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Healthcare Leaders Explain How Racism and Inequities Cut Black Life Expectancy in Buffalo

After a gunman left 10 dead and three wounded at a supermarket in Buffalo, local Black leaders say it’s another pin in the coffin of racism that has ended Black life far too early.


United States

Pastor George Nicholas of Lincoln Memorial United Methodist Church in Buffalo New York is a founding member of the African American Health Equity Task Force in Buffalo, NY. The Task Force established the Buffalo Center for Health Equity at the University at Buffalo. (Photo courtesy of Pastor George Nicholas)

Dr. LaVonne Ansari says more dollars and more Black counselors are the immediate needs in East Buffalo, New York. 

A white supremacist murdered ten people and wounded three others in a Tops Friendly Market on May 14. The Department of Homeland Security characterizes mass shootings as having a random selection of victims; however, the shooter in Buffalo intentionally sought out Black employees and customers at the Tops supermarket.

Ansari’s medical team has remained in the predominantly Black neighborhood to support affected residents. Black employees have told her team that the shooter made pointed comments to them a day before the shooting. As her team works on the ground, Ansari says the long-term need is to dismantle the racism and anti-Black policies that made it possible for the shooting to happen.

Ansari is the CEO and executive director of the Community Health Center of Buffalo (CHCB), a federally qualified health center. She’s kept a physician, nurse, and counselor available to those in need, but her team isn’t being paid for services. There’s also greater demand than the supply of Black counselors.

“When we’re out working in an emergency like this, we aren’t asking people to put their claims in or asking for their insurance,” Ansari said. “We aren’t worried about getting paid, we’re just going out there.”

She says that they’ve been traumatized in the process by losing their neighbors to the shooting and listening to store employees recount the occurrence.

“One of the young men, who actually brings in the carts, [the shooter] told him he was going to kill him the day before,” Ansari said. “So there’s all those other dynamics of, he didn’t just come in and blow us away. He was strategically having interactions with people in the store and the workers. So it puts a different kind of burden on us.”

Ansari also shared that many Tops employees work multiple jobs and were expected to show up to their other places of employment after the shooting.

Others have also donated their time, transportation, and groceries. The racist attack left many mentally traumatized and physically without access to a supermarket and pharmacy, as the supermarket has yet to reopen. Ansari said that non-Black counselors have been willing to offer their services, but the community and store employees are fearful and non-trusting after the horrific event. 

“We’re all still in shock,” she said. “We still are all traumatized.”

Leaders and volunteers like Dr. Ansari’s team continue to address the community’s immediate needs; however, they say it’s not sustainable. The gruesome event has highlighted what East Buffalo’s Black community has stressed for years: Racism is decreasing their life expectancy. As the Masten community begins to rebuild, local Black leaders say dismantling racist ideology and supporting the economic development of their neighborhood is the only way to increase their survival.

A history of health inequity

Ansari said that 80% of the patients who come to CHCB are seeking medical care as a response to social determinants of health. She said the survivors of the shooting have been left with extreme anxiety and that some did not sleep for days following.

Dr. Ansari, right, working with Dr. Kenyani Davis, MD, MPH, Chief Medical Officer, Community Health Center of Buffalo, Inc. Dr. Ansari dispatched a team including Dr. Davis, a nurse and counselors to provide care for Tops survivors in the immediate aftermath of the shootings. (Photo courtesy of Community Health Center of Buffalo, Inc.)

The Buffalo Center for Health Equity reported that Black residents of Erie County were dying at three times the rate of their white counterparts in a 2019 report. Researchers found health inequities through social determinants of health had decreased life expectancy for Black residents by about 12 years.

These inequities have shown up as increased risk of chronic diseases, maternal health disparities, mental health issues, lack of nutritious options, over-policing in neighborhoods, and increased tobacco use.

The Center is housed at the University of Buffalo and created through the African American Health Equity Taskforce. Their goal is to eliminate the city’s racial, economic, and geographic-based health inequities. Buffalo’s storied history of segregation has greatly attributed to health inequities through redlining, or housing policies that created restrictions on where non-white residents could own property.

“I’m unapologetically in love with Black people,” Pastor George Nicholas said on why he founded the task force that led to the Center and the Health Department’s health equity department. “Looking at the condition of Black people living in the city of Buffalo and seeing the high levels of poverty, unemployment, residential segregation, and poor health outcomes that are driven by the social determinants of health and the region at that time, the city [was] not really embracing that as a priority.”

Now, the religious leader is adding hate crimes to the list.

A segregated design

About 34 percent of Buffalo’s population is Black, and most live in segregated neighborhoods. About 27% of Buffalo’s Black population lives in a neighborhood with extreme poverty, compared to 2% of Buffalo’s white population. And 37% of Buffalo’s Black population lives in a neighborhood with high poverty, compared to 12% of Buffalo’s white population, according to a 2018 study by another local equity group.

The Center has focused on five ZIP codes where Black residents are dying prematurely. Nicholas says all four are at the intersection of the 14208 ZIP code of New York that housed the Tops supermarket.

According to the University at Buffalo’s Regional Institute, just over 10,300 people reside in the 14208 ZIP code. Of those residents, 78% are Black. Almost half of 14208 residents stopped their education during high school, and one-third of the households are without a vehicle. Now that the Tops supermarket is closed, the next nearest Tops is a 40-minute ride away on public transportation. Other branded grocers are about a 25-minute ride on public transport.

Before the shooting, it was almost guaranteed that any Black person within a 5-mile radius would visit the Tops supermarket.

Attorney General Merrick B. Garland shared a U.S. Department of Justice press release in mid-June, saying the supermarket shooter would be charged with federal hate crimes, given that he intentionally chose a location that was guaranteed to have a high density of Black people present.

Thomas Beauford, president and CEO of the Buffalo Urban League, said the city’s historic design created the perfect scenario for a white supremacist to walk into the community and cause harm. Beauford said the Tops supermarket was a “critical place” in the community, as it was one of few places for residents to be social, cash checks and pay bills, and purchase food and medications.

The Buffalo Urban League has worked within and built a trusting relationship with the 14208 community for years through their jobs, family services, and community health worker programs. Beauford joined the organization during the height of the coronavirus pandemic in 2020. The Urban League secured Federal Emergency Management Agency dollars that year to create a crisis team to address the pandemic. Buffalo’s Black population was at a higher risk for coronavirus given the chronic health conditions and people-facing jobs that limit social distancing.

Now the crisis team and community health workers who typically address chronic diseases are working to address the ongoing trauma from the supermarket murders.

Creating change

Ansari and Beauford are members of Greater Buffalo’s Racial Equity Roundtable, which produced the 2018 report. Much like Nicholas’ African American Health Equity Taskforce, the roundtable is comprised of a cross-sector community leaders working to address systems change in Buffalo. Their work has focused on narrative change, addressing racism within the justice system, and creating employment opportunities.

Some residents now fear the supermarket will never reopen. Some fear they will never go back if it does. The community fought to have the supermarket open in the neighborhood years ago and again for upgrades to make the store viable in the area.

“We’re often regulated to a zero-sum game of limited resources where we can only have ‘this or that’ and that’s been the story of the East side,” he said. “But you go into other communities, and they have this, that, these and those. They have multiples, a variety, and we’re fighting to just get one.”

Beauford called the differences in Buffalo neighborhoods “legacy problems” that have stemmed from racist public policy. He says the way forward is to allow residents to have a choice in their grocers, increase competition, and build supermarkets of different brands within the area without considering the shooting as the “single point of failure.”

There is an opportunity for economic development operations to change as donations build in response to the shooting. A newer grant program, East Side Avenues, is making strategic investments and capacity-building programs for Buffalo’s East and South sides. One of the five strategically targeted investment areas includes Jefferson Avenue to create a viable commercial district.

Tops Friendly Markets and The Community Foundation of Greater Buffalo have partnered with grantmakers to secure donations for the survivors of the shooting. Some of the dollars are supposed to support Black-led organizations in the area. Millions have already been donated.

But Beauford, who previously worked within the financial industry, said he worries about what restrictions will be put in place for grant dollars and how Black residents will be affected by the proposed development changes. When he looks at how the city has transformed in recent years, Beauford sees intentional investment to revitalize the downtown, the football stadium and the waterfront area. He says that investment has not gone toward predominantly Black neighborhoods.

A critical moment

As the nation responds to the shooting and Buffalo residents grapple with a traumatic event, Beauford, Ansari, and Nicholas say leadership is more critical than ever.

“I’m very concerned with the dialogue and the conversations that are going on right now. Because they’re more in the line of, of just services programs, and not structural change,” Nicholas said.

Beauford says he’s also worried. Two weeks after the shooting in Buffalo, another murderer shot and killed children and teachers at an elementary school in Uvalde, Texas, prompting a national conversation on mass shootings, mental health services, and access to guns.

But Buffalo’s situation was different. It was a targeted, racist attack, and local leaders say how the shooting is discussed will affect the health and well-being of Black lives in the future.

“We don’t want it to all be swept up together,” Beauford said. “We have to be careful not to let the focus shift.”

Since January 2020, Direct Relief has provided local healthcare providers in Buffalo, including Community Health Center of Buffalo, with more than $300,000 in grant funding and donated medical resources.

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