Distrust of health care system adds to toll in rural Black communities gutted by COVID

Bishop Melvin McCluster, seen here at Friendship Missionary Baptist Church in Americus, has still not reopened his church following the pandemic. Now he preaches his Sunday sermon on Facebook. It's difficult for him not to see the faces of his congregation as he speaks to them. But he and parishioners don't want to risk it, after entire families got infected and they lost four members to COVID-19. Sumter County, whose population is just over half African-American, has a long history grappling with the fight against racism. Now it is grappling with the coronavirus' disproportionate impact on Black Americans, who are more likely to get sickened by and die from COVID-19. According to health officials, the struggles against racism and the virus are fused. (Hyosub Shin / Hyosub.Shin@ajc.com)
Bishop Melvin McCluster, seen here at Friendship Missionary Baptist Church in Americus, has still not reopened his church following the pandemic. Now he preaches his Sunday sermon on Facebook. It's difficult for him not to see the faces of his congregation as he speaks to them. But he and parishioners don't want to risk it, after entire families got infected and they lost four members to COVID-19. Sumter County, whose population is just over half African-American, has a long history grappling with the fight against racism. Now it is grappling with the coronavirus' disproportionate impact on Black Americans, who are more likely to get sickened by and die from COVID-19. According to health officials, the struggles against racism and the virus are fused. (Hyosub Shin / Hyosub.Shin@ajc.com)

Credit: HYOSUB SHIN / AJC

Credit: HYOSUB SHIN / AJC

When Melvin McCluster was a child in Middle Georgia, going to the doctor meant first going to a “colored” waiting room. After all the white patients were seen, then the doctor would admit the first African American in line. So McCluster and his family waited, usually several hours, and watched, as sicker patients lost strength.

“I can remember grownups getting upset,” said McCluster, now a bishop at a Baptist church in Americus. “But there was nothing we could do. It turned a lot of us to using home remedies, because we knew we wouldn’t get the same treatment they had.”

Race has played a prominent role in the history of Sumter County, which is currently just over half African American. The county serves international visitors to President Jimmy Carter’s hometown of Plains, the Andersonville Civil War prison site and the historic racially integrated Koinonia Farm. But it’s also just another Southern community that was divided during the civil rights movement and lives with racial divisions now.

And according to health experts, the struggles against racism and against the coronavirus pandemic are fused.

ExploreAfrican-American COVID-19 survivors relate their experiences

Historic racial inequities in health care and environment have more often left people of color with higher rates of conditions such as diabetes, high blood pressure and asthma that leave a person more vulnerable to severe illness or death from COVID-19. If Black people in Georgia died of COVID-19 at the same rates as white Georgia residents do, as of early August 716 Black Georgians would still be alive.

Yet at the very moment when people need vigorous attention to health measures, another legacy of racism is distrust of the health care system that has disrespected and rejected people of color. Black Georgians too often are left wondering whether their loved ones receive the same level of medical care as their white counterparts. That distrust is also reflected in surveys showing that Black people are less likely than whites to agree to get vaccinated for COVID-19, if a vaccine becomes available.

Lorena Barnum Sabbs is president and owner of Barnum Funeral Home in Americus. She says the pandemic has led to never-ending anxiety, yet Black residents mistrust a health care system that has disrespected and discriminated against them.  (Hyosub Shin / Hyosub.Shin@ajc.com)
Lorena Barnum Sabbs is president and owner of Barnum Funeral Home in Americus. She says the pandemic has led to never-ending anxiety, yet Black residents mistrust a health care system that has disrespected and discriminated against them. (Hyosub Shin / Hyosub.Shin@ajc.com)

Credit: HYOSUB SHIN / AJC

Credit: HYOSUB SHIN / AJC

“People are still afraid of the Tuskegee experiment,” in which the federal government withheld treatment from Black men infected with syphilis in order to study how the disease would progress. “People have that in the back of their minds,” said Lorena Barnum Sabbs, an African American funeral home owner with deep roots in Sumter County.

Even now, “If you call your doctor and it’s three days later before they get back to you, what do you think? You’re not a priority.

“Those things are still alive and well,” she said.

ExploreComplete coverage of COVID-19 in Georgia

Compounding the problem is a stigma that has been attached to COVID-19, following reports that the pandemic has hit African Americans harder. Three of the top five counties across the entire country with the highest death rates are majority Black, and all three are in Georgia: Hancock, Randolph and Terrell, according to the COVID Racial Data Tracker, a volunteer organization.

“You kind of can see it or feel it; there’s almost like a COVID shame,” said Marc Arnett, 32, an Americus insurance agent and local education activist.

Across the state in Hancock County, which is 71% Black and has the nation’s highest COVID-19 death rate per capita, Sandra Sherrod has seen the same thing. After she tested positive, she spent five days recovering in the hospital, tethered to an IV and working to strengthen her lungs by breathing into a spirometer.

Sherrod, a Sparta councilwoman, shared her story in part to counteract the stigma surrounding COVID-19. “A lot of people are ashamed and don’t want people to know they have it,” she said.

Sparta City Councilwoman Sandra Sherrod (left) is tossed by the rumbling of the school bus as she works with T'Anna Harris, a paraprofessional at Hancock Central Middle School, to sort and prepare bagged lunches to be delivered to Hancock County Schools District students in Sparta. She has recovered from COVID-19. (ALYSSA POINTER / ALYSSA.POINTER@AJC.COM)
Sparta City Councilwoman Sandra Sherrod (left) is tossed by the rumbling of the school bus as she works with T'Anna Harris, a paraprofessional at Hancock Central Middle School, to sort and prepare bagged lunches to be delivered to Hancock County Schools District students in Sparta. She has recovered from COVID-19. (ALYSSA POINTER / ALYSSA.POINTER@AJC.COM)

Credit: ALYSSA.POINTER@AJC.COM

Credit: ALYSSA.POINTER@AJC.COM

‘An open wound'

The Barnum family’s funeral business has served Black residents of Sumter for 115 years. This year, they stopped or altered important traditions. Visitations that serve as family reunions in the presence of the deceased are done. Now foot traffic inside the building is barred to all but a handful of close family.

Others pay their respects at a safe distance, through a window she had installed by an outdoor walk. Flowers, a backdrop, and special lighting surround the open casket, nestled right up to the window.

In her experience, Barnum Sabbs says, nothing compares to the impact of the pandemic, not even the 1994 storm that dropped 27 inches of rain on Americus at once and killed dozens in days of floods. Then, like now, she said, death calls came in for days with stories of families ripped apart.

Lorena Barnum Sabbs directs staff members as they prepare for a visitation at Barnum Funeral Home in Americus. While most foot traffic inside the home has been barred during the pandemic, a window was added so visitors can see the deceased during the visitation part of a funeral. The Barnum family's funeral business has served Sumter County's black community for 115 years, after the Barnums came out of slavery from nearby Stewart County.   (Hyosub Shin / Hyosub.Shin@ajc.com)
Lorena Barnum Sabbs directs staff members as they prepare for a visitation at Barnum Funeral Home in Americus. While most foot traffic inside the home has been barred during the pandemic, a window was added so visitors can see the deceased during the visitation part of a funeral. The Barnum family's funeral business has served Sumter County's black community for 115 years, after the Barnums came out of slavery from nearby Stewart County. (Hyosub Shin / Hyosub.Shin@ajc.com)

Credit: HYOSUB SHIN / AJC

Credit: HYOSUB SHIN / AJC

But at least you knew when it was over. Now, an initial wave of trauma has turned to never-ending anxiety. When she has a death call for COVID-19 and meets with the relatives, she said, she knows they are coping not just with the recent death but with questions about who else may be infected.

“This, it feels like an open wound.”

She wants it over.

For that, people must be convinced to get tested and treated. If a vaccine arrives, the most vulnerable must be persuaded to take it quickly.

ExploreAtlanta mayor orders report on COVID's impact on minorities

Many are resistant to that message, though, said LaTanya Abbott-Austin, who does COVID-19 outreach for Coastal Community Health Services, far across the state from Americus, in Glynn County. As part of her job, she has tried convincing hundreds of people, usually the under-served, to get tested, wear masks and be careful.

While the clinics have managed to test more than 3,000 people, some whites she has spoken with refuse because they see the virus itself as a hoax. Among African Americans, though, she sees mistrust rooted in history.

Surveys about Americans’ willingness to get a COVID-19 vaccine, if it becomes available, also signals that distrust. While less than 60% of Americans said they would get vaccinated, a recent survey by Tufts University’s Research Group on Equity in Health, Wealth and Civil Engagement found that whites are much more likely to say they would.

That stems in part from what the president of the American Medical Association, Dr. Susan R. Bailey, called “decades and decades of mistreatment, exploitation and injustice” at the hands of the health system.

The Tuskegee experiment on Black American men ran 40 years until a whistleblower exposed it in 1972. After Tuskegee, more recent research shows that health care givers on average have unwitting racial bias, resulting in poorer diagnoses, curtailed treatment and worse outcomes for African Americans and Hispanics.

Additionally, there is misinformation poisoning the effort— hardening a concern that African Americans could be used to see if the speedily developed vaccine is safe. “We have seen flyers flying around encouraging African Americans in particular not to be tested, not to get the vaccine whenever it’s available,” Dr. Georges Benjamin, director of the American Public Health Association, said at a recent panel at the virtual conference of the National Medical Association, which represents Black physicians. “They quote the infamous Tuskegee study.”

ExploreFirst Georgia doctor dies from COVID-19

Barnum Sabbs deplores the message, but she says it wouldn’t gain traction if it didn’t draw on hard-earned experiences.

“We still feel on some level like lab rats,” she said.

Pride and a virus

There’s also misinformation that Blacks are at higher risk of contracting COVID-19 not because of systemic inequities but because of their lifestyles or behavior.

Abbott-Austin, who works with clinics on the Georgia coast, said patients have repeatedly come to the office to dispute their positive test results, saying they’ve done nothing wrong and can’t be infected.

ExploreFrom April: Outbreak apparently taking heavier toll on blacks

Barnum Sabbs has heard people suggesting that, of course, the public schools that are majority black might stay closed because of the pandemic, but the majority-white private academies could open.

“I truly believe there are people who think if you go to a predominantly white environment you’ll be safer,” she said.

“And I’m thinking, are you insane?” she said.

Bishop Melvin McCluster, in his office at Friendship Missionary Baptist Church in Americus, now preaches his Sunday sermon on Facebook, after closing the church because of the pandemic. He misses seeing the faces of his congregation as he speaks to them, but he and parishioners don't want to risk returning, after entire families got infected and four members were lost to COVID-19. (Hyosub Shin / Hyosub.Shin@ajc.com)
Bishop Melvin McCluster, in his office at Friendship Missionary Baptist Church in Americus, now preaches his Sunday sermon on Facebook, after closing the church because of the pandemic. He misses seeing the faces of his congregation as he speaks to them, but he and parishioners don't want to risk returning, after entire families got infected and four members were lost to COVID-19. (Hyosub Shin / Hyosub.Shin@ajc.com)

Credit: HYOSUB SHIN / AJC

Credit: HYOSUB SHIN / AJC

Bishop McCluster has been devastated by the deaths of four parishioners to COVID-19. But he is also wary of reports that the pandemic has hit African Americans harder, as if such reports imply that there is something inherently wrong with Black people. The pandemic has hit all races, he noted.

Nationwide, the two counties with the highest infection rate per capita are predominantly white, as is the Georgia county with the highest infection rate, Chattahoochee, the COVID Racial Data Tracker shows.

What McCluster does suggest is that circumstances can make it harder on average for Black people to be healthy. Blacks are more likely to live in areas with environmental contaminants and to work in service jobs exposed to the public. They also are less likely to have ready access to fresh fruits and vegetables. Toxic stress from lived racism also has a harmful effect on Black people’s blood pressure and health, University of Michigan research suggests.

Researchers at New York University found that taking two low-income counties, one majority-white and one not, a person in the majority-minority county was nine times more likely to die of COVID-19 than a person in the majority-white county. They included 28 metro Atlanta counties in their national study.

“We can’t fix these issues overnight; they’ve evolved over 400 years,” Surgeon General Jerome Adams said at the recent panel. However, he said, with the attention and impetus to change brought by the pandemic, “the data that we’re seeing, this history, does not have to be our nation’s future.”

Linda James (right) regularly babysits her 2-year-old granddaughter, Ava Taylor, at her Montezuma home, to help her daughter Britney James (left). Linda James has mostly kept in isolation at her home for the past five months, ever since she left her Americus hair salon after hearing casual talk of infections being spread. Her Americus clinets keep calling, pressing her to come back to work, but James has Type 2 diabetes and high blood pressure, putting her at high risk if she became infected with the coronavirus. (Hyosub Shin / Hyosub.Shin@ajc.com)
Linda James (right) regularly babysits her 2-year-old granddaughter, Ava Taylor, at her Montezuma home, to help her daughter Britney James (left). Linda James has mostly kept in isolation at her home for the past five months, ever since she left her Americus hair salon after hearing casual talk of infections being spread. Her Americus clinets keep calling, pressing her to come back to work, but James has Type 2 diabetes and high blood pressure, putting her at high risk if she became infected with the coronavirus. (Hyosub Shin / Hyosub.Shin@ajc.com)

Credit: HYOSUB SHIN / AJC

Credit: HYOSUB SHIN / AJC

Linda James, an Americus hairdresser, believes that. She has seen all the factors: People distrustful of the medical system, people proud to do for themselves but who should also see a doctor, and people who just don’t seem to know caution.

Not her. She has underlying conditions and has been mostly isolated at her home across the Sumter County line for five months.

“The walls are closing in,” she said, but she has no doubts.

“I want to live.”

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