Doctors and public health experts will tell you that, compared to white Americans, African American people die prematurely and disproportionately of many ills: heart disease, stroke, COVID-19, police violence.
The proximate causes of these early deaths vary. But there is a sameness to the pattern, experts say, and a common source of the skewed statistics.
Racism -- not in its overt, name-calling form, but the kind woven deeply into the nation's institutions -- harms the 44 million Americans who identify as black and potentially shortens their lives, according to those who study racial inequities in health. For some, including Minnesotan George Floyd, it causes premature death in minutes. For others, a lifetime of disadvantage takes its toll in subtler ways.
"At the end of the day, racism is the original sin here," said Dr. Georges Benjamin, executive director of the American Public Health Association. "Racism attacks people's physical and mental health," he said. It's "an ongoing public health crisis that needs our attention now."
And in the midst of a pandemic, Benjamin and others fear that as crowds fill the streets to protest yet another police killing of an unarmed black man, people of color will again bear the disproportionate brunt of renewed infections.
It is an agonizing trade-off, they acknowledge. But it's hardly a choice.
"I've spent the last several months of my life imploring and exhorting people to protect themselves, to reduce the spread of this virus and save lives," said Dr. Clyde W. Yancy, a cardiologist at Northwestern University's Feinberg School of Medicine who is African American. But after Floyd's death under the knee of Minneapolis police officer Derek Chauvin, he said, "it dawned on me that my greatest risk is not COVID-19. It's the color of my skin."
Dr. Atheendar Venkataramani, an internist and health policy researcher at the University of Pennsylvania, has plumbed the power of despair to erode the health of specific American populations. He was part of a team that assessed changes in the mental health of Americans who lived in states where at least one unarmed black man had been killed by police.
In the three months following these deaths, the team found a measurable drop in mental health among black Americans -- and the more deaths there were, the greater the effect. Mental health did not suffer in cases when police killed a black person with a weapon.
The mental health of white Americans was not associated with fatal police encounters involving either armed or unarmed black Americans. The findings were published in 2018 in the medical journal the Lancet.