These variables affect whether you live, die or receive help during the pandemic

Joe Biden: America is ready to eradicate systemic racism 3:17

(CNN) - As the U.S. continues to grapple with the dual crisis of coronavirus and racism, two things have become clear: People of color are hit the hardest by the virus, and systemic inequalities are largely the drivers. guilty.

Eight months after the pandemic, race and ethnicity data in covid-19 now show a more complete picture than before. The numbers are grim, confirming what experts and minority communities have long suspected.

Black, Latino, and Native American people are nearly three times more likely to be infected with COVID-19 than their white counterparts. Those three groups are five times more likely to be hospitalized. And people of color across the board are more likely to die from the virus.

The statistics are not a coincidence: Public health officials have long known that systemic racism is a public health problem. But the coronavirus pandemic, contrasted with a national reckoning on race since George Floyd's murder, has amplified the problem.

"What Covid-19 does is actually shed light on a problem that already existed," said Dr. Lisa Cooper, director of the Johns Hopkins Center for Health Equity.

Race affects who can flee from a viral hotspot to a second home and who shares a roof over the generations with family members. It affects who can telecommute and who has to leave home to keep society afloat. It affects who has easy access to testing and who postpones treatment because they are concerned about costs.

In other words, as the US approaches six million confirmed coronavirus cases, race plays a big role in who lives, who dies, and who gets help.

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Race affects where you live

The advice of health experts has been constant: keep your physical distance from others to avoid contracting the virus.

But for many marginalized groups, this is easier said than done.

Latinos, American Indians and Alaska Natives are 2.8 times more likely to be infected with COVID-19 than whites, according to recent data from the Centers for Disease Control and Prevention (CDC). English). Black people are 2.6 times more likely to be infected.

The higher infection rates among African Americans and Latinos can be explained, at least in part, by housing conditions, according to a report released last week by the National Urban League. Those conditions are a legacy of discriminatory practices such as financial exclusion and segregation dating back decades.

Black and Latino people are more likely to live in densely populated cities and neighborhoods that expose them to more people. They are also more likely to live in narrow, multi-generational households that create the potential for younger people to expose their older relatives.

Doctors transport a man with probable symptoms of Covid-19 in Austin, Texas. Blacks continue to be disproportionately affected by the pandemic.

"We are talking about homes that are probably older and of poorer quality," Cooper told CNN. "They are smaller rooms in houses that do not have several bathrooms."

She cited a Covid-19 patient she spoke with who worked as a hotel cleaner. The patient's family shared a house with a bathroom, and all members of her family were infected. The woman's husband died from the virus, Cooper said.

Some Latino immigrants, particularly farm workers, live in overcrowded housing with other "essential" workers with whom they are not related, said Randy Capps, director of research for US programs at the Migration Policy Institute.

"In normal times, it's a survival strategy, a way to be able to survive and do quite well on limited income," Capps said. "But in this environment, it can be problematic."

Those problems have become apparent in recent months in California's Central Valley, the heart of the state's agricultural industry.

The region is now a hotspot for coronavirus, and essential farm workers, Latinos and those living in shared housing - groups that often overlap with each other, are being disproportionately infected, Governor Gavin Newsom said last month. .

Multi-generational households are also a prevalent reality for American Indians and Alaska Natives, said Stacy Bohlen, executive director of the National Indian Health Board and a Sault Ste. Marie member of the Chippewa Indians.

"You see very bad housing for our people," he said. "And yet we view family as a top priority in the way we approach the world."

That means there could be multiple generations living in a house designed for four people, Bohlen said. Add to that the lack of running water, sewerage and sanitation on some tribal lands, and even complying with basic guidelines on hand washing can be challenging.

Given those conditions, plus centuries of underfunding and negligence despite treaties with the US government, the current situation in the indigenous country was inevitable, Bohlen said.

"If you look at history and see where we are, there was no other way for it to unfold," he said.

It affects whether you can work from home

Another commonly cited coronavirus safety tip: stay home.

But the ability to work remotely "differs vastly by race and ethnicity," experts from the Economic Policy Institute have noted.

Black and Hispanic workers in the United States are "much less likely" to be able to work from home, wrote economists Heidi Shierholz and Elise Gould in a March publication.

About 20% of black workers could do their job remotely, while about 16% of Hispanic or Latino workers could, according to data from the U.S. Bureau of Labor Statistics. 30% of white workers and 37% of Asian workers could work from home.

Those discrepancies have to do with "occupational segregation by race and ethnicity," Shierholz told CNN at the time.

Farm workers harvest lettuce among split plastics for social distancing in April, in Greenfield, California.

Hispanics and Latinos are overrepresented in industries like construction, agriculture and hospitality, jobs that cannot be done from home. Blacks are also overrepresented among low-wage workers, most of whom are unable to telecommute.

That means they are more likely to be exposed to the virus while at work, if they still have it.

Black and Latino people are also more likely to rely on public transportation and may need to make more frequent trips to the store because they can't afford to stock up, Cooper said.

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It affects your risk of serious illness

Even before becoming infected, many people of color face greater risks.

People who have underlying health problems, including chronic lung disease, asthma, and heart problems, are among the most vulnerable to serious Covid-19 illnesses. And due to factors like less access to healthy food and the great outdoors, minority populations experience higher rates of chronic disease.

"It's like a double jeopardy right now," Cooper said.

Black people are more likely than whites to experience high blood pressure, diabetes, and stroke; in fact, they are more likely to die at an early age from all causes. Native Americans have the highest rates of diabetes in the nation. And Pacific Islanders, who have experienced one of the steepest spikes in fatality rates in recent weeks, have higher rates of smoking, alcohol use and obesity compared to other racial groups.

Those disparities also appear in covid-19 hospitalization rates.

The hospitalization rate for Native Americans is 5.3 times that of white Americans, according to recent CDC data. African Americans are 4.7 times more likely to be hospitalized, while Hispanics or Latinos are 4.6 times more likely.

It affects your access to health care

When people of color become infected, they don't always get the treatment they need.

African Americans and Latinos are more likely than whites to be uninsured and tend to postpone seeking care, according to the National Urban League report. So by the time they see a health care provider, they are sicker.

Meanwhile, blacks have a legacy of mistrust of medical institutions, Cooper said. That's partly due to an unconscious bias that doctors can display when treating black patients, such as minimizing their complaints or referring them for advanced care less often. It also has to do with a history of exploitation, like the infamous Tuskegee Syphilis Study, in which researchers tricked black men with syphilis into thinking they were getting treatment when they weren't.

That mistrust can make blacks more susceptible to misinformation.

"With that, it's not surprising that people don't believe what they hear from experts, or are afraid of being harmed in some way," Cooper said.

Native Americans on tribal lands are in a unique situation when it comes to health care. In treaties with the federal government, tribal nations ceded their lands and promised peace in exchange for medical care and other benefits, according to the National Board of Indian Health. But the federal government has not fulfilled its obligations, Bohlen said.

The Indian Health Service, which is responsible for providing services to American Indians and Alaska Natives, is generally underfunded for 50% to 60% of needs, according to the National Council on Urban Indian Health. As a result, the agency generally runs out of money in the middle of the fiscal year.

"That is so underfunded that the joke in the indigenous country used to be: 'Don't get sick after June 1,'" Bohlen said. "Because allocations start on October 1 and June 1, all that money for specialty care has been used up."

Another barrier Native Americans face, lack of broadband access, affects their ability to receive up-to-date public health information and participate in telemedicine calls.

LOOK : What figures from Medicare and Medicaid reveal about the unequal impact of coronavirus among the poor and minorities

How we advance

The systemic barriers that contribute to racial disparities around COVID-19 are deeply ingrained and cannot be easily reversed. They stem from long-standing inequalities in housing, education, employment, and other sectors.

"There are only layers and layers of problems that have led to extreme social disadvantage in those communities," Cooper said.

Still, organizations that advocate for Blacks, Latinos, and Native Americans have been working through the pandemic to make sure their communities receive the support they need.

Medical workers at a demonstration organized by the White Coats for Black Lives group on June 6 in New York.

The NAACP recommends that legislators increase funding for federally qualified health centers, which are community providers that tend to serve black and brown neighborhoods.

UnidosUS is among the groups calling for an end to President Donald Trump's "public charge rule," which experts say makes Latino immigrants reluctant to seek medical care.

The National Indian Health Board is demanding multi-billion dollar investments from the federal government for water and sanitation infrastructure and Indian Health Service facilities in tribal communities, among other priorities.

These problems are big and demand big solutions, advocates say. Unraveling them will require removing layers and committing to tackling them, piece by piece.

CNN's Catherine Shoichet contributed to this report.

Pandemic racism