From://www.scientificamerican.com/article/too-many-black-americans-are-dying-from-covid-19/ 6park.com
2020年，美国被两场表面上似乎毫无关联的危机搅乱了：冠状病毒大流行和执法杀害美国黑人--后者导致大规模抗议和警察对抗议者的暴力行为。虽然这两种悲剧的直接原因似乎是不同的，但两者的根源都是结构性的种族主义。这种病毒杀死了不成比例的黑人(以及其他有色人种)，据估计，黑人被警察杀害的可能性是白人的2.5倍。警察改革得到了越来越多的支持，我们可以立即采取具体措施来保护美国黑人的健康。 6park.com

 6park.com
在美国，严重的健康不平等现象一直存在，但这场大流行却对它们发出了特别严厉的光芒。美国疾病控制和预防中心对580名因新冠肺炎确诊病例住院的患者的报告发现，33%的患者是黑人，而只有18%的人是黑人。白人占同一人口的59%，但只有45%的人受到感染。截至4月16日，纽约市黑人死亡率为每10万人92人，拉脱维亚人死亡率为每10万人74人，而白人和亚洲人的死亡率分别为每10万人45人和35人。这些趋势并不局限于纽约：在整个美国，冠状病毒已经感染并杀死了数量庞大的黑人。 6park.com

 6park.com
许多有色人种工作在所谓的基本行业，如护理或家庭保健，杂货店和公共交通，在那里他们更有可能与病人密切接触。更糟糕的是，这些工作的报酬往往很低，其中很大一部分人没有健康或人寿保险。此外，许多黑人、拉丁人和土著社区都有很高的潜在健康状况，包括糖尿病、高血压和心脏病，这是已知的严重疾病和新冠肺炎死亡的危险因素。这些差异在很大程度上可以追溯到种族主义和赤裸裸的现象，它们导致了贫困、过度拥挤的住房，使有色人种暴露在更严重的空气污染之下--这些因素加剧了所有这些健康问题。美国国会3月份通过的“家庭第一冠状病毒应对法案”(First Coronavirus Response Act)和“冠状病毒援助、救济和经济安全法案”(Coronavirus Assistant and Economic Security(CARE)Act)对保护基本工人的健康没有多大作用，因为他们更注重提供经济救济，而不是医疗或福利。 6park.com
要全面解决这些健康不平等问题，就必须对我们的医疗保险制度进行重大改革，并真正努力解决根深蒂固的种族和经济不公正问题。一些可能的短期解决方案已经存在：无党派的布鲁金斯学会(Brookings Institution)在3月份发表了一份报告，呼吁将所有未投保的第一线基本工人及其家人纳入一个新的“联邦医疗保险中心”(Medicare COVID)项目，该计划将涵盖所有与新冠肺炎相关的检测、治疗和疫苗接种。(“关爱法”规定，保险公司必须覆盖新冠肺炎测试，而不是治疗。) 6park.com

 6park.com
进步倡导组织美国进步中心(CAP)的一项提案要求为基本工人提供危险津贴，并为工人提供带薪医疗或家庭假以照顾自己或生病的家庭成员(家庭第一项立法包括一项两周带薪病假的规定，但大部分是针对大企业和保健提供者的豁免)。盖特还呼吁国会确保新冠肺炎检测和治疗的覆盖范围，无论移民身份如何。众议院最近通过了一项3万亿美元的法案，其中包括许多条款，但这项法案在参议院似乎注定失败。 6park.com

 6park.com
我们应该采取这些措施作为权宜之计。但从长远来看，我们需要扩大所有美国人获得负担得起的医疗保健的机会，而这不应与就业挂钩。“平价医疗法案”(ACA)在实现这一目标方面取得了长足的进步，尽管共和党试图废除该法案，但事实证明，该法案在大多数美国人中很受欢迎。至少，我们需要在每个州重新开放aca注册，并为所有州提供扩大医疗补助的激励措施，这确保了大约7500万低收入美国人。 6park.com

 6park.com
太多的有色人种连最基本的医疗保健都得不到，而另一些人如果失去工作，就有可能失去对自己和家人的医疗保险。下一次大流行--而且下一次也会--我们不能允许同样骇人听闻的种族差异来决定谁活谁死。 6park.com
Too Many Black Americans Are Dying from COVID-19
The U.S. has been roiled this year by two crises that seem on the surface to be unrelated: the coronavirus pandemic and law-enforcement killings of black Americans—the latter leading to mass protests and police violence toward protesters. Although the immediate causes of these two tragedies seem distinct, both have their roots in structural racism. The virus has killed a disproportionate number of black people (as well as other people of color), and black people are by some estimates 2.5 times more likely than white people to be killed by the police. Support is building for police reform, and we can take concrete steps immediately to protect the health of black Americans.
Deep health inequities have always existed in the U.S., but the pandemic has shone an especially harsh light on them. A report from the Centers for Disease Control and Prevention on a sample of 580 people hospitalized with confirmed cases of COVID-19 found that 33 percent of patients were black in a population sample where just 18 percent of the people were black. White people made up 59 percent of the same population, but only 45 percent were infected. Through April 16 in New York City, the death rate among blacks was 92 per 100,000 people and among Latinx people 74 per 100,000—whereas the numbers for white people and Asian people were 45 and 35 per 100,000, respectively. These trends are not limited to New York: the coronavirus has infected and killed an outsize number of black people across the U.S.
Many people of color work in so-called essential industries such as nursing or home health care, grocery stores and mass transit, where they are more likely to come into close contact with people who are sick. To make matters worse, these jobs are often poorly paid, and a large proportion of such workers lack health or life insurance. In addition, many black, Latinx and indigenous communities have high rates of underlying health conditions, including diabetes, hypertension and heart disease, which are known risk factors for severe illness and death from COVID-19. These disparities can be traced back largely to the racism and redlining that have resulted in poor, overcrowded housing and exposed people of color to more severe levels of air pollution—factors that exacerbate all these health problems. The Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security (CARES) Act, both of which Congress passed in March, did very little to protect the health of essential workers, according to policy experts across the political spectrum, because they focused more on providing economic relief than medical care or benefits.

Tackling these health inequalities fully will require major reforms in our health insurance system and a true effort to address deep-seated racial and economic injustices. Some possible short-term solutions are out there: the nonpartisan Brookings Institution published a report in March that called for enrolling all uninsured frontline essential workers and their families in a new “Medicare COVID” program that would cover all testing, treatment and vaccinations related to COVID-19. (The CARES Act mandates that insurance providers cover COVID-19 testing but not treatment.)
A proposal from the progressive advocacy group Center for American Progress (CAP) asks for hazard pay for essential workers and paid medical or family leave for workers to care for themselves or a sick family member (the Families First legislation included a provision for two weeks' paid sick leave but was full of exemptions, mostly for large businesses and health care providers). CAP also called for Congress to ensure coverage for COVID-19 testing and treatments, regardless of immigration status. The House recently passed a $3-trillion bill that would include many of these provisions, but the legislation appears doomed in the Senate.
We should adopt these measures as a stopgap. But in the long term, we need to expand access to affordable health care for all Americans, and it should not be tied to employment. The Affordable Care Act (ACA) has made great strides toward this end and has proved popular with most Americans, despite Republican efforts to dismantle it. At minimum, we need to reopen ACA enrollment in every state and provide incentives for all states to expand Medicaid, which insures about 75 million low-income Americans.
Too many people of color lack access to even the most basic health care, and others risk losing coverage for themselves and their families if they lose their jobs. The next time there is a pandemic—and there will be a next time—we cannot allow the same appalling racial disparities to determine who lives and who dies.

Read more about the coronavirus outbreak from Scientific American here. And read coverage from our international network of magazines here.
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