Recently, Mayor Duggan seems to have taken offense with the media’s characterization of Detroit as a “hotspot” and the association of high rates of poverty, chronic illness, and lack of health care among Detroiters as contributing factors to the spread of the virus. While it is true that we may all be susceptible to infection with the virus, we are not all equally susceptible to the impacts of the virus in terms of related illness, social and economic impacts. For our elected officials and senior public health leadership to fail to articulate this important distinction is extremely problematic.
As we see it, the media are only repeating principles rooted in current public health practice and medical science that say, certain physical and social conditions contribute to the vulnerability of certain population groups to disease and illness. Those conditions include individual, family health history and genetics which contribute to underlying/pre-existing health conditions.
It is well known that Black Detroiters along with their counterparts across the nation, experience higher rates of asthma, heart disease, hypertension, and diabetes. Medical experts generally agree that these pre-existing conditions make individuals more susceptible to the severity of the coronavirus. That may account for emerging data that suggesting death rates attributable to the coronavirus may be higher among African Americans. As of this writing in Michigan where African Americans account for 14% of the population as of this writing, they now account for 35% of coronavirus cases and 40% of coronavirus deaths in Michigan.
And then there are social and physical conditions that impact the overall health and well-being of our community. These conditions are referred to as determinants of health. Social and physical determinants of health include factors like access to quality health care, affordable and quality housing, reliable transportation, access for the disabled; clean air, access to fresh water and healthy green space to name a few. The interplay between our individual health status and determinants of health in our neighborhoods and communities ultimately defines the resilience of our neighborhoods and communities in the face of a pandemic such as the coronavirus.
The failure of our local administration to embrace this very basic principle of modern public health has resulted in bad public policy no doubt contributing to the current crisis.
Nowhere is this bad policymaking better illustrated than when, as recent as a month ago, public health officials at both the state and local level steadfastly refused to restore the water in thousands of homes in Detroit. They did this in the face of the growing pandemic and recommendations for frequent hand washing as a primary prevention strategy to combat the spread of the coronavirus. Instead, the administration and their sympathizers tap-danced and split hairs around scientific study terms like causation vs association, debating the link of illness to lack of household water.
Seemingly beyond professional accountability these arguments were used to justify mass water shutoffs over the past five years and the decision to leave hundreds if not thousands of Detroiters vulnerable and at increased risk for coronavirus infection. Only in the face of yet another demand put forth by local water justice advocates making by then the obvious connection between access to running water in the household and the primary prevention strategy of hand washing did Mayor Duggan reconsider and allow the restoration of water to families in shutoff.
Yet even now, those of us who monitor the Mayor’s position on water shutoffs grow nervous as we hear the not so veiled threat to deal with household discovered to have so called “illegal water hookups” and the Mayor’s growing impatience with the “restore water to all” demands.
Detroiters now understand that the health and the fate of our city during this pandemic and those to come will be linked across neighborhoods and households. We can no longer go along with the tactics of pitting Detroiters who can pay against those who cannot pay, while letting the administration and policy makers off the hook for creating a just and equitable solution to the problem of water affordability.
Scientist and public health officials predict the coronavirus will be around for a while. The virus may decrease and reappear in coming months. Access to household water will remain one of the front-line prevention strategies we will have to rely upon. We will all need access to fresh and affordable water. We risk the peril of all otherwise. A policy for water affordability put forth by our water justice colleagues must be adopted and implemented with a sense of urgency.
With the economic downturn and the devastating job losses caused by the coronavirus pandemic, right now and at least into the foreseeable future, an ever increasing number of Detroiters will struggle with the basics of putting food on the table, keeping a roof over their heads and paying water bills. It is the truth that this situation is like nothing we have experienced in our lives, and that means we as residents must demand our government enact extraordinary and bold public policy initiatives that address the unique economic and social needs of the nation’s largest Black majority city.
When the Mayor and his senior health officials fail to make the connections between long standing health disparities and inequities fueled by neighborhood and household poverty and chronic illness now exacerbated by the coronavirus; we know we cannot count on them to make decisions rooted in racial justice and equity that produce benefits for all; and we cannot count on them to create policies that drive resources to transform and build the capacity of our neighborhoods to live thru and into a post coronavirus future.
What the present and future moments call for is that Detroiters build on our collective strength, embrace our legacy as radical change makers, and demand better from our government and elected officials than a return to the status quo. Watch for and participate in the coming online organizing and calls to action from Detroit People’s Platform until we are able to join you in community again.