The coronavirus pandemic is having an impact all over the world, but a disturbing trend is evident in the U.S.: People of color, particularly African Americans, are experiencing more serious illness and death due to COVID-19 than white people.

According to media reports, in Chicago, where African Americans comprise a third of the city’s population, they account for half of those who have tested positive for the coronavirus, and almost three-quarters of COVID-19 deaths.

Likewise, in Milwaukee County, Wisconsin, African Americans make up 70% of deaths because of the coronavirus, but just 26% of the county’s population. So why is this happening?

First, people of color share common social and economic factors, already in place before the pandemic, that increase their risk for COVID-19. For example, living in crowded housing conditions makes physical distancing within the home much more difficult.

Second, working in essential fields such as environmental services, food services, the transportation sector, and home health care cannot work from home. These positions put workers in close contact with others. Also, fear of lost wages or loss of employment may lead African Americans and other vulnerable Americans to work when they are ill, contributing to the further spread of the disease within their communities.

Third, inconsistent access to health care due to lack of insurance or underinsurance. Being able to afford doctors’ visits, medications, and equipment to manage chronic disease is essential to lowering the risk of death from COVID-19 and other conditions. For instance, a patient with badly controlled diabetes or asthma because of inconsistent treatment is more at risk for severe, even deadly, coronavirus infection.

Fourth, people of color have a higher burden of chronic health conditions associated with a poor outcome from COVID-19, including diabetes, heart disease, and lung disease. In a study cited by the U.S. Centers for Disease Control and Prevention (CDC), about 90% of those hospitalized with severe COVID-19 had at least one of these underlying medical conditions.

Finally, stress and immunity. Studies have proved that stress has a physiological effect on the body’s ability to defend itself against disease. Income inequality, discrimination, violence, and institutional racism contribute to chronic stress in people of color that can wear down immunity, making them more vulnerable to infectious disease.

Not only acknowledging this discrepancy but also working to change the reasons for it is essential. There should be no one group of people who are being hit harder than others during a global pandemic. Addressing the root of the problems that have caused this trend and working towards finding a solution to change it should be a priority as we continue our global attempts to pull through the coronavirus pandemic.