Abstract
INTRODUCTION: This report uses a present day global pandemic as a case study of health inequities that are best understood by considering the role of time and place. METHOD: I provide a historical overview of Milwaukee, Wisconsin-one of the most segregated cities in the U.S.-to consider prior health disparities and social conditions. I then focus on COVID-19, tracking the monthly census tract distribution of cases for 6 months, including case and mortality data by race and class. RESULTS: As expected, Black and Hispanic majority census tracts are the most affected by COVID-19, with some communities experiencing nearly 1 positive case per 10 residents. In previous years, Blacks and Hispanics provided approximately 27% and 3% of the shares of "natural" deaths, respectively; their shares of COVID-19 deaths in the first 6 months of the pandemic were approximately 35% and 13%. On the contrary, the share of natural deaths for whites was approximately 65% in previous years and dropped to 47% for COVID-19 deaths. The average ages of COVID-19 deaths were 72.5 for Blacks, 61.3 for Hispanics, and 79.9 for whites. CONCLUSION: The disparities in COVID-19 outcomes in Milwaukee cannot be separated from historical forces, including race-based politics that intensified during the Great Migration of African Americans from the Jim Crow South. The paper concludes by returning to the turn of the 19th century with a historical snapshot of Jane Addams, who lived a short distance south, in a time with conspicuous parallels to the COVID-19 crisis.