Sometime in the past week, my neighborhood ceased its 7 p.m. nightly cheers. We began them in March as a way to acknowledge health care workers, taxi drivers, delivery workers, grocery store employees, transit workers, and others whose continued labor allowed the rest of the city to stay home. At the beginning, we came to our windows at twilight and retreated two minutes later into apartments illuminated from within, shutting out the chill of early spring. More recently, our cheers have taken place in the lingering sunlight of evenings lengthening toward the solstice. Over time, our nightly gatherings evolved into a way to keep tabs on one another and express community during confinement. From my window, I kept an eye on the gay couple at the corner of my block, the long-haired woman in her third-floor apartment across the street, and the child who started bringing a tambourine to each evening’s noisemaking.
It has been a long, strange spring. I think we stopped cheering, in part, because things feel so different now from a few months ago. Back then, each day, even each hour, brought new, alarming updates about the virus and its toll on our city. Subway ridership plunged 90% as people stopped going to their offices. We confronted empty grocery shelves, shuttered restaurants and cafes, overburdened ICUs, isolation, devastating loss, and our own fear and uncertainty about when we might start to emerge from the darkness. Now NYC has begun to reopen, however cautiously. I’ve noticed more cars on the roads, more people on the sidewalks, more stores beginning to raise their gates. We’re not returning to a pre-COVID era, but we have moved past the initial shock of the sudden and substantial changes we were compelled to make. Now we seem resigned to an extended pandemic and have adapted our behaviors and our attitudes to account for a prolonged period of social distancing, mask wearing, and ambiguity.
We stopped cheering each night, as well, because events of the past few weeks have altered the political mood. The killing of George Floyd and the ensuing protests against police brutality and racial injustice, in the midst of a pandemic disproportionately affecting Black people, Latinos, and Native Americans, have made unbearably clear the relationship between racism and health. Nationwide, the mortality rate for African Americans from COVID-19 is 2.4 times higher than for whites. We know that Blacks and Latinos are more likely to be “essential workers” whose numerous contacts with others put them at increased risk. They’re more likely to be uninsured or underinsured, and to have underlying conditions such as asthma, diabetes, or hypertension that are linked to worse outcomes.
But poor health is not simply a matter of poverty or economic status. There’s a growing body of scholarship on the social production of illness, premised on the idea that patterns of disease distribution are shaped by power and politics. It’s not just race but racism that affects one’s health. Social epidemiologists, notably Nancy Krieger of the Harvard School of Public Health, have shown that constant exposure to stress raises blood pressure and cortisol levels and hardens one’s arteries, prematurely aging the body. It includes the effects not only of interpersonal hostility and violence, but also of unsafe neighborhoods and other structural conditions that become written corporally.
Racial justice and public health are inextricably linked, and our attempts to address the coronavirus must include measures to mitigate structural racism. Otherwise, the racial disparities in health and health outcomes that the pandemic has exposed will persist, and in our failure to act we will have indicated our acquiescence to it.