The coronavirus is killing black Missourians at a disproportionate rate, especially in the two urban areas of the state, prompting some local African American leaders to question if outreach is falling short.

O'FALLON — The coronavirus is killing black Missourians at a disproportionate rate, especially in the two urban areas of the state, prompting some local African American leaders to question if outreach is falling short.

The St. Louis Health Department on Sunday night announced the deaths of two black men, one in his 50s and one in his 60s. Of the 19 people in St. Louis who died from COVID-19, the illness caused by the coronavirus, 16 were black, one white and one Hispanic. The race of one person was unknown. St. Louis is nearly evenly split between black and white residents.

Blacks have accounted for 20 of the 42 deaths in St. Louis County, while 14 victims were white and no race was listed for eight others, according to data on the county health department's website. About one-quarter of St. Louis County residents are black.

Kansas City — Missouri's largest city — has reported eight deaths from the coronavirus, including five black residents, two whites and one whose raced was cited as "other" by the local health agency. About 29% of Kansas City residents are black.

Missouri NAACP President Nimrod Chapel on Monday said he has written to Republican Gov. Mike Parson but has been unable to get answers about what the state is doing to help black residents get tested and treated for the coronavirus.

"Their only job is to look after the public welfare, and they're literally watching people die," Chapel said in a phone interview.

Email messages left with spokeswomen for Parson and the Missouri Department of Health and Senior Services were not immediately returned.

The health department does not provide a racial breakdown for coronavirus cases or deaths, noting that about 40% of medical providers were not reporting that information. Chapel questioned how local departments could not be required to provide information that could help direct outreach.

"Who's in charge?" he asked. "If we're going to leave this to cities and counties and they're not doing the job right, somebody's got to step in to save lives."

Other places also are seeing a significant racial discrepancy. Blacks account for 72% of deaths from COVID-19 complications in Chicago and 52% of positive tests, despite making up only 30% of the city's population.

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, and death.

Gwen Grant, president of the Urban League of Greater Kansas City, said blacks are more prone to suffer disproportionately because of economic disparities: They are more likely to have jobs that don't allow them to work from home, less likely to have health insurance and more likely to suffer from pre-existing health conditions like asthma or diabetes.

"Whenever there's a crisis such as this you find it takes its greatest tolls in communities of color," Grant said.

Johns Hopkins University's Center for Systems Science and Engineering, which has been tracking COVID-19 cases worldwide, reported Monday that Missouri has had 4,272 cases of the disease, including 118 deaths.