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Human Rights Watch Testimony to US House of Representatives Ways and Means Committee

Covid-19 Disparities Reflect Structural Racism, Abuses

Introduction

Thank you for the opportunity to submit this written testimony on the disproportionate impact of Covid-19 on communities of color in the United States. Human Rights Watch recommends the Committee address this crisis by recognizing that racial disparities in illness and death from Covid-19 are inextricably linked to failures at all levels of government in the United States to fully protect the human rights of Black and brown people, as well as government policies over generations that have directly contributed to racial disparities across multiple systems—health, education, housing, and criminal justice, among others. These disparities compound each other in ways that exacerbate the vulnerability of people of color to Covid-19.

Based on decades of investigations and advocacy in the United States, Human Rights Watch’s submission analyzes the links between current disparities in Covid-19 and racial disparities in protecting: (1) The right to health for communities of color, especially for women of color; (2) The rights to water and sanitation for communities of color; (3) The right to be free from racial segregation; (4) The right to be free from racially discriminatory and unnecessary policing and incarceration; (5) The right to safe and healthy working conditions; and (6) The right to the highest attainable standard of living. The United States is obligated under international human rights law to overcome the longstanding structural discrimination that is evident in Covid-19’s disparate racial impact.[1]

Right to health for communities of color, and especially for women of color

Racial disparities in the enjoyment of the right to health[2] in the United States are stark.[3] Black Americans are significantly more likely to die of HIV, cancer, asthma, stroke, heart disease, diabetes, obesity and maternal mortality than white Americans.[4] Blacks are more likely than whites to be living below the poverty level and less likely to have health insurance.[5] In the midst of a national overdose crisis, Black people in the US are disproportionately likely to be arrested for possessing drugs for personal use, and less likely to receive voluntary drug treatment.[6] Black and brown people are also more likely to experience the impacts of air pollution.[7]

These disparities are in part driven by government policies, including a historic underinvestment in health in communities of color. Rates of insurance are dropping, starting before the pandemic and accelerating in the last few months, with people of color particularly impacted.[8] In the absence of insurance, the cost of medical care may keep people from seeking treatment.[9] In addition, unethical experimentation by the scientific community has caused severe trauma and distrust of medical institutions among Black people in the United States.[10]

These factors and systemic racial disparities in other areas, translate into disparate health outcomes for people of color. This is particularly evident with Black women in the United States.

Black women are more likely to live in poverty and face multiple barriers to health, including lack of access to health insurance, adequate housing, transportation, and employment.[11] Implicit bias and structural racism in the medical field also impact the quality of care and responsiveness to health concerns that women of color receive, contributing to racial disparities in health.

Black women are more than three times as likely to die from pregnancy-related complications as white women in the US.[12] Research has also shown that low-income women and women of color are more likely to die from cervical cancer than white women. In Alabama, for example, Human Rights Watch’s research found that racial discrimination and state neglect of women living in poverty contributed to high cervical cancer mortality rates for Black women, leaving them twice as likely to die from cervical cancer as white women in the state.[13] Black women are also more likely to suffer from chronic illnesses, such as diabetes and hypertension, putting them at a greater risk of complications arising from Covid-19.

The same racial inequities that lead to disparate health outcomes in other areas are also contributing to more severe illness and rates of infection from Covid-19 for people of color. People of color—particularly women—are overrepresented in low-wage service jobs that put them on the front lines of the pandemic and often in close contact with others. One analysis found that women of color disproportionately work as maids, nursing assistants, and personal care and home health aides.[14] Among families with children, women of color are also more likely to be the breadwinner and are also less likely to have the savings and financial resources to deal with a reduction of income or job loss caused by the pandemic, often leaving them with no choice but to continue working in conditions which increase exposure to the virus.

In turn, the Covid-19 pandemic itself exacerbates barriers to accessing adequate and quality health care. Reliance on public transportation, at a time when it is not safe, and a lack of reliable internet access for telemedicine when in-person appointments may not be available or safe create greater challenges to accessing necessary healthcare for low-income people and people of color, especially those living in rural areas in the United States where access to medical care, including obstetric care, is limited and often requires traveling far distances.

Policies put in place by healthcare systems to respond to the pandemic — including those limiting support to people during labor and delivery and encouraging early discharge after childbirth,[15] which is already more deadly for Black women — also compound with structural racism in the medical field to increase the risk of adverse health outcomes faced by women of color during the Covid-19 pandemic.

Right to water for communities of color

Access to safe and affordable water is essential to human health, and to following basic recommendations issued by US federal and independent public health experts on hand hygiene and Covid-19.[16] Despite this, communities of color, especially Native Americans living on reservations, are facing Covid-19 without adequate access to water.[17]

Despite the country’s wealth, many people in the United States live with unsafe drinking water. According to a UN expert, the United States ranks 36th in the world in terms of access to water and sanitation.[18] Reports estimate that nearly 77 million US residents are served by drinking water systems with one or more violations of the federal Safe Drinking Water Act.[19] While the data are not available to disaggregate this number by race or income, we know that race and income are central factors in both urban and rural water vulnerabilities.[20]

The human right to water is derived from the right to the highest attainable standard of living.[21] However, the US government and state and municipal authorities have refused to acknowledge this basic right to water.[22] In 2014, a US federal judge in Michigan ruled that there was “no enforceable right” to water after the city of Detroit started massive shut-offs of household water supplies if people did not pay their water bills.[23]

The case of Flint, Michigan is well known.  Under state-appointed emergency management, Flint switched its water source from Lake Huron to the Flint River as a cost-savings measure in 2014, causing the number of children with elevated lead levels in their blood to double—and in some neighborhoods to triple—after the water supply switch.[24] The disaster in Flint (a city with 40 percent of its population living below the poverty line, and with 53 percent of its residents identifying as Black),[25] is just one of many ways the rights to water and sanitation have been jeopardized in the United States, disproportionately affecting people of color, women and children, and with clear links to the racial disparities evident in the Covid-19 pandemic.[26]

Discontinuing water services for being unable to pay is incompatible with human rights and can be particularly harmful in the context of public health crises like the Covid-19 pandemic. Governments and utilities, like those in Detroit since 2014, have a history of mass shut-offs for inability to pay.[27] Detroit has recently been spotlighted for failing to reconnect households—mostly in communities of color—that had been shut off prior to the pandemic, leading some activists to call for a broad movement under the hashtag #KeepWaterOn.[28] 

Right to be free from racial segregation

There are ample research findings indicating correlation between high rates of racial segregation and poor health outcomes in the United States.[29]  This is now evident in the context of the Covid-19 crisis.

To take one example from the southeastern corner of Wisconsin, the city of Milwaukee is the second most segregated city in the United States, according to US Census data.[30] Poverty and race are in lockstep in most neighborhoods in southeastern Wisconsin,[31] and the region is showing early evidence of the links between racial segregation and higher incidence of Covid-19 morbidity and mortality.[32] The city of Milwaukee has pronounced racial segregation and extreme racial disparities in deaths from Covid-19.[33] Experts have analyzed the correlations between race, neighborhoods, and Covid-19 infections in Milwaukee, finding that “the prevalence of the virus in individual neighborhood areas appears to correlate with neighborhood demographics, especially race and income.”[34] Four of the five Wisconsin counties with the highest numbers of positive cases and deaths from Covid-19 are located in the southeastern region, comprising Milwaukee, Racine, Kenosha, and Waukesha counties.[35] Wisconsin ranks in the top eight states for racial disparities between death rates for Black and white people and in the top three for disparities between death rates for Latino and white people.[36] Black people represent 6 percent of Wisconsin’s population, but to date 28 percent of people who have died from Covid-19 in the state.[37]

Right to be free from racially discriminatory and unnecessary policing and incarceration

Incarceration significantly increases the risks of infection with Covid-19.[38]  Custodial arrests, which involve direct contact and incarceration, also pose heightened risk. Black and brown people are disproportionately subject to arrest and incarceration in the United States, with Black people being incarcerated at a rate approximately five times greater than white people.[39] Despite repeated calls by advocates for significant releases of people from jails and prisons and calls for rollbacks in custodial arrests, inadequate safety procedures and authorities’ failure to use discretionary release from prisons and jails have led to outbreaks and endangered the health and lives of many incarcerated people, disproportionately people of color.[40]

Studies have also linked racially discriminatory policing and incarceration[41] to increased stress, anxiety, depleted economic opportunities, and poor health outcomes among Black people.[42] In turn, poor health may increase the vulnerability of people of color to Covid-19.

The May 25, 2020 killing of George Floyd in Minneapolis is the latest in a long history of killings of Black people by police in the United States with little or no accountability. In recent years, these include Eric Garner, Philando Castile, Alton Sterling, Delrawn Small, Terence Crutcher, Breonna Taylor, and many others. In other cases, police or prosecutors have refused to properly investigate killings of Black people, like that of Ahmaud Arbery, a 25-year-old Black man killed in February by two white men as Arbery was jogging in Georgia.[43]

Police across the United States use force and engage in abuses that do not cause death but are harmful and pervasive, especially toward Black people. Police use force on Black people at vastly higher rates than on white people, including tasers, dog bites, batons, punches, and kicks.[44]

In 2019, Human Rights Watch investigated policing, poverty and racial inequality in Tulsa, Oklahoma, a city with a history of racial oppression stemming from a 1921 race massacre during which an estimated 300 Black people were killed, through the period of legalized segregation and on to the de facto segregation that currently exists.[45]  We found that Black people in Tulsa are disproportionately exposed to police detention, searches, citations, arrests and physical violence, including deadly force, as compared to white people.[46] Officers in Tulsa deployed tasers against Black people at a rate almost 3 times as great as against white people and Black people were subjected to police violence 2.7 times as frequently.[47]

Abusive policing also includes unnecessary and harassing detentions and searches, often driven by racial bias. [48] Since Black people are disproportionately arrested, they disproportionately bear the brunt of criminal fines and fees imposed as a part of the criminal system, which can force people to forgo meeting basic needs—including those related to health.[49] Their children are also disproportionately impacted: One in nine Black children, compared to one in 14 children of all races, has experienced parental incarceration.[50] Incarceration and criminalization also create further barriers to accessing housing, education, health, and employment, trapping people in cycles of poverty and further compounding structural disparities that render people of color more vulnerable to Covid-19.

Throughout the United States, officials use police to respond to situations involving problematic substance use, homelessness, mental health issues, and poverty, rather than funding appropriate services to address these issues outside a policing context. Governments should vastly reduce their reliance on police and instead invest in housing, affordable and accessible health care, economic development, and education – initiatives that directly address the problems – instead of criminalizing people in need.

Right to safe and healthy working conditions

For low-income workers who are considered “essential,” the risk of exposure to Covid-19 is compounded by authorities’ failure to consistently ensure safe and healthy work conditions. A clear example are the many workers at meat and poultry plants across the United States who are battling for their health during the Covid-19 pandemic. Meat processing jobs are some of the country’s most dangerous, and many of the low-wage workers in these jobs are from marginalized communities, with many people of color and women making up their ranks.[51] Nearly one-third are immigrants, including a significant number who are undocumented. Plant workers depend on these jobs for themselves and their families, and fear losing them. Workers fear repercussions for voicing complaints, particularly threats to their immigration status and their employment. Failure to protect the right to safe and healthy working conditions[52] in US meat and poultry plants is inextricably linked to high rates of Covid-19 infection among meat and poultry workers.[53]

Right to an adequate standard of living

US economic inequality is closely linked to a racial divide in income and wealth. Incomes and wealth are lower, and poverty is most acute among Black people and Latinos. About 21 percent of Black people and 18 percent of Hispanic people live under the poverty line, compared with eight percent of white people.[54] The median white household has 41 times more wealth[55] (measured as the sum of assets held by a family minus total household debt) than the median Black family and 22 times more than the median Latino family.[56] Past recessions have disproportionately affected Black and Latino families, partly because they have less wealth to fall back on.

In addition to being more likely to work in “essential” jobs, which increase their risk of contracting Covid-19, people of color are more likely to need to use public transportation and to live in close quarters, where it is hard to do effective social distancing.

People of color may also suffer more severe economic impacts as a result of the Covid-19 pandemic.[57] Those impacts are exacerbated by the practices of predatory lenders who take advantage of the economic crisis through small dollar loans at exorbitant interest rates, which in turn can prevent people from meeting their basic needs necessary for an adequate standard of living.[58] Payday, vehicle title, and other predatory lenders target poor communities and Black neighborhoods in particular.[59] Many people take these loans to cover routine costs, like food, utilities, and rent.[60] These loans, many with three-digit interest rates, can trap people in a cycle of debt, with new loans needed to keep up with the late payments and fees. The average length in debt is about five months but can extend for much longer.[61] One study found that Black people are more than twice as likely to use payday loans than other races or ethnicities, and that race is a stronger predictor of who takes out a payday loan than income.[62] The impacts of growing debt, particularly predatory loans, on communities of color can have long ranging impacts, entrenching and growing the racial wealth gap in this country and cementing racial disparities in health and well-being.

Under international human rights law, governments are obligated to protect the right to an adequate standard of living.[63] Yet across the country, governments are planning further cuts to an already fragile safety net, and the economic measures adopted by this Congress have not consistently focused on the Black, brown, low-income, and immigrant communities that need the most support.[64]

***

The US failure to protect the basic human rights of communities of color provides a stark and troubling explanation for the current disproportionate suffering from the Covid-19 pandemic. The way forward is to ensure the human rights of all people, and to adopt concrete measures designed to eliminate the structural racism that permeates many institutions and aspects of life in the United States. This includes, but is not limited to, the following:

  • Ensuring that federal assistance packages related to Covid-19 focus on helping those most in need, such as people of color living in poverty, and do not leave out segments of the population, such as immigrants.
  • Targeting federal appropriations to programs designed to overcome racial disparities in a variety of systems, including housing, health, education, access to employment, and access to capital.
  • Pressing state and local governments, including through conditioning federal resources, to move away from policing as a solution to social problems and to invest resources in communities—with a particular focus on communities of color—instead. This should include protecting rights to health, water, safe and healthy working conditions, housing, and an adequate standard of living.
  • Promptly reducing federal jail and prison populations to the point, at a minimum, at which all people in the facilities can engage in social distancing without resorting to punitive conditions that resemble solitary confinement, and the facility has enough available space to put all people who are ill or close contacts of those who are ill in non-punitive quarantine or isolation with access to appropriate medical care. Incentivize state and local facilities to do the same with their prison and jail populations.
  • Passing House Resolution (H.R.) 40, the Commission to Study and Develop Reparation Proposals for African-Americans Act, and establish an expert commission to collect data and produce studies on persistent racial disparities in the United States at large.

[1] International Convention on the Elimination of All Forms of Racial Discrimination (ICERD), adopted December 21, 1965, GA Res. 2106 (XX), annex, 20 UN GAOR Supp. (No. 14) at 47, UN Doc. A/6014 (1966), 660 UNTS 195, entered into force January 4, 1969, ratified by the United States on November 20, 1994; UN Committee on the Elimination of Racial Discrimination, “Racial Discrimination Against People of African Descent,” General Comment 34, (2011), https://www.refworld.org/docid/4ef19d592.html (accessed June 9, 2020), paras. 5, 6, 7, 50.

[2] The International Covenant on Economic Social and Cultural Rights (ICESCR) recognizes “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.” International Covenant on Economic, Social and Cultural Rights (ICESCR) adopted December 16, 1966, GA Res. 2200A (XXI), UN GAOR (no. 16) at 49, UN Doc. A/6316 (1966), 99 UNTS 3, entered into force January 3, 1976, signed by the US on October 5, 1977. As a signatory, the US government must refrain from taking steps that undermine the “object and purpose” of the treaty.  Vienna Convention on the Law of Treaties, May 23, 1969 (entry into force January 27, 1980), article 18. According to the Committee on Economic Social and Cultural Rights, the right to health means health services, goods and facilities should be available, accessible, acceptable and of good quality, without discrimination. Committee on Economic Social and Cultural Rights, “The Right to the Highest Attainable Standard of Health,” General Comment No. 14, U.N. Doc. E/C.12/2000/4 (2000), para. 12. The right to racial equality in access to public health is protected in article 5 of ICERD.

[3] Kaiser Family Foundation, “Key Facts on Health and Health Care by Race and Ethnicity,” June 7, 2016, https://www.kff.org/disparities-policy/report/key-facts-on-health-and-health-care-by-race-and-ethnicity/ (accessed June 13, 2019).

[4] National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Community-Based Solutions to Promote Health Equity in the United States; A. Baciu, Y. Negussie, A. Geller, et al., editors, Communities in Action: Pathways to Health Equity, (US: National Academies Press, January 11, 2017), ch. 2, https://www.ncbi.nlm.nih.gov/books/NBK425844/ (accessed June 4, 2020); Human Rights Watch, “Valuing Black Women’s and Infant’s Lives,” https://www.hrw.org/news/2018/04/13/valuing-black-womens-and-infants-lives-us (accessed June 4, 2020); Centers for Disease Control and Prevention, National Vital Statistics System, “Deaths: Final Data for 2017,” Vol. 68, No. 9 (2019), https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf (accessed June 4, 2020).

[5] Families USA, “African-American Health Disparities Compared to Non-Hispanic Whites,” January 2019, https://familiesusa.org/product/african-american-health-disparities-compared-to-non-hispanic-whites (accessed June 4, 2020).

[6] Kaiser Health News, “White Patients 35 Times More Likely to Receive Addiction Medication than African-American Ones,” May 9, 2019, https://khn.org/morning-breakout/white-patients-35-times-more-likely-to-receive-addiction-medication-than-african-american-ones/ (accessed June 13, 2019); Vann R. Newkirk II, “America’s Health Segregation Problem,” The Atlantic, May 18, 2016, https://www.theatlantic.com/politics/archive/2016/05/americas-health-segregation-problem/483219/ (accessed June 13, 2019); James Hamblin, “The Race Problem in Medicine,” The Atlantic, December 10, 2014, https://www.theatlantic.com/health/archive/2014/12/the-race-problem-in-medicine-race/383613/ (accessed June 13, 2019).

[7] Human Rights Watch, “Air Pollution in US Exacerbates Covid-19 Dangers,” April 20, 2020, https://www.hrw.org/news/2020/04/20/air-pollution-us-exacerbates-covid-19-dangers (accessed June 10, 2019).

[8] Jennifer Tolbert, Kendal Orgera, Natalie Singer, and Anthony Damico, “Key Facts about the Uninsured Population,” Kaiser Family Foundation, December 13, 2019, https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/(accessed June 4, 2019).

[9] Human Rights Watch, “US: Ensure Affordable Covid-19 Treatment,” March 20, 2020, https://www.hrw.org/news/2020/03/20/us-ensure-affordable-covid-19-treatment (accessed June 4, 2020).

[10] Austin Frakt, “Race and Medicine: The Harm That Comes from Mistrust,” The New York Times, January 13, 2020, https://www.nytimes.com/2020/01/13/upshot/race-and-medicine-the-harm-that-comes-from-mistrust.html (accessed June 9, 2020); Human Rights Watch, It Should Not Happen: Alabama’s Failure to Prevent Cervical Cancer Death in the Black Belt, November 29, 2018, https://www.hrw.org/report/2018/11/29/it-should-not-happen/alabamas-failure-prevent-cervical-cancer-death-black-belt (accessed June 9, 2020).

[11] National Partnership for Women and Families, “Black Women’s Maternal Health: A Multifaceted Approach to Addressing Persistent and Dire Health Disparities,” April 2018, https://www.nationalpartnership.org/our-work/health/reports/black-womens-maternal-health.html (accessed June 3, 2020).

[12] Petersen EE, Davis NL, Goodman D, et al. “Racial/Ethnic Disparities in Pregnancy-Related Deaths — United States, 2007–2016,” MMWR and Morbidity and Mortality Weekly Report (2019): 68, doi: http://dx.doi.org/10.15585/mmwr.mm6835a3external icon (accessed June 3, 2020); Centers for Disease Control and Prevention, “Racial and Ethnic Disparities Continue in Pregnancy-Related Deaths,” https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html (accessed June 3, 2020).

[13] Human Rights Watch, It Should Not Happen: Alabama’s Failure to Prevent Cervical Cancer Death in the Black Belt, November 29, 2018, https://www.hrw.org/report/2018/11/29/it-should-not-happen/alabamas-failure-prevent-cervical-cancer-death-black-belt (accessed June 9, 2020).

[14] Center for American Progress, “On the Frontlines at Work and at Home: The Disproportionate Economic Effects of the Coronavirus Pandemic on Women of Color,” April 2020, https://www.americanprogress.org/issues/women/reports/2020/04/23/483846/frontlines-work-home/ (accessed May 29, 2020).

[15] Center for Reproductive Rights, “Safeguarding Maternal Health and Rights in the United States During the COVID-19 Pandemic,” May 2020, https://reproductiverights.org/sites/default/files/documents/Safeguarding%20Maternal%20Health%20and%20Rights%20in%20the%20United%20States%20During%20the%20COVID-19%20Pandemic.pdf (accessed June 3, 2020).

[16] Centers for Disease Control and Prevention, “Hand Hygiene Recommendations,” https://www.cdc.gov/coronavirus/2019-ncov/hcp/hand-hygiene.html (accessed June 3, 2020).

[17] Heather Hansmann, “How a Lack of Water Fueled COVID-19 in Navajo Nation,” Outside On Line, https://www.outsideonline.com/2413938/navajo-nation-coronavirus-spread-water-rights (accessed June 4, 2020); Grace Baek, “Navajo Nation residents face coronavirus without running water,” CBS News, May 8, 2020, https://www.cbsnews.com/news/coronavirus-navajo-nation-running-water-cbsn-originals/ (accessed June 4, 2020).

[18] United Nations Office of the High Commissioner for Human Rights, “Statement on Visit to the USA, by Professor Philip Alston, United Nations Special Rapporteur on Extreme Poverty and Human Rights,” December 15, 2017, https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=22533&LangID=E (accessed June 4, 2020).

[19] Natural Resources Defense Council, “Threats on Tap: Widespread Violations Highlight Need for Investment in Water Infrastructure and Protections,” May 2, 2017, https://www.nrdc.org/resources/threats-tap-widespread-violations-water-infrastructure (accessed June 4, 2020).

[20] Dig Deep, US Water Alliance, Closing the Water Access Gap in the United States, https://closethewatergap.org/ (accessed June 4, 2020).

[21] The right to water entitles everyone, without discrimination, to have access to sufficient, safe, acceptable, physically accessible, and affordable water for personal and domestic use. Various resolutions from the UN General Assembly and Human Rights Council affirm that the right to safe drinking water is derived from the right to an adequate standard of living. The right to an adequate standard of living is enshrined in the ICESCR, a human rights treaty signed by the United States. The Committee on Economic, Social and Cultural Rights is the UN body responsible for monitoring compliance with the ICESCR. UN Committee on Economic, Social and Cultural Rights, General Comment No. 15, The Right to Water, U.N. Doc. E/C.12/2002/11(2003), para. 12(b). See also UN General Assembly, “The human rights to safe drinking water and sanitation,” Resolution 70/169, U.N. Doc. A/RES/70/169/ (February 22, 2016); UN Human Rights Council resolution 15/9 of September 2010, Resolution 16/2 of March 2011, Resolution 18/1 of September 2011 and Resolution 21/2 of September 2012.

[22] Amanda Klasing, “Water Is a Human Right – in Flint, in Michigan, and the US,” commentary, Human Rights Watch Dispatch, July 11, 2018, https://www.hrw.org/news/2018/07/11/water-human-right-flint-michigan-and-us (accessed June 2, 2020). In 2015, the United States finally joined the consensus at the United Nations General Assembly in acknowledging that the right to water entitled everyone “to have access to sufficient, safe, acceptable, physically accessible and affordable water for personal and domestic use.” “Joint Statement from Amnesty International, Human Rights Watch, and WASH United on UN General Assembly Resolution 70/169 on the Human Rights to Water and to Sanitation,” Human Rights Watch news release, December 17, 2015, https://www.hrw.org/news/2015/12/17/joint-statement-amnesty-international-human-rights-watch-and-wash-united-un-general (accessed June 9, 2020). However, the US has not accepted that the right to water applies in the US, nor that it is related to any rights that do apply in the US. In 2019, the US mission to the United Nations stated that it “disagree[s] with any assertion that the right to safe drinking water and sanitation is inextricably related to or otherwise essential to enjoyment of other human rights, such as the right to life as properly understood under the International Covenant on Civil and Political Rights (ICCPR).” https://usun.usmission.gov/united-states-statement-on-agenda-item-70-the-human-rights-to-safe-drinking-water-and-sanitation/ (accessed June 8, 2020).

[23] Amanda Klasing, “Dispatches: Detroit, US Out of Step on Right to Water,” commentary, Human Rights Watch Dispatch, October 1, 2014, https://www.hrw.org/news/2014/10/01/dispatches-detroit-us-out-step-right-water (accessed June 2, 2020).

[24] Human Rights Watch, The Human Right to Water, October 23, 2019, https://www.hrw.org/report/2019/10/23/human-right-water/guide-first-nations-communities-and-advocates#3119.

[25] US Census Bureau, QuickFacts, https://www.census.gov/quickfacts/flintcitymichigan (accessed June 5, 2020).

[26] Amanda Klasing (Human Rights Watch), “What Brazil could teach US about Zika,” Op-ed, CNN, August 21, 2017, https://www.hrw.org/news/2017/08/21/what-brazil-could-teach-us-about-zika.

[27] Human Rights Watch, “Detroit, US Out of Step on the Right to Water,” October 1, 2010, https://www.hrw.org/news/2014/10/01/dispatches-detroit-us-out-step-right-water (accessed June 2, 2020).

[28] Poppy Noor, “Detroit Families Still without Clean Water Despite Shutoffs Being Lifted,” The Guardian, May 20, 2020, https://www.theguardian.com/us-news/2020/may/20/detroit-water-shutoffs-covid-coronavirus (accessed June 4, 2020).

[29] SA Jackson, RT Anderson, NJ Johnson, PD Sorlie, “The Relation of Residential Segregation to All-cause Mortality: a Study in Black and White,” American Journal of Public Health; Vol. 90, No. 4, (2000), p. 615–7; MA Bravo, R Anthopolos, RT Kimbro, ML Miranda,  “Residential Racial Isolation and Spatial Patterning of Type 2 Diabetes Mellitus in Durham, North Carolina,” American Journal of Epidemiology, Vol. 187 No. 7, (2018), p. 1467–7; R. Anthopolos, SA James, AE Gelfand, ML Miranda, “A Spatial Measure of Neighborhood Level Racial Isolation Applied to Low Birthweight, Preterm Birth, and Birthweight in North Carolina,” Spat Spatio-Temporal Epidemiology, Vol. 2 No. 4, (2011), p. 235–46; MO Hearst, JM Oakes, PJ Johnson PJ, “The Effect of Racial Residential Segregation on Black Infant Mortality,” American Journal of Epidemiology, Vol. 168 No. 11, (2008), p. 1247–54. The human right to be free from racial segregation is enshrined in article 3 of the International Convention on the Elimination of All Forms of Racial Discrimination (ICERD). The international expert body charged with interpreting and applying the ICERD to state practice has stated that racial segregation that violates the ICERD can originate “as an unintended by-product of the actions of private persons.” Committee on the Elimination of Racial Discrimination, “The Prevention, Prohibition and Eradication of Racial Segregation and Apartheid,” General Recommendation 19, U.N. Doc. A/50/18 at 140 (1995), http://hrlibrary.umn.edu/gencomm/genrexix.htm (accessed June 9, 2020). 

[30] American Communities Project, Brown University, “Diversity and Disparities,” 2010, https://s4.ad.brown.edu/Projects/Diversity/SegSorting/Default.aspx (accessed June 4, 2020).

[31] Federal Reserve Bank of Chicago, Housing Opportunity Partnership for Southeast Wisconsin, “Sprawl, Race, and Concentrated Poverty in Southeast Wisconsin,” April 2001, https://www.chicagofed.org/~/media/others/utilities/about-us/cca/sprawl-race-and-concentrated-poverty-in-southeast-wisconsin-pdf.pdf, (accessed June 4, 2020).

[32] Teran Powell, “Milwaukee’s Covid-19 Spread Highlights the Disparities Between White and Black,” The Guardian, April 14, 2020, https://www.theguardian.com/world/2020/apr/14/milwaukees-covid-19-spread-highlights-the-disparities-between-white-and-black (accessed June 2, 2020).

[33] Ibid.

[34] Center for Economic Development, University of Wisconsin-Milwaukee, “Milwaukee’s Coronavirus

Racial Divide,” https://uwm.edu/ced/wp-content/uploads/sites/431/2020/04/COVID-report-final-version.pdf (accessed June 2, 2020).

[35] Wisconsin Department of Health Services, “Covid-19: Mapped Deaths by County, updated June 7, 2020,” https://www.dhs.wisconsin.gov/covid-19/deaths-map.htm (accessed June 7, 2020).

[36] APM Research Lab, “The Color of Coronavirus: Covid-19 Deaths by Race and Ethnicity in the US,” May 27, 2020  https://www.apmresearchlab.org/covid/deaths-by-race (accessed June 7, 2020).

[37] Ibid.

[38] Human Rights Watch, “Averting an Imminent Catastrophe: Recommendations to US Local, State and Federal Officials to Covid-19 in Jails and Prisons,” April 29, 2020, https://www.hrw.org/news/2020/04/29/averting-imminent-catastrophe-recommendations-us-local-state-and-federal-officials (accessed June 2, 2020); Prison Policy Institute, “Responses to the COVID-19 Pandemic,” https://www.prisonpolicy.org/virus/virusresponse.html (accessed June 2, 2020).

[39] Leah Sakala, “Breaking Down Mass Incarceration in the 2010 Census: State-by-State Incarceration Rates by Race/Ethnicity,” Prison Policy Initiative, May 28, 2014, https://www.prisonpolicy.org/reports/rates.html (accessed June 2019). A recent survey found that 95 percent of US police departments arrested Black people at higher rates than white people, some as much as 10 times as frequently. Brad Heath, “Racial Gap in U.S. Arrest Rates: 'Staggering disparity,'” USA Today, https://www.usatoday.com/story/news/nation/2014/11/18/ferguson-black-arrest-rates/19043207/ (accessed June 2, 2020). Human Rights Watch has previously documented significant and unwarranted racial disparities in arrests of people for possessing drugs for personal use, with Black people using drugs at the same rate as white people yet being arrested in connection with that use nearly three times as often. Human Rights Watch, Every 25 Seconds: The Human Toll of Criminalizing Drug Use in the United States, October 12, 2016, https://www.hrw.org/report/2016/10/12/every-25-seconds/human-toll-criminalizing-drug-use-united-states.

[40] John Raphling (Human Rights Watch), “COVID-19 Running Rampant in Ohio Prisons,” Columbus Dispatch, May 21, 2020, https://www.dispatch.com/opinion/20200521/column-covid-19-running-rampant-in-ohio-prisons (accessed June 9, 2020).

[41] The human rights to be free from racially discriminatory, arbitrary and unnecessary arrest and incarceration are enshrined in articles 9 and 26 of the International Covenant on Civil and Political Rights (ICCPR), which the United States has ratified, and which guarantees the right to liberty and security of person and equal protection of the law. International Covenant on Civil and Political Rights, adopted December 16, 1966, G.A. Res. 2200A (XXI), 21 U.N. GAOR Supp. (No. 16) at 52, U.N. Doc. A/6316 (1966), 999 U.N.T.S. 171, entered into force March 23, 1976, ratified by the United States on June 8, 1992, http://www.ohchr.org/english/countries/ratification/4.htm (accessed June 10, 2020). US obligations under the ICCPR apply to the federal, state, and local governments.

[42] Joscha Legewie, “Police Violence and the Health of Black Infants,” Science Advances, December 4, 2019

Vol. 5, no. 12, https://advances.sciencemag.org/content/5/12/eaax7894 (accessed June 2, 2020); “Police Brutality and Black Health: Setting the Agenda for Public Health Scholars,” American Journal of Public Health, Vol. 107, No. 5, p. 662-665, https://www.unboundmedicine.com/medline/citation/28323470/Police_Brutality_and_Black_Health:_Setting_the_Agenda_for_Public_Health_Scholars (accessed June 2, 2020).

[43] Richard Fausset, “What We Know About the Shooting Death of Ahmaud Arbery,” The New York Times, https://www.nytimes.com/article/ahmaud-arbery-shooting-georgia.html (accessed June 2, 2020).

[44] The Center for Policing Equity, “The Science of Justice: Race, Arrests, and Police Use of Force,” https://policingequity.org/images/pdfs-doc/CPE_SoJ_Race-Arrests-UoF_2016-07-08-1130.pdf  (accessed June 2, 2020).

[45] A commission created by the Oklahoma state legislature in 1997 to study the massacre and make recommendations concluded in 2001 that reparations should be made but nearly 20 years later, neither state nor local authorities have done so. In 2020, Human Rights Watch called for such reparations in Tulsa. Human Rights Watch, “The Case for Reparations in Tulsa, Oklahoma,” May 29, 2020, https://www.hrw.org/news/2020/05/29/case-reparations-tulsa-oklahoma.

[46] Human Rights Watch, “Get on the Ground!”: Policing, Poverty, and Racial Inequality in Tulsa, Oklahoma, September 12, 2019, https://www.hrw.org/report/2019/09/12/get-ground-policing-poverty-and-racial-inequality-tulsa-oklahoma/case-study-us (accessed June 2, 2020)

[47] Ibid.

[48] Kirsten Weir, “Policing in Black & White,” American Psychological Association, December 2016, https://www.apa.org/monitor/2016/12/cover-policing (accessed June 2019).

[49] A 2017 investigation and report by the U.S. Commission on Civil Rights found that unchecked discretion or stringent requirements to impose fines or fees can lead and have led to discrimination and inequitable access to justice. The consequences of fines and fees can include driver’s license suspensions, which can be a barrier to employment, childcare, or getting to medical appointments. They also can force people to choose between paying fines or purchasing basic needs. U.S. Commission on Civil Rights, “Targeted Fines and Fees against Communities of Color,” September 2017, https://www.usccr.gov/pubs/2017/Statutory_Enforcement_Report2017.pdf (accessed June 2019),  pp. 35-36.

[50] David Murphey and Mae Cooper, “Parents Behind Bars: What Happens to Their Children,” Child Trends, October 2015, https://www.childtrends.org/wp-content/uploads/2015/10/2015-42ParentsBehindBars.pdf, p. 4, (accessed June 4, 2020). Human Rights Watch and the American Civil Liberties Union have documented that post-incarceration reunification of families can be impeded by the imposition of timelines and the lack of legal representation for parents in court, prolonging family separation. Human Rights Watch, You Miss So Much When You’re Gone: The Lasting Harm of Jailing Mothers Before Trial in Oklahoma, September 26, 2018, https://www.hrw.org/report/2018/09/26/you-miss-so-much-when-youre-gone/lasting-harm-jailing-mothers-trial-oklahoma. Black children are more likely to be removed from their families in circumstances where families with white children would receive support to help keep the family together. Dorothy Roberts & Lisa Sangoi, “Black Families Matter: How the Child Welfare System Punishes Poor Families of Color,” The Appeal, March 26, 2018, https://theappeal.org/black-families-matter-how-the-child-welfare-system-punishes-poor-families-of-color-33ad20e2882e/ (accessed June 4, 2020). Black children are overrepresented in the child welfare system with their population in foster care (23 percent) exceeding their population (14 percent) in the US. US Department of Health and Human Services Children’s Bureau, “Preliminary FY 2018 Estimates as of August 22, 2019,” https://www.acf.hhs.gov/sites/default/files/cb/afcarsreport26.pdf (accessed June 4 2020), p. 2; Kids Count Data Center, “Child Population by Race in the United States,” August 2018, https://datacenter.kidscount.org/data/tables/103-child-population-by-race#detailed/1/any/false/871,870,573,869,36,868,867,133,38,35/68,69,67,12,70,66,71,72/423,424 (accessed June 4, 2020).

[51] Human Rights Watch, When We’re Dead and Buried Our Bones Will Keep Hurting: Workers’ Rights Under Threat in US Meat and Poultry Plants, September 4, 2019, https://www.hrw.org/report/2019/09/04/when-were-dead-and-buried-our-bones-will-keep-hurting/workers-rights-under-threat (accessed June 2, 2020); Human Rights Watch, Blood, Sweat, and Fear: Workers’ Rights in U.S. Meat and Poultry Plants, January 24, 2005, https://www.hrw.org/report/2005/01/24/blood-sweat-and-fear/workers-rights-us-meat-and-poultry-plants (accessed June 2, 2020).

[52] The Universal Declaration of Human Rights, which is widely accepted as reflecting customary international law, states that “[e]veryone has the right to … just and favorable conditions of work.” Universal Declaration of Human Rights, G.A. Res. 217 (III) A, U.N. Doc. A/RES/217(III) (Dec. 10, 1948). Similarly, the International Covenant on Economic, Social and Cultural Rights guarantees, in article 7, “the right of everyone to the enjoyment of just and favorable conditions of work which ensure … safe and healthy working conditions.”

[53] Centers for Disease Control and Prevention, “COVID-19 Among Workers in Meat and Poultry Processing Facilities ― 19 States, April 2020,” May 8, 2020, https://www.cdc.gov/mmwr/volumes/69/wr/mm6918e3.htm (accessed June 4, 2020).

[54] Erin Duffin, “Poverty Rate in the United States by Ethnic Group 2018,” Statista, September 24, 2019, https://www.statista.com/statistics/200476/us-poverty-rate-by-ethnic-group/ (accessed June 2, 2020).

[55] Institute for Policy Studies, “Racial Economic Inequality,” https://inequality.org/facts/racial-inequality/ (accessed June 2, 2020)

[56]  Ibid.

[57] Jeanna Smialek and Jim Tankersley, “Black Workers, Already Lagging, Face Big Economic Risks,” The New York Times, June 1, 2020, https://www.nytimes.com/2020/06/01/business/economy/black-workers-inequality-economic-risks.html (accessed June 9, 2020).

[58] Darrick Hamilton, “Race, Wealth, and Intergenerational Poverty,” The American Prospect, August 14, 2009, https://prospect.org/special-report/race-wealth-intergenerational-poverty/ (accessed June 9, 2020).

[59] One study in North Carolina found that there were three times as many payday storefronts in African-American neighborhoods than in white neighborhoods, while another in California found that payday lenders were nearly eight times as concentrated in African-American and Latino neighborhoods. Center for Responsible Lending, “Race Matters: The Concentration of Payday Lenders in African-American Neighborhoods in North Carolina,” March 2005, https://www.responsiblelending.org/payday-lending/research-analysis/rr006-Race_Matters_Payday_in_NC-0305.pdf (accessed June 2019), p. 2; Center for Responsible Lending, “Predatory Profiling: The Role of Race and Ethnicity in the Location of Payday Lenders California,” March 2009, http://www.responsiblelending.org/payday-lending/research-analysis/predatory-profiling.pdf (accessed June 2019), p. 10.

[60] Pew Charitable Trusts, “Payday Lending in America: Who Borrows, Where They Borrow, and Why,” July 2012, https://www.pewtrusts.org/-/media/legacy/uploadedfiles/pcs_assets/2012/pewpaydaylendingreportpdf.pdf (accessed June 2019), p. 14.

[61] Ibid., p. 13.

[62] Pew Charitable Trusts, “Payday Lending in America,” p. 9.

[63] Universal Declaration of Human Rights, article 25(1); International Covenant on Economic, Social, and Cultural Rights, article 11.

[64] Many immigrant workers who do not have social security numbers will not receive coronavirus stimulus checks at all, even if they have been paying taxes. See, e.g., Human Rights Watch, “US: Address Impact of Covid-19 on Poor,” https://www.hrw.org/news/2020/03/19/us-address-impact-covid-19-poor (accessed June 4, 2020). Lena Simet, “The Forgotten, Suffering without Aid,” New York Daily News, April 30, 2020, https://www.hrw.org/news/2020/04/30/forgotten-suffering-without-aid#.

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