The UN Sustainable Development Goals (SDGs) have never been more poignant or relevant during a crisis, especially for one that is taking the world by storm, such as Covid-19. There is an increasing body of work, blogs, papers, and opinion pieces in writing and podcasts form which analyse the impact a world-wide pandemic will and is having on the delivery of the SDGs. My intention here is not only to build on that excellent work but also bring in stark contrast the direct connection between SDG delivery and the level of deaths seen in communities of colour, especially in the USA.
I was inspired to address the connection of SDG and the health crisis, by a podcast from the “New Yorker, Radio Hour” who had as its guest speaker, Arline Geronimus, a public health researcher at the University of Michigan’s Population Studies Center. Her research that sparked my attention is the phenomenon of ‘weathering’ and the health of African-Americans; exploring ethnicity and disease. This spark lead to the SDGs and how imperative it is to continue to put the successful delivery of the SDGs, front and centre, especially if we, as a world-community, are going to come out of this pandemic with new skills and a fundamental change in how to do thing differently.
As an expert on the SDGs, the SDGs which have been the shiniest of late, climate change, poverty, and inequality have been receiving the most attention. But SDG16, promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels, is not seen as a shiny SDG and thus gets little attention outside of super-engaged individuals and organisations.
In addition, there are some SDGs which are immediately, for many, affiliated with developing or transitional countries and are not really seen as a focus for a developed country. SDG 16 is definitely seen as more of a developing country SDG, because inclusive social institutions are assumed to have been already established in developed countries; so what’s the issue? It is perceived that institutions in developed countries are clear and grant universal access (to a large extent); and the only controversy is within the context of the institution not in the make-up and accessibility.
Why focus on SDG16 and why link to the amazing work done by Dr Geronimus on the death rate of African-Americans in the USA due to the Coronavirus? It is a confirmed fact that in the state of Georgia, African-Americans make up only 30% of the population, but take up 80% of critical care beds in hospitals due to Coronavirus. To put it in more stark contrast, in Detroit an African-American is two to three times more likely to die from Covid-19 than a Caucasian. The facts bear out the deadliness of this virus to people of colour. Dr Geronimus’ work is especially enlightening to explain why the death rate for communities of colour is so great, beyond the obvious social-economic issues; is due to ‘weathering’. Simply put, it posits that the cumulative racism experienced by the African-American community causes a biological breakdown in the body. The chronic stress of ‘weathering’ prematurely ages the body and significantly impairs the body’s ability to fight off disease. In one of Dr Geronimus works, “’Weathering’ and Age Patterns of Allostatic Load Scores Among Blacks and Whites in the United States,” in the American Journal of Public Health[1], the argument is most elegantly stated that, “[…] US Blacks experience early health deterioration, as measured across biological indicators of repeated exposure and adaptation to stressors.”
To draw it back to the higher death rates in African-Americans, due to Coronavirus, the Allostatic load scores for Blacks, were much higher than the White population. This racial-inequality cannot be explained by social-economic issues or pre-existing health issues; but by the consistent and stressful coping efforts needed by communities of colour to live in a race-conscious society. The conclusions are very clear; repeated experience with social and economic adversity and political marginalisation – which fundamentally means that African-Americans are in a constant state of ‘fight or flight’ arousal – this constant and unrelenting stressors has a deleterious impact on health leading to a significant lack of ability to fight off disease. Inherent racism in the American culture breeds death in African-American communities.
A successful delivery of SDG 16, would go a long way in alleviating the stressors. Let us look at the specific targets of SDG 16:
16.1 Significantly reduce all forms of violence and related death rates everywhere
16.2 End abuse, exploitation, trafficking and all forms of violence against and torture of children
16.3 Promote the rule of law at the national and international levels and ensure equal access to justice for all
16.6 Develop effective, accountable and transparent institutions at all levels
16.7 Ensure responsive, inclusive, participatory and representative decision-making at all levels
16.10 Ensure public access to information and protect fundamental freedoms, in accordance with national legislation and international agreements
16.b Promote and enforce non-discriminatory laws and policies for sustainable development[2]
These specific targets of SDG 16 focus on one thing – universal access to institutions; access without discrimination or stigmatisation. The delivery of these targets would indeed decrease the chronic stressors to a certain area of the population. Ergo, one must ask again, is SDG16 only relevant for developing countries? Which other SDGs are being assumed to be well established in developed countries, but are in this assumption harming their populations? If these SDG 16 Targets would be addressed and delivered within the USA; maybe the next generation of African-Americans would be healthier.
Delivery of all the SDGs is key for all nations, regions, cities, and individuals. Indeed, if the SDGs are to be delivered, ‘we all must lead.’ But if we consign some SDGs for developing countries only, and other SDGs for developed countries – issues highlighted by this pandemic on societies and communities globally (irrespective of status of the country) – then key ways to lead would be missed and the positive implications of SDG delivery at the developed country level, in the case for SDG 16, would be unexplored. This pandemic, Covid-19- has put a sharp and distinctive edge to the issue of institutional racism in the US. Concerted efforts of the US to lead in delivery of the SDGs, especially SDG 16, would have a demonstrable impact on American communities and lead to a healthier and more empowered population.