00 pm||7:30 am-7:00 pm||7:30 am-7:00 pm||7:30 am-7:00 pm||10am-4pm|
|Gill Community Center||7902 Westshire||8am-5pm||8am-5pm||8am-5pm||8am-5pm||8am-5pm||Closed|
|Granados Adult and Senior Center||500 Freiling Dr||Closed||Closed||Closed||Closed||Closed||Closed|
|Hamilton Community Center||10700 Nacogdoches Rd||7:30 am-5:30 pm||7:30 am-9pm||7:30 am-5:30 pm||7:30 am-9pm||7:30 am-5:30 pm||9am-5pm|
|Harlandale Community Center||301 Sussex Ave||2pm-9pm||2pm-9pm||2pm-9pm||2pm-9pm||2pm-7pm||9am-5pm|
|Lincoln Community Center||2915 E Commerce St||3pm-9pm||3pm-9pm||3pm-9pm||3pm-9pm||3pm-7pm||11am-3pm|
|Lions Field Adult & Senior Citizens Center||2809 Broadway St||8am-5pm||8am-5pm||8am-5pm||8am-5pm||8am-5pm||Closed|
|Melendrez Community Center||5909 W Commerce St||2pm-9pm||2pm-9pm||2pm-9pm||2pm-9pm||2pm-7pm||9am-5pm|
|Miller’s Pond Community Center||6075 Old Pearsall Rd||2pm-9pm||2pm-9pm||2pm-9pm||2pm-9pm||2pm-7pm||9am-5pm|
|Normoyle Community Center & Senior Center||700 Culberson Ave||2pm-9pm||2pm-9pm||2pm-9pm||2pm-9pm||2pm-7pm||9am-5pm|
|Palm Heights Community Center||1201 W Malone Ave||7:30 am-7 pm||7:30 am-7:00 pm||7:30 am-7:00 pm||7:30 am-7:00 pm||7:30 am-7 pm||10am-4pm|
|San Juan Community Center||2307 S Calaveras||2pm-9pm||2pm-9pm||2pm-9pm||2pm-9pm||2pm-7pm||9am-5pm|
|South San Community Center||2031 Quintana Rd||7:30 am-5:30 pm||7:30 am-9pm||7:30 am-5:30 pm||7:30 am-9pm||7:30 am-5:30 pm||1pm-5pm|
|Southside Lions Community Center||3100 Hiawatha Dr||7:30 am-7:00 pm||7:30 am-7:00 pm||7:30 am-7:00 pm||7:30 am-7:00 pm||7:30 am-7:00 pm||10am-4pm|
|Tobin Community Center||1900 W Martin||Closed||Closed||Closed||Closed||Closed||Closed|
|Ward Community Center||435 E Sunshine||2pm-9pm||2pm-9pm||2pm-9pm||2pm-9pm||2pm-7pm||9am-5pm|
|Woodard Community Center||1011 Locke St||2pm-9pm||2pm-9pm||2pm-9pm||2pm-9pm||2pm-7pm||9am-5pm|
|Alicia Trevino Lopez Senior Center||8353 Culebra Rd||7am-4pm||7am-4pm||7am-4pm||7am-4pm||7am-4pm||Closed|
|Claude Black Community Center (District 2)||2805 E Commerce St||7am-4pm||7am-4pm||7am-4pm||7am-4pm||7am-4pm||Closed||1pm-6pm|
|District 2 Senior Center||1751 S WW White Rd||7am-4pm||7am-4pm||7am-4pm||7am-4pm||7am-4pm||Closed|
|District 5 Senior Center||2701 S Presa St||7am-4pm||7am-4pm||7am-4pm||7am-4pm||7am-4pm||Closed|
|Doris Griffin Senior Center||6154 NW Loop 410||7am-4pm||7am-4pm||7am-4pm||7am-4pm||7am-4pm||Closed|
|Frank Garrett Multi-Service Center||1226 NW 18th St||7am-4pm||7am-4pm||7am-4pm||7am-4pm||7am-4pm||Closed||1pm-6pm|
|Northeast Senior Center||4135 Thousand Oaks||7am-4pm||7am-4pm||7am-4pm||7am-4pm||7am-4pm||Closed|
|West End Park Comprehensive Senior Center||1226 NW 18th St||7am-4pm||7am-4pm||7am-4pm||7am-4pm||7am-4pm||Closed|
|Bob Ross Senior Center||2219 Babcock Rd,||7am-4pm||7am-4pm||7am-4pm||7am-4pm||7am-4pm||Closed||1pm-6pm|
|Southside Lions Senior Center||3303 Pecan Valley Dr||7am-4pm||7am-4pm||7am-4pm||7am-4pm||7am-4pm||Closed||1pm-6pm|
Text COSAGOV to 55000 to receive updates and information
City Budget- Your Input Is Important
City of San Antonio invites residents to participate in virtual FY 2022 budget telephone town hall meetings
The City of San Antonio will host two virtual telephone town hall meetings to inform the public about the Fiscal Year 2022 budget development process, answer public questions and gather input. The virtual meetings will include telephone town hall features, which allow residents to register in advance and receive a call when it’s time to join the event. City Manager Erik Walsh, Deputy City Manager Maria Villagomez and Budget Director Scott Huizenga will lead the public meeting.
The meetings will be held Tuesday, June 22 and Wednesday, June 23 at 6 p.m. Residents can register here to participate at https://www.surveymonkey.com/r/FY2022telephonemtg. Registration closes three hours prior to each event.
“Telephone town hall meetings are a convenient way to hear directly from our residents, from the comfort of their homes. Each of our residents leads a busy life, whether that’s tending to their families, commuting to and from work, balancing schoolwork, or other priorities. These telephone town hall events allow the public to participate wherever they are,” said City Manager Erik Walsh. “The annual budget process sets the framework for our work in the community and our strategic goals.”
The City also opened a brief budget survey, which will remain open through June 21, 2021. The survey gives residents the opportunity to weigh in on their service priorities, as well as share their thoughts on restoring programming from budget cuts made in FY 2020 and FY 2021. City residents can take the survey on www.saspeakup.com or by texting SASpeakUp to 55000 to take the survey on their mobile devices.
More information about the telephone town hall meetings and survey are available at www.saspeakup.com.
Complimentary One-day Ticket To Six Flags Fiesta Texas
Six Flags Fiesta Texas is partnering with SA Metro Health to give away 20,000 one-day tickets – over $1.5 million in value – to people who get a COVID-19 vaccination at any Metro Health or partner vaccine clinic.
Beginning Tuesday, May 25, individuals who get vaccinated at any of these clinics will receive a complimentary one-day ticket to Six Flags Fiesta Texas valid through Sept 6, 2021 to enjoy a fun day at the park.
“Six Flags Fiesta Texas is honored to partner with city leaders to encourage residents to get vaccinated, especially in underserved communities,” said Park President Jeffrey Siebert. “We appreciate Mayor Nirenberg’s leadership on this initiative and we look forward to partnering with the City of San Antonio Metro Health to assist with their vaccine campaign efforts.”
Metro Health will also share the theme park tickets with its partners – including UT Health San Antonio, University Health System, University of the Incarnate Word, WellMed, San Antonio Fire Department, Bexar County Health Collaborative and Curative – to give to those who receive their vaccine at designated vaccine clinics.
“With so many people who enjoy visiting Six Flags Fiesta Texas each year, we hope people take advantage of this generous ticket giveaway and go get vaccinated. This could mean that 20,000 more residents get vaccinated to help us end the pandemic,” said Mayor Ron Nirenberg.
As a reminder, people can get vaccinated either by walk-in or appointment at the Alamodome drive-thru clinic from noon to 8 p.m. Wednesday-Friday.
For a list of locations of Metro Health vaccine clinics around the city, visit http://covid19.sanantonio.gov.
For more information about Six Flags Fiesta Texas, including operating hours, visit https://www.sixflags.com/fiestatexas.