Joe Kane grew up in East Baltimore with his cousins, aunts and uncles close by. It was the way his grandmother, Phyllis Waters, wanted it.
He says she loved her family – and her Seventh Day Adventist church.
"When I say ‘all her time’ – I mean all her time was in church," he says. "She’d stay there all day."
Waters loved to sing. Kane says her favorite hymn was “When We All Get to Heaven.”
As the years progressed, Kane says, her list of ailments looked all too familiar to many black men and women: diabetes, hypertension, and more. Black patients are more likely to be diagnosed with diabetes than white patients and blacks are two to three times as likely as whites to die of preventable heart disease and stroke.
About a year ago, Waters developed more serious health issues related to her diabetes, a massive infection in her lower leg. Doctors suggested she have her lower leg amputated to fully get rid of the infection.
But she grew up in the Jim Crow era, when Johns Hopkins doctors used cancer cells taken from the cervix of Henrietta Lacks, a black woman, for research without her permission. And she knew of the infamous, federally-funded Tuskegee syphilis study, which didn't end until 1972.
"[Waters] had a general mistrust of white institutions in general," Kane says. "She really didn’t think that her best interests would be taken care of."
She stayed in a nursing home for a year, trying to avoid the operation and hoping the infection would go away. But she eventually relented. Then, while she was in the hospital for the amputation, the doctors contacted her family with the bad news. Waters was diagnosed with COVID-19. She died less than a month later.
Kane says it was excruciating to not be able to see his grandmother, to hold her hand before she passed.
Waters was one of many black men and women dying of COVID-19 at a disproportionate rate in the United States as well as Maryland.
In Maryland, black people represent 30 percent of the population, yet 42 percent of those who die from the disease.
The racial disparities in COVID-19 numbers show a prevalence of pre-existing health conditions. And that tells a story about access to healthcare, systemic racism, and implicit racial bias, says Dr. Jevay Grooms, a professor who researches healthcare from an economic standpoint at Howard University.
"Think of the jobs you work, the money you make," Grooms says. "Do you have the means to buy health insurance?"
She says there are other reasons for racial health disparities.
"There are also social constructs, like embedded racism in how physicians prescribe. There are reasons why individuals who are black are less likely to go to the doctor and less likely to trust the doctor."
Among those reasons, she says, is a lack of diversity within the health care field.
The Maryland Department of Health didn’t have recent data available, but according to a report from 2010, African Americans, Hispanics, and Native Americans represent only 13% of medical school graduates in the state.
A woman we’ll call "Laura" because she didn’t want her real name used - is a white social worker at a hospital in one of the Baltimore zip codes that has been hit hard by COVID-19. It’s a hospital that predominantly serves black patients. She says she hears the distrust from patients’ families and that their fears are very real.
"I’ve had people say 'how do I know that you’re actually giving them the medication," she says. "How do I actually know that you’re doing your best? Do you have medication that you’re just not giving?"
The anxiety and distrust was heightened during the pandemic, she says, because many of the families she worked with needed to make end of life decisions.
"How can you expect me to make medical decision when I can’t see them," says they asked.
She says every day she’s left asking, “How do we make this situation work?”
