COVID-19 has disproportionately affected people of color both nationwide and in Washington state.

Nationally, infection and mortality rates are much higher in Black communities, Spokane County Health Officer Dr. Bob Lutz said Wednesday morning, though he noted not all states have released or sorted out all their data on confirmed cases.

In Washington state, 30% of ethnicity data related to COVID-19 cases is still unconfirmed. But based on the cases where ethnicity data has been identified, Hispanic residents account for the most cases in the state of any ethnic group, with 40% of confirmed cases, despite making up only 13% of the total state population.

Black and Pacific Islander residents are also disproportionately represented in the state’s COVID-19 data.

Lutz pointed to historic inequities, social determinants of health and systemic racism as the reasons for these health outcomes.

“Longstanding societal and institutional policies and practices that lead to health inequities, differences in health status between social groups that are unfair, avoidable and preventable lead to what is referred to as embodied inequality, discrimination and social injustice that lead to poor health outcomes that are multigenerational,” Lutz said.

Toni Lodge, chief executive of the NATIVE Project health clinic, said that her clinic was ground zero for COVID-19 in Spokane County.

“It was the first clinic to test, and it was a tribal member from out of state who had it,” she said. “And that has been the experience all across the U.S. urban Indian health system.”

The NATIVE project receives funding from the federal government, including from Indian Health Services. That meant the clinic received supplies from the national stockpile – but Lodge said they were expired.

“We got N95 masks that were expired from the national warehouse,” Lodge said. “So if you think about PPE, they say, ‘It’s good enough, use it,’ and we do. But our PPE is expired in our health care system, and that’s a health inequity.”

The Navajo Nation, the largest tribe in the U.S., with about 300,000 members, has reported 252 deaths due to COVID-19. By contrast, Spokane County, which has more than 500,000 people, has 34 recorded deaths due to the virus.

Lodge said the NATIVE project’s largest issue is access to testing for members of more than 300 tribes who live in Spokane.

“We sent a lot of people to the fairgrounds or other places to be tested, but we can’t do that culturally specific care unless we have that testing capacity in every community, and that’s the African American, Native and Hispanic communities,” she said.