US Surgeon General Jerome Adams is facing criticism for controversial remarks he made during a White House coronavirus press conference on Friday, during which he discussed how communities of color can fight the spread of coronavirus and asked them to observe social distancing protocols “for your big mama.”

Adams made the remarks as he worked to address that the Covid-19 death rate is higher for Americans of color than it is for white Americans, pointing out, for example, that in Wisconsin’s Milwaukee County, African Americans make up 25 percent of the population, but 75 percent of the confirmed deaths.

But while Adams brought up a number of underlying issues that contribute to this tragic reality, his remarks on those issues were ultimately overshadowed by rhetoric many found offensive — and that appeared to suggest minority Covid-19 deaths were a matter of personal responsibility rather than part of an ongoing crisis public health experts have said they are struggling to control.

Adams, who is a member of the White House’s coronavirus task force and often speaks during its daily briefings, ended his remarks Friday by telling communities of color they “are not helpless” in working to limit the spread of the virus. After prescribing social distancing and hand-washing, the surgeon general said:

Avoid alcohol, tobacco, and drugs. And call your friends and family. Check in on your mother; she wants to hear from you right now. And speaking of mothers, we need you to do this, if not for yourself, then for your abuela. Do it for your granddaddy. Do it for your Big Mama. Do it for your Pop-Pop. We need you to understand — especially in communities of color, we need you to step up and help stop the spread so that we can protect those who are most vulnerable.

Adams’s comments swiftly received sharp pushback from progressive commentators. Given that this kind of rhetoric has generally not been targeted at general audiences or white communities, it implicitly seems to hold people of color to a uniquely high bar.

When Yamiche Alcindor, White House correspondent for PBS NewsHour, asked Adams to respond to criticism that his language was “offensive,” he said he was simply trying to be targeted in his communication.

“We need targeted outreach to the African American community, and I use the language that is used in my family. I have a Puerto Rican brother-in-law. I call my granddaddy ‘granddaddy.’ I have relatives who call their grandparents, ‘big momma’,” Adams said. “So that was not meant to be offensive. That is the language that we use, and that I use, and we need to continue to target our outreach to those communities.”

He added, “We need everyone, black, brown, white, whatever color you are, to follow the president’s coronavirus guidelines.”

Adams’s clarification did little to address the pressing social inequities that are contributing to the disparity in health outcomes — and ultimately, his attempt to “target our outreach” obscured the portion of his address that did begin to speak to the larger problems that have led Covid-19 to kill minorities more often than white Americans.

Adams touched on a number of factors contributing to health disparities

Adams began his remarks by saying communities of color are more vulnerable to coronavirus complications and fatalities because they suffer disproportionately from chronic health conditions, and due to the “burden of social ills.”

He pointed out that Latinos represent a majority of Covid-related deaths in New York City, the epicenter of the American coronavirus crisis, even though they make up less than a third of the population.

“People of color experience [are] both more likely [to have] exposure to Covid-19 and increased complications from it,” Adams said. “But let me be crystal clear: We do not think people of color are biologically or genetically predisposed to get Covid-19. There is nothing inherently wrong with you. But they are socially predisposed to coronavirus ... exposure and to have a higher incidence of the very diseases that put you at risk for severe complications of coronavirus.”

And this is true due to a long history of institutional racism and economic inequity, as Vox’s Anna North explained:

[B]lack Americans are more likely to have underlying conditions because of widespread racism and inequality, experts say. Many differences in health outcomes in America are “produced by access to things like adequate time to prepare healthy foods at home” and “adequate money to not be working three shifts and have really high stress levels,” Lynch said — access that white people are just more likely to have. As [Fabiola] Cineas notes, 22 percent of black Americans lived in poverty in 2018, compared with 9 percent of white Americans. Beyond poverty, a number of factors contribute to poor health among black people, from racism in medical settings to the physical health effects of discrimination. Redlining and other forms of housing discrimination have made black Americans more likely to live in neighborhoods affected by environmental contamination, which federal and state officials have been slow to respond to, in turn raising rates of chronic illness.

Adams did not clarify precisely what he meant by “social ills” or “socially predisposed,” but he mentioned — among other things — that people of color are more likely to live in multigenerational homes and that “only one in five African Americans and one in six Hispanics has a job that lets them work from home.”

“We tell people to wash their hands, but as studies showed, 30 percent of the homes on Navajo Nation don’t have running water. So how are they going to do that?” Adams said.

So Adams’s remarks did acknowledge that there are structural socioeconomic factors like housing and job conditions contributing to the acute vulnerabilities of communities of color. But he didn’t get into why they exist and how much of it doesn’t come down to individual behavior. Instead, his talk of personal responsibility — a familiar trope that’s often used to blame communities of color for their suffering — obscured the fact that a lot of these issues stem from a history of institutional racism.

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