Reparations for Black American descendants of persons enslaved in the U.S. and their potential impact on SARS-CoV-2 transmission

Highlights

• Black Americans are suffering from a disproportionate incidence of COVID-19.

• This disparity is driven by structural racism.

• The potential health impacts of racial-justice interventions are rarely explored.

• Reparations for Black Americans would have decreased their COVID-19 risk.

• A reparative program would also have decreased R₀ for the population at large.

Abstract

Background

In the United States, Black Americans are suffering from a significantly disproportionate incidence of COVID-19. Going beyond mere epidemiological tallying, the potential for racial-justice interventions, including reparations payments, to ameliorate these disparities has not been adequately explored.

Methods

We compared the COVID-19 time-varying R_t curves of relatively disparate polities in terms of social equity (South Korea vs. Louisiana). Next, we considered a range of reproductive ratios to back-calculate the transmission rates ${\beta }_{i\to j}$ for 4 cells of the simplified next-generation matrix (from which R₀ is calculated for structured models) for the outbreak in Louisiana. Lastly, we considered the potential structural effects monetary payments as reparations for Black American descendants of persons enslaved in the U.S. would have had on pre-intervention ${\beta }_{i\to j}$ and consequently R₀.

Results

Once their respective epidemics begin to propagate, Louisiana displays R_t values with an absolute difference of 1.3–2.5 compared to South Korea. It also takes Louisiana more than twice as long to bring R_t below 1. Reasoning through the consequences of increased equity via matrix transmission models, we demonstrate how the benefits of a successful reparations program (reflected in the ratio ${\beta }_{b\to b}/{\beta }_{w\to w}$) could reduce R₀ by 31–68%.

Discussion

While there are compelling moral and historical arguments for racial-injustice interventions such as reparations, our study considers potential health benefits in the form of reduced SARS-CoV-2 transmission risk. A restitutive program targeted towards Black individuals would not only decrease COVID-19 risk for recipients of the wealth redistribution; the mitigating effects would also be distributed across racial groups, benefiting the population at large.