Around 3 a.m. on a Sunday morning last October, Christina Summers got a phone call she'll never forget. It was a doctor at the Baltimore hospital where her husband, James, had been admitted a week earlier for COVID-19. He'd been struggling to breathe. Now, they were calling to tell her James was being put on a ventilator.
She picked up the phone and turned to the people who had been there for her most of her life: James's family. "I called his siblings immediately in the middle of the night and I said, 'You all got to come here immediately. I'm scared, I'm scared.'"
One of her sisters-in-law had just arrived when the doctor called back with the news: James had died, leaving Christina, who was 36 at the time, to raise their nine children on her own. "Me and my husband really worked like a team," she says. "My teammate's not here to help me, so I'm really feeling a single mom vibe, just trying to get accustomed to this."
With his death at age 37, James Summers, who was Black, became part of a devastating demographic fact of this pandemic: In the U.S., people of color on average have had younger ages of death from COVID than whites – and lower-income communities have been hardest hit. The age-adjusted COVID death rates are about twice as high among Black and Latino communities compared to whites and Asians, and that reflects the fact that these populations are dying at younger ages, researchers say. It's even worse for Native Americans, Native Hawaiians and Pacific Islanders, although there's less data available for those populations.
While the gap between whites and people of color narrowed in 2021, that is largely due to the fact that more middle-aged white people died in 2021, rather than things getting dramatically better for Blacks and Latinos, according to a preprint study from researchers at Princeton University and University of Southern California.
Many of these deaths have come in people in the prime of life. As the U.S. approaches the grim milestone of 1 million deaths from COVID, the nation has yet to reckon with the effects of these losses, says Debra Furr-Holden, an epidemiologist at Michigan State University who has been studying the disparate effects of the pandemic.
"The impact of COVID on families, especially families who are already on the margin, has been profound. I feel like we've glossed over this. We haven't thought through what is the long-term implication of that," she says.
The reasons are manifold, though underlying them all is systemic racism, Furr-Holden says. "COVID was the snitch. COVID told the truth to us about what was happening," she says.
People of color are overrepresented in low-paying frontline jobs that increase their exposure, Furr-Holden notes; they also face unequal access to health care and have more underlying conditions that make them more vulnerable to begin with. All of these are ongoing factors that raise the risk of infection and death. Coupled with the fact that the U.S. Black and Latino populations are younger than Whites, these factors help explain the higher death rates at younger ages, says Noreen Goldman, a demographer at Princeton University who has studied disparities in life expectancy resulting from COVID.
Living with loss
Christina Summers is living those implications every day. She says her husband, James, was a large man — over 6 feet tall and 300 pounds — and his presence was outsized too.
"You know, he was very uplifting, always, trying to push through our struggles and keep my head up."
James was an optimist, and a jokester. He'd put on her wigs and walk around the house to elicit giggles, tell corny jokes and make silly TikTok videos. "He just brought a lot of joy in my home," she says, adding that he always put family first. "He was just always there for his kids, you know, was there for every graduation, every birthday, every holiday."
Her children, 5 boys and 4 girls — ranging in age from 6 to 17 — were all close to their father. Now, she says, they're all struggling with his loss. Several of her middle-school-age children are scared to go back to school, afraid they'll catch COVID — a heightened vigilance that experts say is common among children who've lost a parent. Her 16-year-old son, Matthew, has become withdrawn. Her 6-year-old daughter, Madison, keeps thinking her father will return.
"I have to sit there and tell my daughter, you know, he's not coming back, unfortunately. So it's really hard for me to keep trying to push through," she says.
And there's a lot to push through. James was the family's main breadwinner. Christina stayed home with the kids. She says finances were always tight, but somehow they made do. Now, with James gone, the family is surviving on savings and the disability benefits her 15-year-old son, Marcus, receives. He has autism. Christina doesn't drive, and the family car was repossessed.
"It's really tough because you know what? Hardly no income coming in right now and trying to get things together for my life to start all over again. It's hard," Summers says.
Even families that were on firmer economic footing have seen their finances upended. And because of that, their whole lives can be upended, too.
"I've known many families who have had to move because they couldn't pay their rent, have had to move in with family, folks who have had to live in transitional housing, whether that's a hotel room or a car ... because they've lost the breadwinner and didn't have a plan for for a sudden death of a young breadwinner in the family," says Kristin Urquiza, cofounder of Marked By COVID, an advocacy and awareness group that seeks to humanize the losses of this pandemic. The group is calling for a national COVID memorial day on the first Monday of March each year, as well as the construction of physical memorials in cities across the country.
Urquiza started the organization after her own father died of COVID in 2020 at age 65. He was a first-generation Mexican American and had worked his whole life in a blue-collar job.
"He hadn't even had a chance to retire yet," Urquiza says. "That entire chapter of his life, he was kind of barely starting to see the light at the end of the tunnel, and that was completely stolen from him."
Since her father's death, she's taken on financial responsibility for her widowed mother. She's also been living off her savings since losing her job as an environmental justice advocate with a nonprofit during the pandemic. Because of the strain of the last two years, goals like having her own home one day are starting to feel unattainable.
"I'm sort of feeling any of the dreams I had for myself kind of slip away," she says, adding, "It's like the hits don't stop."
A cascade of effects
And the hits aren't just financial. The grief of losing a loved one can have profound repercussions on mental health, says Debra Umberson, a sociologist at the University of Texas at Austin who studies racial disparities and the impact of loss.
"For example, if you develop a lot of anxiety or depression, you may carry that with you for more years of your life, which takes a toll on health," she says.
And that can have lasting impact on physical health, affecting cardiovascular health, mortality risk and dementia risk, Umberson says. "It's written on the body."
And for children, the loss of a parent early in life can also have serious educational ramifications. Studies show they're more likely to drop out of high school, less likely to go to college and less likely to pursue a degree beyond a bachelor's, if that had been their plan, says Ashton Verdery, a sociologist and demographer at Penn State who has studied the impact on children from parental loss due to COVID. He says the evidence is really strong that losing a parent "is very consequential for the child's educational trajectory." And that in turn influences a child's job prospects and earning potential later in life.
"And of course, socioeconomic status is linked to health outcomes as well. So it's this cascade of effects," Umberson says.
Umberson points to Verdery's research suggesting that for every person killed by COVID, nine family members have been left behind. She says the fact that so many unexpected COVID deaths at younger ages are happening among communities of color is bound to exacerbate existing disparities in health and wealth. "So it's this huge impact, it's this ballooning effect, because for each person who dies, there are multiple people who are affected by it," she says.
For Christina Summers, the battle is just to get herself and her nine kids through each day. "It's been very hard because we're still all grieving," Summers says.
She's been trying to find grief counseling for the kids, but so far, no luck. With demand so high since the pandemic, the wait for therapy can be months long. She's also been busy navigating the bureaucracy – trying to secure Social Security survivor benefits and other resources for her children, all while still coming to terms with the reality that her life partner and best friend is never coming home.
"Every day I just look for him to come through the door, you know? 'Cause sometimes I feel like he's going to come through the door still. It's surreal how COVID just takes them out."