The “Delmar Divide,” a recognizable term for many of us, refers to “Delmar Boulevard as a socioeconomic and racial dividing line in St. Louis, Missouri” . Crossing from north of Delmar Boulevard to the south reveals significant socioeconomic and racial segregations where the population goes from over 98% African American to over 70% white, the median income increases by $30,000 and the median home value increases by $250,000 . This segregation plays a major role in the wide range of health disparities experienced by the Black and African American communities in cities across the United States, but specifically in St. Louis, where the city has been ranked as the 10th most segregated city in the nation . The ongoing COVID-19 pandemic has only worsened the already existing health disparities in these communities.
St. Louis’ history of having distinctive divisions of wards, territories and counties ties back to housing discrimination against African Americans, as well as redlining policies created in the 1920s that “further segregated minority groups through government-issued zoning and programs” . Specifically, the policy “white flight” supported white families to move from city centers into suburban areas. Overtime, pockets of St. Louis became racially segregated, contributing to the uprise in health disparities due to less funding for education, poor job opportunities and, ultimately, high concentrations of poverty . Studies have shown correlations between high concentrations of African American residents – as well as high rates of poverty – and experiencing higher rates of death from chronic diseases, including heart disease and cancer, in St. Louis neighborhoods . Furthermore, these rates have continued to increase over the years. In 2016, Black St. Louisans were 34% more likely to die of any cause compared to white residents; however, that number increased to 47% by 2018 and is still continuing to rise .
With the COVID-19 pandemic, the mortality rate gap continues to widen between Black and white St. Louisans. This pandemic has further revealed the inequalities in healthcare in the St. Louis area. Given that pre-existing health conditions, like heart conditions or cancer, can increase the severity of coronavirus infections, Black and African American communities are disproportionately affected. Moreover, the lack of access to quality and reliable healthcare surely does not improve the situation. On April 8, 2020, Dr. Frederick Echols, the City of St. Louis Health Director, reported the twelve total fatalities among the city’s nearly 500 cases were all African American. A research study was conducted to assess the relationship between COVID-19-related health disparities in the St. Louis region and the demographic composition of the various ZIP codes. The study found that ZIP codes with a majority Black or African American population accounted for 16% of the St. Louis region’s population, but 34% of its confirmed COVID-19 cases on April 20, 2020 . This observation is not limited to only St. Louis; it has been seen nationwide where Black and African American residents in about every state have higher contraction rates and higher death rates of COVID-19 from the available data . The inequalities of extreme poverty, poor education systems, no access to major hospitals and homelessness caused by racial segregation and discrimination has paved a path for the COVID-19 pandemic to devastate the Black and African American communities in St. Louis and nationwide.
Health officials have advised residents to get tested for COVID-19 to better prevent the spread of the virus, but this important protocol was not implemented in areas with high concentrations of Black and African American residents until much later. The first coronavirus testing site opened in Chesterfield with sites in southern St. Louis soon followed, but it was not until two weeks later that the first testing site in northern St. Louis, an area with majority Black and African American communities, opened. Even then, the near downtown location of the testing site was inaccessible to many neighborhoods far north .
Similar trends were also seen with the lack of access to the COVID-19 vaccines. These same Black and African American communities who were being infected by the coronavirus at a rate four times higher than white residents were the ones who did not have reliable access to vaccines when they were initially being distributed throughout the end of 2020 into 2021. Also known as “vaccine deserts,” these are areas with little to no access to the vaccines and are also where some of the most vulnerable populations live. By March 7, 2021, only 5.2% of Black residents received their first COVID-19 vaccine dose, in comparison to 13.5% of white residents .
Black and African American communities have been and are continuously being disproportionately affected, and the COVID-19 pandemic has been no exception. This pandemic has, in turn, further revealed the health inequalities experienced by these communities in not only St. Louis, but in cities across the United States. Various organizations, such as PrepareSTL, are helping to deliver timely information about the pandemic to north St. Louis and how community members can protect themselves. However, these efforts are just the beginning and are brushing the surface of what must change. Ultimately, the existing racial and wealth gap between predominantly Black and African American communities in north St. Louis and the majority white communities in south St. Louis needs to lessen and close. Only then will we be able to implement long-term plans to reach health equity for everyone.
Edited by: Nick Rogers