Enduring second impeachment, Trump stands largely silent and alone


Abandoned by some in his own party, Trump could do nothing but watch history unfold on television. The suspension of his Twitter account deprived Trump of his most potent means to keep Republicans in line, giving a sense that Trump had been defanged and, for the first time, his hold on his adopted party was in question.

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He was finally heard from hours after the vote, in a subdued video that condemned the insurrection at the Capitol and warned his supporters from engaging in any further violence. It was a message that was largely missing one week earlier, when rioters marching in Trump’s name descended on the Capitol to try to prevent Congress from certifying Biden’s victory.

“I want to be very clear: I unequivocally condemn the violence that we saw last week,” said Trump. He added that “no true supporter” of his “could ever endorse political violence.”

But that message, partially motivated to warn off legal exposure for sparking the riot, ran contrary to what Trump has said throughout his term, including when he urged his supporters to “fight” for him last week.

Trump said not a word about his impeachment in the video, though he complained about the ban on his social media. And later, he asked allies if he had gone too far with the video, wondering if it might upset some of his supporters. Four White House officials and Republicans close to the West Wing discussed Trump’s private conversations on condition of anonymity because they weren’t authorised to do so publicly.

With only a week left in Trump’s term, there were no bellicose messages from the White House fighting the proceedings on the other end of Pennsylvania Avenue and no organised legal response. Some congressional Republicans did defend the President during House debate on impeachment, their words carrying across the same space violated by rioters one week earlier during a siege of the citadel of democracy that left five dead.

In the end, 10 Republicans voted to impeach.

It was a marked change from Trump’s first impeachment. That December 2019 vote in the House, which made Trump only the third president ever impeached, played out along partisan lines. The charges then were that he had used the powers of the office to pressure Ukraine to investigate a political foe, Joe Biden, now the President-elect.

At that time, the White House was criticised for failing to create the kind of robust “war room” that President Bill Clinton mobilised during his own impeachment fight. Nonetheless, Trump allies did mount their own push-back campaign. There were lawyers, White House messaging meetings, and a media blitz run by allies on conservative television, radio and websites.

Trump was acquitted in 2020 by the Republican-controlled Senate and his approval ratings were undamaged. But this time, as some members of his own party recoiled and accused him of committing impeachable offences, Trump was isolated and quiet. A presidency centred on the bombastic declaration “I alone can fix it” seemed to be ending with a whimper.

The third-ranking Republican in the House, Representaive Liz Cheney of Wyoming, said there had “never been a greater betrayal” by a president. Senate Majority Leader Mitch McConnell, of Kentucky, told colleagues in a letter that he had not decided how he would vote in an impeachment trial.

For the first time, Trump’s future seemed in doubt, and what was once unthinkable – that enough Republican senators would defy him and vote to remove him from office – seemed at least possible, if unlikely.

But there was no effort from the White House to line up votes in the President’s defence.

The team around Trump is hollowed out, with the White House counsel’s office not drawing up a legal defence plan and the legislative affairs team largely abandoned. Trump leaned on Senator Lindsey Graham, of South Carolina, to push Republican senators to oppose removal. Graham’s spokesman said the senator was making the calls of his own volition.

Trump and his allies believed that the President’s sturdy popularity with the lawmakers’ Republican constituents would deter them from voting against him. The President was livid with perceived disloyalty from McConnell and Cheney and has been deeply frustrated that he could not hit back with his Twitter account, which has kept Republicans in line for years.

He also has turned on his personal attorney Rudy Giuliani, who touted election conspiracy theories and whom many in the president’s orbit believe shoulders some of the blame for both impeachments. Trump had grown irritated at Giuliani’s lavish spending, which included a request to be paid $US20,000 ($25,700) a day, and told aides to stop paying him.

Trump has even turned on Rudy Giuliani, his personal attorney.Credit:Bloomberg

Trump watched much of the day’s proceedings on TV from the White House residence and his private dining area off the Oval Office. A short time before he was impeached, Trump was in the White House East Room presenting the National Medal of Arts to singers Toby Keith and Ricky Skaggs as well as former Associated Press photographer Nick Ut.

His paramount concern, beyond his legacy, was what a second impeachment could do to his immediate political and financial future.

The loss of his Twitter account and fundraising lists could complicate Trump’s efforts to remain a Republican kingmaker and potentially run again in 2024. Moreover, Trump seethed at the blows being dealt to his business, including the withdrawal of a PGA tournament from one of his golf courses and the decision by New York City to cease dealings with his company.

There’s the possibility that if the Senate were to convict him, he also could be barred from seeking election again, dashing any hopes of another presidential campaign.

A White House spokesman did not respond to questions about whether anyone in the building was trying to defend Trump, who was now the subject of half of the presidential impeachments in the nation’s history.

One campaign adviser, Jason Miller, argued Democrats’ efforts will serve to galvanise the Republican base behind Trump and end up harming Biden. He blamed the Democrats’ swift pace for the silence, saying there wasn’t “time for mounting a traditional response operation.” But he pledged that “the real battle will be the Senate where there’ll be a more traditional push-back effort.”

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The reminders of the Capitol siege were everywhere as the House moved toward the impeachment roll call.

Some of the Capitol’s doors were broken and windows were shattered. A barricade had gone up around outside the building and there were new checkpoints. Hundreds of members of the National Guard patrolled the hallways, even sleeping on the marble floors of the same rotunda that once housed Abraham Lincoln’s casket.

And now the Capitol is the site of more history, adding to the chapter that features Clinton, impeached 21 years ago for lying under oath about sex with White House intern Monica Lewinsky, and Andrew Johnson, impeached 151 years ago for defying Congress on Reconstruction. Another entry is for Richard Nixon, who avoided impeachment by resigning during the Watergate investigation.

But Trump, the only one impeached twice, will once more be alone.

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Pokhran nuclear tests Vajpayee’s ‘most enduring contribution’, says Jaishankar


There is no question that he was the transformational leader when it came to Indian foreign policy, Jaishankar pointed out

New Delhi: India’s decision to carry out the Pokhran nuclear explosions in 1998 will remain then prime minister Atal Bihari Vajpayee’s “most enduring contribution”, External Affairs Minister (EAM) S. Jaishankar said on Friday, even as President of the US-India Business Council and former US State Department official Nisha Biswal said Mr. Vajpayee foresaw the “potential dangers posed by a rising and unchecked China”. In an indication of the almost certain increased focus on human rights and democratic values by the forthcoming Biden Presidency, she also said that the Indo-US strategic convergence “needs to be buttressed with a broader focus on our shared democratic values”.  Ms. Biswal was delivering the A.B. Vajpayee Memorial Lecture, an annual lecture series begun by the Ministry of External Affairs (MEA) on the occasion of the former PM’s 96th birth anniversary.

Ms. Biswal, who previously served as US Assistant Secretary of State for South Asia during the Obama Administration, said in her Address, “Prime Minister Vajpayee was able to foresee what many others failed to see, he saw the potential dangers posed by a rising and unchecked China. And he saw the importance of a US-India partnership, built on the foundation of our democratic values, to advance a rules-based order that would enable a more peaceful, prosperous and pluralistic Asia.”

 

She further said, “The last several years have seen a more aggressive and assertive China that sought to leverage its growing economic clout to advance its strategic ambitions, often at the expense of its neighbors. The words of Prime Minister Vajpayee, some 20 years ago, foreshadowed the challenges that we are seeing play out across the Indo-Pacific. And in the face of these destabilising actions, the United States and India have forged a closer partnership and cooperation.”

Ms. Biswal added, “With the incoming Biden-Harris Administration, there will be a renewed focus on restoring our global alliances and strengthening our global institutions. And the advances of the past four years and the strategic convergence which we have seen deepened in the current administration will continue but they need to be buttressed with a broader focus on our shared democratic values.” In her Address, Ms. Biswal, significantly, did not mention India’s 1998 Pokhran nuclear explosions that had then led to imposition of sanctions by the US on India.

 

In his Opening Remarks on the occasion, EAM Jaishankar said, “On a whole range of national security and foreign policy issues, Atalji introduced corrections, some bold and others more nuanced. His 1998 exercise of the nuclear option will remain his most enduring contribution. If our Russia relationship remains steady to this day, this owes partly to his endeavours. Our principled approach of engaging China on the basis of mutual respect and mutual sensitivity also reflects his thinking.”

The EAM pointed out, “Looking back at Atalji’s life and legacy, there is no question that he was the transformational leader when it came to Indian foreign policy. He had an intuitive understanding that the post-Cold War world required India to drastically rework its relationships and interests. This vision led to a new beginning with the United States that has since been developed by successive Governments on both sides.”

 

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The enduring allure of erotic masterpiece Black Narcissus



That movie was made by an English director and a Hungarian-born writer-producer: Michael Powell and Emeric Pressburger, the celebrated cinema partnership revered for a series of groundbreaking and influential British films, of which Black Narcissus has become one of the best-loved. Now, there is a new adaptation, this time a joint BBC-FX production made for the small screen and starring Gemma Arterton and Aisling Franciosi.

The book, Godden’s third, and first bestseller, was praised by critics for its “rare beauty” and its “subtlety and freshness”, yet the story is not commonly described in such terms now. Rather Amanda Coe, the writer of the new three-part television version, says she thinks of it as “The Shining with nuns”.

Godden, who died aged 90 in 1998, was born in England but spent much of her childhood in India where her father managed a steamship company. She was a bestselling author who wrote more than 60 books, several of which were filmed. However her popularity has waned to the point where the most familiar Rumer to some will be the actress daughter of Bruce Willis and Demi Moore, apparently named after the writer.

Black Narcissus is Godden’s best-known work, partly because of the success and enduring popularity of the 1947 film. It tells the story of a small cadre of nuns from an Anglo-Catholic order sent to a remote mountaintop palace 8,000ft (2,400m) up in the Himalayas to establish a school and dispensary for the ‘natives’ – whether the ‘natives’ want one or not. The young, relatively inexperienced and rather self-important Sister Clodagh is placed in charge of this mission. Among the nuns is the highly-strung, difficult Sister Ruth.



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Understanding the Enduring Consequences of Covid-19


November 09, 2020

Azeem Azhar speaks with Yale Professor of Social and Natural Science, Internal Medicine & Biomedical Engineering, Nicholas Christakis, whose latest book “Apollo’s Arrow,” lays out the three phases of the world’s recovery from the Covid-19 pandemic. Christakis argues that each phase will be fraught with risk and will leave an enduring impact on our society, economy, and politics.

They also discuss:

  • How a successful vaccine will influence global geopolitics as a soft power.
  • How to deal with the pandemic on individual and community levels.
  • How the “Swiss Cheese model” of accident causation can help policymakers build resilient prevention and response systems.

Further resources:

@NAChristakis
@azeem
@exponentialview

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HBR Presents is a network of podcasts curated by HBR editors, bringing you the best business ideas from the leading minds in management. The views and opinions expressed are solely those of the authors and do not necessarily reflect the official policy or position of Harvard Business Review or its affiliates.





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Why Penrith Panthers are enjoying rather than enduring grand final week


“Obviously with the restrictions, the COVID, you have to cross a lot of things off the list. I guess it helps both teams but for us, with a young group, we can focus on the task as much as possible. Obviously we’re trying to minimise as much outside noise as possible.”

Yeo, fellow Penrith forward James Tamou and coach Ivan Cleary were at ANZ Stadium on Thursday afternoon for one of their only promotional obligations for the week. The trio are among the most seasoned Panthers in a relatively inexperienced squad, one that hasn’t had to go through the hoopla that usually accompanies the most anticipated game of the year.

“I don’t want to upset anyone, but I’m a bit like Yeo-ey,” said Cleary. “Just the feeling of being in a grand final [is enough]. This year we had a fan day and you’re not exactly mingling like you normally would, but you can feel the excitement around town without actually getting immersed in it.

Grand final week has been just like every other one for the Panthers.Credit:SMH

“For example, if one of the boys was to go into a restaurant or something this week, it would be nuts. We’ve sort of been away from it but still get to feel it. At the end of the day, we’re here, our main concern this week is to prepare properly.”

Grand final week is nothing new to Melbourne. The Storm have contested four of the past five deciders and the build-ups that come with it. However, that advantage has been largely nullified given this week will be like most others for the young Panthers.

“The difference in grand final week because of COVID has fallen into our hands a little bit with the fact that, apart from a couple of days here and there, the rest of the week is very similar to every other week,” Cleary said. “We’ve prepared really well all year and the early signs have been very good this week too.”

Panthers coach Ivan Cleary and captain James Tamou with the premiership trophy.

Panthers coach Ivan Cleary and captain James Tamou with the premiership trophy.Credit:getty

It’s a point not lost on Apisai Koroisau. The Panthers hooker, thrust into the limelight when forced to replace suspended hooker Rabbitohs rake Issac Luke for the 2014 decider, appreciates this isn’t your usually build up.

Moments after booking another grand final appearance, courtesy over a nailbiting win against South Sydney, the Fijian international predicted the coronavirus would prove a leveller this time around.

“I remember the week leading up to the grand final was all promos and events,” he said of his initial grand final week experience. Nearly every day we had to do something, we were in Darling Harbour and all these other things.

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“It’s just evens the playing field because neither team has done this before. We’ll just go into the game pretty fresh, not doing as many promos and events. It does take it out of you during the week. To be able to roll in fresh will be a first for both teams.”

One player rolling in fresh will be Viliame Kikau. A member of the Dally M team of the year, Kikau missed the preliminary final after being suspended for a dangerous throw.

“One thing about Kiks is he isn’t overly emotional, he doesn’t give a lot away. After the siren last week he was visibly upbeat,” Cleary said.

“He feels as though he owes the boys. It’s an unfortunate situation where he didn’t play last week. He certainly showing good signs throughout the week. He’s asking when he can start training after the game, that’s pretty unusual for Kiks. Hopefully that’s a good sign.”

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Princess Diana’s enduring fashion legacy


It was a precursor for what was to come; as the newly minted princess stepped into her role as ultimate fashion muse – a role she continues to hold 23 years after her untimely death – in both her red carpet looks, and the more casual outfits she adopted as a young mother.

The late Diana, Princess of Wales, in her famous wedding dress by David & Elizabeth Emanuel in July 1981.Credit:AP

Princess Diana’s style was on Virgil Abloh’s mood board for the spring 2018 collection of his brand Off__White and the inspiration behind American fashion designer Tory Burch’s preppy spring/summer 2020 collection.

Last year Vogue Paris shot “it” girl Hailey Bieber in an homage to Diana’s extremely ‘90s “off-duty” aesthetic. Incidentally, those looks – bike shorts with oversized sweaters and high-waisted jeans paired with big shouldered blazers, cowboy boots and baseball hats – became the pin-up for lockdown style, according to Instagram feeds and dozens of articles written over the past few months.

Diana’s wardrobe mirrors many of the trends we’re still slavishly wearing now. From athleisure to the oversized collars seen in collections from cool-girl Danish brand Ganni to Chanel; from puffed sleeves (see them at Cecilie Bahnsen, Miu Miu and more) to polka dots (Hedi Slimane recently sent them down the runway at Celine).

But it’s the fashion transformation of Princess Diana, from shy pie-crust collar wearing “Sloane Ranger” – the nickname given to a preppy Londoner – to a woman with undeniable magnetism, and the way she used clothes to project her new image, that remains most compelling.

Princess of Wales in a Christina Stamboulian gown at a party given at the Serpentine Gallery in London, 1994.

Princess of Wales in a Christina Stamboulian gown at a party given at the Serpentine Gallery in London, 1994.Credit:AP

Former British prime minister Tony Blair once said Princess Diana represented not just a new way to be a royal, but “a new way to be British.”

In all this her clothes mattered.

NGV senior curator of fashion and textiles, Danielle Whitfield, says Diana used fashion to transform herself. As Whitfield notes, while Diana relied on the advice of the likes of ex-British Vogue fashion editor Anna Harvey in the early days of her royal life, she eventually started making her own choices.

“By the late 1980s Diana took greater ownership over her fashions and was choosing to wear more fashion-forward designers. By the time of her separation from Charles [in 1992] she was wearing high-profile labels like Versace and Christian LaCroix, et cetera.

“The famous posthumous 1997 Harpers Bazaar cover image of Diana in an ice-blue embellished Versace gown is actually a portrait that was taken in 1991, so you can see how she is starting to ‘rebrand’ at a critical point in time in her life,” she says.

“These looks allowed her to project a more empowered and independent image, even a slightly sexy one by association. To give another example of how her style became more daring in this decade, there is the [John] Galliano ‘lingerie’ dress Diana wore to the Met Ball in 1996, which was from his first collection for Dior.”

Perhaps the pinnacle of this though was the famous so-called “revenge dress” she wore to a gala at the Serpentine Gallery in London in 1994, the same night Prince Charles admitted in a national television interview that he’d been unfaithful. Designed by Christina Stambolian, it was black (royals typically only wear it when in mourning), daringly sexy and head-turning. Three years later Diana sold the dress at auction for $US65,000. The money went to AIDS and cancer charities.

Writer Eloise Moran, who documents Diana’s best ‘90s fashion looks post-divorce on the popular Instagram account @ladydirevengelooks, agrees the appeal of Diana’s fashion goes beyond clothes.

“Diana’s ‘90s style transition represents something much bigger than a simple change of wardrobe aesthetic. It was utterly anti-establishment, and it was her taking control of her own narrative, after years of having it been dictated by the royal family and the press,” says Moran.

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“Of course, over the last few years, ‘90s nostalgia has largely influenced fashion and trends, so it makes sense that people would be drawn to Diana … but I do think the surge in interest in the princess comes down to more than that. In the era of #metoo, and industries being revolutionised because of it, Diana is a hugely relatable figure.

“She was massively ahead of her time, and I think the understanding of Diana’s personal story and challenges made her post-Charles outfits … eternally more appealing.”

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A nation still potty for snooker’s enduring appeal


August 14, 2020

By Martyn Herman

(Reuters) – Park a snooker table inside Sheffield’s Crucible Theatre and weird and wonderful things can occur.

In 1985, 18 million people across Britain stayed glued to their TV screens past midnight as Dennis Taylor beat Steve Davis in the most gripping World Championship final ever.

Two years earlier Canadian Cliff Thorburn made the first televised maximum 147 break as compatriot Bill Werbeniuk memorably peered around a partition.

Snooker’s unpredictable genius Alex ‘Hurricane’ Higgins broke down in tears when he won the title in 1982 and in 1997 Ronnie ‘Rocket’ O’Sullivan swept a 147 in five minutes.

On Friday, snooker’s spiritual home since 1977 witnessed more magic as England’s Kyren Wilson beat Anthony McGill 17-16 in a semi-final decided in a surreal last frame.

A 33rd frame spanning an hour featured nine successive failed attempts to get out of a snooker on the last red by McGill who conceded 43 points worth of fouls in the process.

Wilson almost handed the match back to McGill in an incredible sequence of play before fluking a green and eventually potting the pink to reach the final against O’Sullivan.

“That’s the most incredible frame I’ve ever seen at the Crucible,” seven-time world champion Steven Hendry, commentating for the BBC, said.

The Scot was almost as lost for words later in the night as O’Sullivan somehow fashioned a 17-16 win over Mark Selby by winning the last three frames having riled his opponent by crashing the cue ball around the table to lose the 30th frame rather than attempt to get out of a snooker.

Sadly there were no spectators in the Crucible to see the thrilling spectacle, with the British government having decided after one day of the two-week tournament to suspend its experiment to have fans back inside venues as part of the loosening of COVID-19 lockdown rules.

A limited number of spectators will be present for the final, although for most people it will be viewed as it has always been, from the comfort of an armchair with a regular supply of tea and biscuits, or something stronger.

When the pandemic forced organisers to postpone the championship in April, it deprived millions of locked-down Britons the reassuring click of colliding snooker balls.

LOCKDOWN SPORT

Thankfully this year’s event was given a new late July slot and with the country still mired in a health crisis, the kings of the green baize have provided a much-needed distraction from the daily diet of coronavirus updates.

Unlike soccer matches, in which empty stadiums stand out like a sore thumb, snooker is the perfect lockdown sport. By nature it is played in silence with applause traditionally reserved for the conclusion of breaks or for special shots.

Some players, the likes of O’Sullivan attract more raucous followings, as was the case with past greats Jimmy ‘Whirlwind’ White and Higgins. But the hushed arena creates its own energy.

Given Friday’s incredible semi-finals, it would surely be asking too much for this weekend’s decider to come anywhere close to Taylor’s ‘black ball’ decider against Davis in 1985 — the climax of which was watched by one third of Britain’s population — still a post-midnight viewing record.

Davis had led underdog Taylor 8-0 but the Northern Irishman, sporting comical-looking upside-down glasses for better vision, hauled himself back. After two gruelling days the final went down to the final black of the final frame.

At one point Taylor even approached the trophy and said a prayer and when Davis missed a black he would have made 99 times out of 100, it seemed divine intervention was at work.

The 36-year-old duly sunk the black and as the crowd erupted he brandished his cue above his head in a celebration that has become part of British TV folklore.

It was the peak of snooker’s popularity when the players were as popular as today’s Premier League footballers.

They even made a hit record with much-loved pop duo Chas and Dave called Snooker Loopy.

Those heady days of table-top pantomime when players wore suits like the Bee Gees, dragged on cigarettes and downed pints of beer while sitting at their chairs have gone for good.

These days its the preserve of clean-cut, ultra-professional cuemen donning sponsors’ logos on their tailored suits.

Televised snooker no longer stops the country in its tracks but, as Friday proved, the geometric wizardry of the world’s top potters is still an addictive spectacle.

(Reporting by Martyn Herman, editing by Pritha Sarkar)





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The enduring whiteness of the Fed


Fortune takes on the racial wealth gap, the Fed has a white man problem, Disney finally retires Uncle Remus, and Ursula Burns knows you know the answer to your own damn question.

But first, here is your racist-erasing week in review, in Haiku.

Pity the sweet cup,
once a health care hero. Will
it go the way of

The Chicks? Good-bye to
racism there in plain sight, 
hello, Lady A!

Go on now, Sambo,
PlantationsGeneral Lee,
and dead Indians!

Don’t come around here
asking for Eskimo Pies
(But keep this guy, please.)

Take care: What’s in a
name is also in your heart.
Keep Breonna close.

Ellen McGirt
@ellmcgirt
Ellen.McGirt@fortune.com

By the way: Fortune is looking for submissions for our 40 Under 40 list — this is a special year of transformation and breakthrough leadership. We’re looking for stars in all sectors, so share your heroes here.





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The enduring history of health care inequality for black Americans


It’s tempting to think that the coronavirus pandemic sees no color. This is, after all, a pathogen. A virus. A virus infects a host, and it spreads with no regard for who or what unto it may latch.

But the numbers tell a different story—a tale that’s a depressing continuation of longstanding health care disparities for people of color in general and black Americans in particular.

The racial COVID conundrum

COVID-19 has a disproportionate impact on black Americans. That’s a basic reality that’s become clear over the past few months of the pandemic. While black people constitute just 13% of the U.S. population, nearly one in four COVID-19 deaths where the patient’s race is known is black, according to the COVID Tracking Project’s racial data initiative.

Of the 20 U.S. counties with the highest COVID-related death rates, eight of them were regions with predominantly black residents.

Credit: COVID Tracking Project
COVID Tracking Project

Surveys underscore how much further the crisis extends. “You see these disparities play out particularly acutely during the COVID crisis,” says Jennifer Benz, principal research scientist and deputy director of The Associated Press-NORC Center for Public Affairs Research at the University of Chicago. “One of our key measures that illustrates the racial and ethnic disparities is asking people if they have a family member or close friend who they know has died from COVID. And the differences are incredibly stark.”

Across the U.S., about 4% of white Americans surveyed know somebody who’s died from COVID-19 versus 11% of black Americans. It can vary from region to region, and the disparity is even larger in certain areas as reflected in the COVID Tracking Project data. In Atlanta, 4% of whites versus 14% of blacks know someone who has died from COVID. The figures are similar in Baltimore and even worse in Birmingham.

The precise reason for these stark disparities is nebulous. Genetics may play a part, to an extent. But numerous other factors may come into play.

“The outcomes are so much worse when people have other pre-existing conditions. Decades of research have shown the disproportionate rate at which black Americans have heart disease, diabetes, hypertension, and other such conditions,” says Benz. “And then you begin to see how all these longstanding inequities fit together in the puzzle that is COVID.”

A perfect storm of health inequities

The “nature versus nurture” debate has raged for decades. If someone develops heart disease or another chronic condition, is it their fault because they ostensibly chose to eat unhealthy foods, smoke cigarettes, drink alcohol, or not exercise? Or is that a far more complicated issue that stems from years of systemic inequities?

Bernard Tyson, the late CEO of nonprofit health giant Kaiser Permanente, was an ardent evangelist for the theory of the “social determinants of health” which lays significant blame on the latter proposition.

“We think all the ingredients are in place to move into other lanes that are directly linked to the health and wellbeing of people that would not fit neatly under the category of ‘health care,’ but that are part of the whole ecosystem of health,” he told Fortune a year before his untimely death. “And we now know that the social determinants of health—many of the other categories that we haven’t really addressed concretely—impact a person’s health much more than medical care. One of the big ones is the thing called the zip code. Literally, you can see the differences in the life expectancy in one zip code versus another.”

“Somebody’s zip code can be so predictive of what health outcomes they face. It’s not just individual choices, but one’s environment and the policy structures within which they live their lives,” adds Benz.

A zip code can mean the difference between living in a region with abundant access to supermarkets that sell fresh produce versus food deserts where one must rely on a corner store or bodega for nutrition. A lack of socioeconomic opportunity may spell the difference between being able to prepare a home cooked meal or working the graveyard shift. A 2018 Environmental Protection Agency (EPA) analysis found that black people “had 1.54 times higher burden” in exposure to PM 2.5, an air pollutant created by burning fossil fuels that’s linked with heart disease, lung disease, and generally shorter life spans.

In the COVID era, these are all factors that play into the inequities clearly on display.

A persisting history of medical discrimination

Americans have swung sharply in support of the Black Lives Matter movement in the wake of George Floyd’s killing by a white police officer. A survey by Fortune and Deloitte of 222 CEOs found that 62% of the chief executives are planning tangible policy challenges in their workplaces as a response to the protests and unrest.

Coronavirus cases have risen as states reopen, and some officials have pointed to the impact of the socially undistanced Black Lives Matters protests. Officials have encouraged protestors to isolate, wear masks, and get tested after attending group events—but black Americans are less likely to have access to testing facilities. It’s also unclear whether or not an open air protest where people are properly masked or distanced and taking other precautions is nearly as much of a problem as being in enclosed spaces unmasked.

The public cognizance of systemic racism when it comes to police brutality, though, doesn’t appear to extend to medicine.

“A lot of Americans aren’t even aware that these disparities in health care exist,” says Benz. University of Chicago’s NORC conducted a series of studies in the early 2000s and 2010s finding that while more than 70% of respondents believed black people were treated more unfairly than white people when it came to interactions with police, just 42% said the same of access to health care.

Multiple studies paint a different reality. Black Americans consistently face fewer opportunities to get medical care and, even if they do, tend to receive substandard care or face discrimination based on antiquated stereotypes and communication barriers.

“Physicians use clusters of information in making diagnostic and other complex judgments that must be arrived at without the luxury of the time and other resources to collect all the information that might be relevant,” reads a sweeping report by the Institute of Medicine (US) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. “These conditions of time pressure and resource constraints are common to many clinical encounters, and map closely onto those identified as producing negative outcomes due to lack of information, to stereotypes, and to prejudice.”

A separate study from Johns Hopkins concludes that “communication skills training programs targeting emotion-handling and rapport-building behaviors are promising strategies to reduce disparities in health care and to enhance trust among ethnic minority patients.”

In other words: A largely white physician force doesn’t necessarily know the best ways to interact with black patients, and that leads to an inherent dearth of trust—the beating heart of medical decision-making.

And then there’s access to health care itself. While the Affordable Care Act, also known as Obamacare, significantly ramped up government programs such as Medicaid, the insurance option for poor or disabled Americans, its benefits were asymmetric. States had the option to choose to expand Medicaid under the law. The few states which have not expanded Medicaid tend to be poor states in the South, which has an outsize effect on communities of color, according to the nonpartisan Kaiser Family Foundation.

Then there were the 2.3 million Americans who fell into the so-called “coverage gap” where they made just enough money not to qualify for Medicaid but not quite enough to receive Obamacare’s subsidies for individual private plans.

Credit: Kaiser Family Foundation
Kaiser Family Foundation

Southern states with large black populations, particularly Texas and Florida, have some of the biggest gaps in coverage.

The financial catastrophe wrought by the coronavirus pandemic certainly hasn’t made things easier. Nearly half of Americans receive health insurance through their employer, a result of a series of historical accidents which have linked insurance to having a job.

The most recent federal jobs report found that black Americans, and black women in particular, have borne the brunt of the unemployment crisis. While the unemployment rate dipped from 14.2% to 12.4% for white people in May, it rose from 16.7% to 16.8% for black people.

There’s no doubt that health is based on a combination of choice and chance. Our biological machinery can lead to arbitrary outcomes which are the fault of no one. But for many black Americans, the “choices” were made by others on their behalf long ago.

More coverage on the intersection of race and business from Fortune:



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