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
SAAAACF Report Underscores Inequity in San Antonio
Groundbreaking study offers in-depth look at the state of the local African American community
SAN ANTONIO — The local African American community continues to face a significant challenge in closing socioeconomic opportunity gaps as reflected by leading social indicators, according to a new study.
The groundbreaking new report, State of the African American Community in San Antonio and Bexar County, is a joint effort by the San Antonio Area Foundation (SAAFdn) and the San Antonio Area African American Community Fund (SAAAACF). It paints a thorough picture of how much work remains to be done to level the playing field for the local Black community – though recent initiatives are striving to reverse the trend.
We’re all well aware of the fact that our beloved city does suffer from socioeconomic disparity and this extensive report reflects this reality when it comes to the African American communityMarjie French
“We’re all well aware of the fact that our beloved city does suffer from socioeconomic disparity and this extensive report reflects this reality when it comes to the African American community,” said Marjie French, CEO of the Area Foundation. “That’s why we’re supporting nonprofits that address these challenges in order to help create a community where everyone has a chance to succeed.”
Toward that goal, the new community-led study – research conducted by Community Information Now – serves as a clarion call for all of us to think more about how we can help our fellow neighbors in need, said Bobby Blount, Chairman of the SAAAACF Board of Directors.
“This report does more than validate what most of us know: African Americans face many challenges in our community,” Blount said. “It provides a foundation for everyone to understand, discuss and take action to improve the livelihood of San Antonians.”
The research was based on various societal focus areas, selected by a 20-member community advisory committee. Some key findings:
• Population: African Americans comprise seven percent of Bexar County; about 20 percent of African Americans are military veterans; in about half of Black households where grandparents live with their minor grandchildren, those grandparents are raising their grandchildren.
• Housing: African Americans have the lowest rate of home ownership (41 percent); more than one-third (37 percent) of Black mortgage applicants are denied; overrepresentation in public housing (20 percent of all HUD-subsidized households).
• Education: Majority of Black students attend Judson ISD, Northside ISD and Northeast ISD; among all districts and charters, there’s overrepresentation in disciplinary alternative programs and out-of-school suspensions as well as in special education programs; underrepresentation in gifted and talented programs and Advanced Placement (AP) courses.
• Finance: African Americans have a lower median income ($48,509) than the county average ($57,157); nearly two-thirds (64 percent) of work-eligible African Americans are in the workforce; they are more likely than the county workforce overall to be unemployed (seven percent).
• Business: Only one percent of San Antonio-New Braunfels metro area businesses with paid staff and five percent of solo-run businesses are Black-owned.
• Health: About one in six (17 percent) working-age African Americans does not have health insurance and are also more likely to have medical debt in collections.
• Criminal justice: African Americans are overrepresented in police arrests as well as in criminal court cases; Blacks – along with Latinos – are the least to be released in cite and release cases for some misdemeanor offenses.
• Social connection: Majority of African Americans (83 percent) have broadband access but still trail other racial/ethnic groups; San Antonio is home to more than 200 Black churches with an average membership of 120 parishioners (excluding megachurches); about six percent of African Americans moved here from another Texas county or out of state.
The advisory committee, led by Blount, consulted with nonprofit advocacy organization Texas Appleseed to develop various policy recommendations to address the inequities highlighted in the report. Among the recommendations:
• Implement alternative methods of traffic law enforcement, including standardizing collection of metrics based on race and ethnicity.
• Invest in public defense to ensure those unable to retain counsel receive equal representation within the criminal justice system.
• Expand eligibility requirements for early education programs in order to enable Black children to be more kindergarten-ready.
• Create more opportunities for Black students to access Advanced Placement courses and gifted and talented programs.
• Expand paid internships as well as outreach programs to increase African American young adult participation in the workforce.
• Make more resources available and lift barriers impeding access to credit in order to increase financial stability for low-income African American households.
• Expand lending and support services to Black small business owners and entrepreneurs.
Though the new report leaves no doubt as to the tremendous challenge ahead, SAAFdn and SAAAACF are not sitting idle. A renewed focus on equity and social justice have led to the creation of strong and effective initiatives meant to close the opportunity gaps identified in the study. Some examples:
• Creation of the SAAAACF Social Justice Fund providing bail and legal aid to those facing low-level offenses.
• SAAFdn teaming up with UP Partnership on implementing Blue Meridian national funding leading to Youth Leadership Development and Workforce Development grants to nonprofits primarily focused on helping communities of color.
• SAAFdn supporting the Corporate Partners for Racial Equity coalition formed by top San Antonio business executives contributing more than $13 million into programs on equitable education, economic opportunities and social justice.
• SAAFdn partnership with the City of San Antonio/Metro Health providing grants to address health disparities exacerbated by the pandemic.
• SAAFdn launching its first-ever San Antonio Equity Fellowship Program, a unique professional development program to champion and help grow nonprofit leaders of color.
• SAAFdn partnering with Local Initiatives Support Corporation (LISC) on the Leading To Change: Building Equity In Community Program focusing on equitable outcomes on affordable housing.
The report concludes with first-person “community voices” essays featuring local African American experts weighing in on the social indicators examined – each voice poignantly bringing to life the somber significance of the statistics. They are: Dr. Gary Bates, Dr. Adena Williams Loston, Ken Lowe, Dr. Travis Batts, Douglas Greene, Darryl E. Harris, Dr. Kenneth R. Kemp and Deborah Omowale Johnson.
Omowale Johnson, CEO and Director of the San Antonio African American Community Archive and Museum, issued a critical reminder that the local Black community’s relatively small size doesn’t make it any less part of the diverse fabric of our great city.
“The Black community making up 7% of Bexar County may seem at first to be an insignificant group of people,” Omowale Johnson wrote. “However, if the community does not collectively recognize the impact of these statistics, the economic segregation gap will widen.”
About the San Antonio Area Foundation:
The San Antonio Area Foundation (SAAFdn) has served as the city’s community-giving headquarters for nearly 60 years, growing to become one of the top 20 community foundations in the nation. The Area Foundation helps donors achieve their charitable goals supporting our community’s greatest needs, managing more than 500 charitable funds nearly $1 billion in assets. Beyond serving hundreds of nonprofit organizations every year through training and grantmaking, where total impact exceeded $71 million in 2020, the Area Foundation operates a strong student scholarship program. Over $37 million has been invested in our future leaders since 1969 through more than 100 scholarship funds. Learn more at saafdn.org.
MLK Day of Service
Alpha Tau Omega Chapter, San Antonio’s local chapter of Alpha Kappa Alpha Sorority, Incorporated celebrated the Sorority’s 114th Founding Anniversary with a day on and not a day off. For this year’s Dr. Martin Luther King, Jr. service project they hosted a Community-wide Food and Winter Items Drive. Members collected can goods, non-perishable items, winter wear clothing (hoodies, gloves, jackets, etc.), and blankets. The ladies braved the cold and withstood the windy gusts Saturday morning. Their work was not in vain as they continue to be a service to all mankind.
Thanks to the donations from chapter members and the community, several hundred pounds of food as well as winter wear was collected and will be donated to support the San Antonio Food Bank and homeless street outreach efforts in San Antonio.
Nation’s Largest MLK March Cancelled
Due to the current influx of omicron cases in and around San Antonio, the city’s annual Martin Luther King Jr. March has been cancelled. The event was previously scheduled to take place on January 17th, but concerns for public safety and continued presence of the virus on the route led to its cancellation.
The MLK board met and made the decision Thursday night. The board will decide what they plan to include in next Monday’s meeting.
Renee Watson, who is the chairperson of the Martin Luther King march, says that COVID-19 testing will be available together with vaccine shots at Pittman Sullivan Park.
As of Thursday afternoon, the most recent update from DreamWeek says their events are still on but their plans are impromptu.
The in-person event, which had been held every year since 1987, was changed to a virtual event in 2020 at the start of the pandemic.
After over 20,000 diagnoses cases from the first week of the year, it makes sense to cancel a show for safety reasons.
Nathaniel Davis, past chair of Martin Luther King Junior March, died this week. We are saddened by his loss and extend our condolences to his family during this difficult time.
Stayed tuned to Black Video News for the latest statement and updates.
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