This story was produced in partnership with Bloomberg CityLab and is not available for republication.
Patricia Frieson was a caretaker, a nurse by trade who looked after her nieces and nephews when they were children, and tended to her mother in old age. When she became the first person in the state of Illinois to die of the coronavirus, news reports made note of her age, 61, and health issues like her severe asthma that made her more vulnerable to this deadly disease.
Less discussed were the details of her surroundings. Frieson lived in Auburn Gresham, which has the highest asthma rate of any neighborhood on the far southwest side of Chicago. Residents can smell the exhaust of buses and trucks that cut across W 79th Street, one of the busiest roadways in the city. Auburn Gresham is also one of the hottest neighborhoods in Chicago and one of the most vulnerable to flooding. Severe heat worsens pollution, which assaults the lungs, while floodwaters feed mold, which does the same. For locals looking for healthful food or medical care, there is little in the way of grocery stores and not one hospital. Auburn Gresham is 96 percent Black.
Auburn Gresham isn’t an anomaly. Draw a map of Chicago and shade the areas with more poverty, more pollution and more coronavirus. You will find yourself coloring in Black neighborhoods in the south and west. At some point, it will start to look like being Black is a pre-existing condition.
Just as the coronavirus has an accomplice in health conditions like diabetes and asthma, it is also aided and abetted by the stark inequality that makes such conditions possible. A century of racist housing practices — from redlining to contract buying to the grossly unequal lending that persists today — have denied Black Chicagoans generations of wealth. The series of maps below shows the results. Black neighborhoods see more poverty, air pollution, extreme heat and flood damage, and less access to health care and food — all factors that make residents more vulnerable to the coronavirus. The maps are of Chicago, but they reflect the reality of numerous other American cities where coronavirus has devastated communities of color.
“We may be in the same storm together, but we’re on different boats,” said Linda Rae Murray, a former president of the American Public Health Association and former chief medical officer of the Cook County Department of Public Health. “Those people who are on a little raft or on a little dinghy — we need to make sure they’re in the kind of boat that can survive the storm, and we’re not doing that.”
Racial disparities and segregation
Chicago is neatly divided by race and ethnicity. A chasm of inequality divides the mostly white, waterfront neighborhoods on Chicago’s northeast side from the Black neighborhoods to the south and west.
In the Chicago area, Black residents are more than twice as likely to die of the coronavirus as their white counterparts. A number of factors are likely contributing to this inequality.
Poverty and Economic Insecurity
Black neighborhoods tend to see more poverty and higher unemployment than white neighborhoods. Jobs are often poorly paid and, in the age of the coronavirus, deemed essential. Black Chicagoans are more likely to work as hospital support staff, security guards, bus drivers — roles where they are prone to catching the coronavirus and passing it on to friends and family living together in close quarters in small, densely packed homes.
“If people are living in crowded homes, it’s because they can’t afford the rent in larger places,” Murray said. “So they don’t have a basement for somebody to stay in because they’re an essential worker, and they are trying not to infect Grandma, who is also living in the house.”
Air pollution and asthma
In the U.S., white Americans produce more pollution than they breathe, and Black Americans breathe more pollution than they produce. Decades of environmental regulations, though successful in stemming pollution overall, have done almost nothing to resolve this yawning inequality.
This is evident in Chicago, where pollution is heavier in Black and Hispanic neighborhoods. Much of it comes from cars, trucks, industrial sites, ports and rail yards — the result of zoning policies that have concentrated pollution in communities with little political power.
Above we’ve mapped the distribution of asthma, a disease linked to air pollution that shows some of the most stark patterns. Air pollution assaults the lungs, causing inflammation. People who breathe air pollution regularly are more likely to develop COPD and asthma.
These ailments, both risk factors for the coronavirus, are more prevalent in Black neighborhoods in Chicago. By weakening the lungs, air pollution makes it harder to cope with respiratory infection. Several studies have found that coronavirus patients living in neighborhoods with more pollution are more likely to die of the disease.
“If you look at those neighborhoods, historically they’re environmental justice neighborhoods. They’re heavily industrial. They’re along the busiest bus routes in Chicago,” said Tiffany Werner, a field organizer at the Environmental Law & Policy Center. This has consequences for the coronavirus, she said: “They spent their whole life breathing in pollution, and their body can’t fight it off.”
The coolest neighborhoods in Chicago are the mostly white, lakeside communities in the northeast. The hottest are communities of color in the south and west, which lie farther from Lake Michigan.
Heat makes pollution worse, specifically, nitrogen dioxide, a pollutant that has been shown to increase the odds of dying from the coronavirus. Some studies suggest that severe heat also weakens the immune system. Soaring temperatures may also spur people without air conditioning to head to public buildings with air conditioning to cool off, risking further spread.
In the summer, extreme heat can pose a mortal threat in poorer neighborhoods where many people can’t afford cooling or balk at the high cost of powering their air conditioner. During Chicago’s 1995 heat wave, 739 people died, almost all of them in Black neighborhoods on the south and west side of Chicago.
“The map for where those 739 deaths occurred is very similar to the Covid map. It’s very similar to our air pollution map. You’re seeing that certain neighborhoods in Chicago are overburdened by all of these different factors,” said Kiana Courtney, a staff attorney at the Environmental Law and Policy Center. Climate change has accelerated this threat by fueling more severe summer heat.
Floods deal more damage in neighborhoods on the south and west sides of Chicago, seeding mold, which can worsen breathing problems and may leave residents more vulnerable to the coronavirus. That Black neighborhoods endure more damage has partly to do with the geography of the city — water collects more readily at the low-lying south end of the city. But much of it also has to do with the quality of houses, experts say. Older buildings, many of which have fallen into disrepair, are more vulnerable to flood damage.
In May, severe flooding closed a coronavirus testing site in Auburn Gresham. South Side residents inundated the city’s 311 system with flood complaints, fearful of the growth of mold. As with heat, climate change is worsening floods by fueling heavier rainstorms in Chicago.
Fresh food access
Access to fresh food, another key determinant of health, follows similar patterns. Grocery stores are more readily found on the north side of Chicago than they are to the south or west, areas termed “food deserts.”
Eating a healthful diet lowers the risks of diabetes and obesity, two risk factors that can exacerbate the coronavirus. And there is some evidence that eating fresh fruits and vegetables can help protect against air pollution. But the scarcity of supermarkets makes it harder for some communities to find nutritious food. And, in neighborhoods with fewer stores, shoppers are more apt to run into crowds at the grocery, which raises the risk of spreading Covid-19, said Helene Gayle, CEO of the Chicago Community Trust.
Like supermarkets, hospitals are scarce on the South Side, and growing scarcer with the planned closure of the Mercy Hospital and Medical Center in 2021, raising fears of a “health-care desert,” WTTW reported. Norma Sanders, director of special initiatives at the Greater Auburn-Gresham Development Corporation, decried the absence of a hospital in her neighborhood.
“We have 42,000 people that live in this community — not 4,200. 42,000,” she said. “That’s an atrocity.”
With fewer hospitals on the South Side, the ratio of health-care workers to patients tends to be higher, undermining the quality of care, Gayle said. Where the standard of care is low, people often avoid going to the hospital until their condition is truly dire, at which point it may be too late, she said.
History of housing discrimination
Each of these disparities were made possible by public policies, the most pernicious of which may be redlining. In the 1930s, as part of the New Deal, federal housing officials produced maps of American cities outlining which areas were most suitable for investment. Banks were discouraged from lending in neighborhoods colored red, which were deemed “hazardous,” often because of the number of Black residents. As a result, people living in these neighborhoods struggled to secure loans to purchase new homes or form new businesses.
In Chicago, banks also undertook a practice known as “contract buying.” Instead of giving Black homebuyers a mortgage, they gave them a contract that stipulated they would pay off their home in monthly installments, meaning residents did not own their homes. Black residents paid exorbitant prices and faced eviction if they missed even a single payment. By one estimate, banks bilked as much as $4 billion in wealth from Black neighborhoods.
Redlining was formally made illegal in 1968, but even today discrimination in lending persists. A WBEZ analysis of home loans from 2012 to 2018 found that banks invested more in Lincoln Park, a tony, largely white neighborhood on Chicago’s north side, than they invested in every Black neighborhood combined. The lack of investment has tangible effects.
“It means the housing stock is older. It means that people don’t have the same kinds of resources. It also indicates where essential workers live,” Murray said.
Studies have found that redlined neighborhoods also see more poverty, more pollution and asthma, more heat and more coronavirus. In Chicago, Covid-19 has proved more deadly in redlined areas, according to a new paper, which has not yet undergone peer review, from the University of Modena and Reggio Emilia, and Queen’s University Belfast. The results, authors wrote, show the “influence of the racial segregation induced by the discriminatory lending practices of the 1930s.”
North Lawndale, a predominantly Black neighborhood on Chicago’s west side, offers a prime example. During the New Deal, much of North Lawndale was redlined after an influx of Black residents in the early part of the 20th century. Federal officials wrote in their notes, “Negro is filtering in, first as caretakers, and then moving in their families to occupy basement rooms not equipped as living quarters.” Today, North Lawndale is among the neighborhoods hardest hit by the coronavirus.
Taylor Roberts, a North Lawndale resident, said that with so many essential workers living nearby, the coronavirus has spread quickly through her community. It has been enormously stressful, as family members coping with high cholesterol, high blood pressure and respiratory illness are staring down the barrel of a potentially fatal virus.
“I don’t think there’s any mass initiative to aid people in any way. You suffer and maybe you die, or you don’t,” she said. “It’s kind of hard to identify what truly is a result of Covid and what is just a result of white supremacy.”
Community groups like the Greater Auburn-Gresham Development Corporation are trying to revive the South Side by offering needed services. With Covid-19 testing sites more concentrated in white parts of Chicago, the GAGDC set up a testing facility across the street from their office and sent a mobile testing unit to visit senior centers in the area, Sanders said. The group is now trying to raise money to bring a health clinic into the community, and they are working to create a community market so that people can access fresh fruits and vegetables.
But without the power to address systemic causes, such efforts don’t eliminate threats to public health so much as manage them.
Chicago Mayor Lori Lightfoot has undertaken programs to address inequities, such as INVEST South/West, which aims to bring public money and private investment to overlooked neighborhoods, like Auburn-Gresham and North Lawndale. After the coronavirus hit Chicago, Lightfoot assembled a task force to make sure racial inequality was considered in the city’s response to the pandemic. The task force issued a report outlining the specific steps the city should take, like helping Black-owned businesses navigate the economic downturn.
But with temperatures rising fast and the pandemic spreading faster, calls for more radical overhauls are getting louder, from reparations to a dramatically expanded social safety net.
“There’s no way that somebody who is a janitor, who has been exposed to COVID, should still be getting sub-living wages at the end of this pandemic,” Murray said. “They deserve hazard pay. But more importantly, they deserve an income that makes sense with a pension that allows them to raise their children and send their kids to college, all that stuff.”
Murray said that such measures are needed not just as redress for discriminatory lending practices, but also to mitigate future mayhem. Rising temperatures will produce more dangerous viruses, and deliver more deadly heat and floods. In the coming storm, the smallest boats will sink first, and time is running out to build better boats.
“That’s the part that scares me as a physician, is that we have decades and, sometimes, centuries of inequities that exist. And now we have an emergency, and it’s really, really difficult — even if we had agreement on what should be done — to try to get everything in place quickly,” Murray said.
“I’m really disturbed that, not only are we not ready for the next pandemic, we’re not ready in general for the next problem that we face as a country. If we messed up this pandemic, what are we going to do about climate change? And how do we get to the point where we have some hope?”
Jeremy Deaton and Gloria Oladipo write for Nexus Media, a nonprofit climate change news service. You can follow them @deaton_jeremy and @gaoladipo. This story was made possible by a grant from the Society of Environmental Journalists.