Tasha Colbert of Milwaukee, Wisconsin, thinks of her 83-year-old grandmother Loraine as a pillar of the family. “My grandmother is like my mother; she raised me.” But for the past two weeks, the matriarch has been battling Covid-19 in the intensive care unit at Community Memorial hospital.

Loraine’s fight with Covid-19 started with a slight fever. But after her condition worsened, Colbert said her grandmother, who already has chronic lung disease, has been on a breathing machine, and family members are not allowed to see her in person. “To me the isolation is what can kill more than anything,” Colbert said.

Colbert’s grandmother lives on the north side of Milwaukee, a predominantly African American part of a city whose black residents are carrying much of the load of the novel coronavirus, and suffer worse outcomes. As of 9 April, the state of Wisconsin had more than 2,500 positive coronavirus cases, 1,500 of which are in Milwaukee county. Milwaukee is among the most segregated cities in the US.

The disparity in the city of Milwaukee is clear. Census data shows that black people comprise about 41% of the city’s population, yet they have nearly half of the city’s Covid-19 cases. And 44 of the 67 people who have died in the county were black. Most live on the city’s north side.

The way the pandemic has hit the black community here has some people asking why this is happening. But local health experts and community activists are not surprised, given the health and economic disparities black people in Wisconsin face.

Wisconsin has the highest black-white unemployment gap in the US. Black men and women have higher rates of heart disease mortality, and nearly 34% of black people in Milwaukee live below the poverty line. Additionally, the Kaiser Family Foundation reports that 9% of black people in Wisconsin were uninsured in 2018, which means they probably had even less access to basic healthcare already.

“I think any place you see, any community you’re in, if you have a group of poor people and discriminated against people, their ability to withstand anything coming in, let alone something as devastating as Covid, it’s going to affect them here,” said Dr Patricia McManus, the director of the Black Health Coalition of Wisconsin, Inc, an advocacy group.

McManus, who is 71, is herself part of the at-risk age group more likely to develop severe illness from Covid-19, according to the Centers for Disease Control and Prevention.

Meanwhile, Milwaukee’s reputation for being one of the most segregated cities in the country plays a part, as well. “You’ve got urban communities in which black people are more likely to live than white people ... that are often quite densely populated,” said Joshua Garoon is an assistant professor of community and environmental sociology at University of Wisconsin in Madison. Density makes the virus spread more quickly.

Voters in Milwaukee wear masks against the coronavirus as they wait in line. Photograph: Morry Gash/Associated Press

The Milwaukee health commissioner, Jeanette Kowalik, said government officials are mainly using technology to get much of the Covid-19 messaging out through social media. In 2018, about 10% of black people in the city had no internet subscription, and over 12% of black people in Milwaukee didn’t have a computer at all.

Kowalik added that there is another challenge facing public health efforts in the city: getting some black people to take the coronavirus seriously. “Messaging was out there, but people were thinking, ‘Oh it didn’t pertain to me because I’m not traveling, or I didn’t know anybody that went to China’,” Kowalik says.

But local activist Vaun Mayes said that attitude has a lot to do with lack of government outreach. “That has, I know, caused a huge effect as far as how serious people take it here on the north side,” he said.