When Matuor Alier first started experiencing symptoms of COVID-19 in mid-October, he quickly took steps to isolate himself from his community in Fargo, a city on North Dakota’s eastern border with Minnesota.
Alier, a 32-year-old social worker who came to North Dakota in 2008 as a refugee from what is now South Sudan, was able to work from home while he was ill, quarantining in his home while enduring chills and fits of coughing. But the experience made him even more aware of how difficult dealing with COVID-19 was for other members of his community: North Dakota’s growing population of refugees and immigrants, particularly from Africa.
“When the pandemic hit in March, they weren’t getting the information,” Alier said. “They were not understanding what was going on.”
According to the latest data from the COVID Tracking Project, Black North Dakotans had the highest rate of COVID-19 cases relative to their population in the state, eclipsing even other vulnerable groups such as Native Americans. While the state does not release racial data for deaths from COVID-19, the infection rate is over 9,600 per 100,000 for Black people, compared to about 6,700 for people identifying as white, as seen in the chart below.
These numbers reflect what activists and government officials have seen in the state as the virus has devastated African immigrant communities. North Dakota has endured a wave of infections in the fall, and currently has the highest case rate in the nation, but immigrants are particularly vulnerable to the virus due to higher rates of poverty and language barriers that prevent them from getting information about COVID-19.
In response, nonprofit organizations and volunteer groups dedicated to helping immigrants and refugees in North Dakota have stepped up to provide groceries, safe spaces to quarantine and translation assistance for non-English speakers seeking information about COVID-19.
“They don’t speak the language, they don’t have anybody advocating for them,” said Clarissa C. Van Eps, president of the North Dakota chapter of the National Association for the Advancement of Colored People, or NAACP. “We’re telling them that they have a safe space with us and telling them the things that we can do for them if needed.”
Nationwide, people of color have been disproportionately affected by COVID-19 due to a range of factors, including poverty, essential worker status and pre-existing health conditions. But the racial disparity in COVID-19 infections in North Dakota reflects larger trends particular to the state, which has experienced rapid demographic change in recent years. Over the past decade, the population of North Dakotans identifying as a race other than white has grown from just under 10 percent to 13 percent.
The largest growth has been in the Black community, whose numbers have more than tripled since 2010, according to data from the U.S. Census Bureau.
The majority of this increase is driven by growing numbers of “New Americans” — a catch-all term for immigrants and refugees who have come to North Dakota seeking economic opportunity or political asylum. The percentage of foreign-born North Dakotans stood at 4.7 percent in 2018, up from just under 2 percent in 2000. While the state has significant populations of Asian immigrants, including Bhutanese refugees, the largest group identifies as Black, and includes immigrants from Somalia, Sudan, Liberia, Eritrea and the Democratic Republic of the Congo.
With a population of about 125,000, Fargo is North Dakota’s largest and most diverse city, and reflects many of these recent demographic trends. The city’s plentiful jobs in the manufacturing and healthcare industries, along with a relatively low cost of living, have attracted waves of immigrants, while North Dakota as a whole leads the country in refugee resettlement per capita.
But some of the very opportunities that pull New Americans to the region also make them more vulnerable to COVID-19, according to Hukun Dabar, executive director of the Afro-American Development Association of Fargo-Moorhead. Immigrants working manufacturing or retail jobs cannot work from home, while those in the healthcare industry spend more time in COVID-19 hotspots such as nursing homes and hospitals. Immigrant communities tend to be lower-income and less likely to own their own homes, while the state of North Dakota did not enact a rent moratorium during the pandemic.
“At the end of the month, the landlord wants the rent,” Dabar said. “They can’t stay home even one day from work, because they have kids to feed, they have rent to pay, they have bills to pay.”
Cultural and social factors heightened their vulnerability. Stigma against immigrants — who were sometimes blamed for spreading COVID-19, Dabar said — led some to avoid reporting their symptoms, while language barriers caused a general lack of information about the virus and its effects. Many immigrant families also live in large, multi-generational households where one infected person can spread the virus to multiple others, Dabar added.
To address these complex issues, nonprofit and volunteer groups have played a prominent role. Alier helped found the ESHARA Project — which stands for Ethnic Self Help Alliance for Refugee Assistance, and brings together seven community-based nonprofit organizations in the Fargo area — in 2016 as an employment assistance program for New Americans, and worked on pivoting the coalition to COVID-19 response in June. Throughout June and July, ESHARA coalition members helped nearly 300 people with rental assistance, grocery delivery services, and help getting tested for COVID-19 or filing for unemployment benefits.
Other groups have also stepped in to help, including the North Dakota chapter of the NAACP. The chapter, which was only created a few months ago in the wake of nationwide protests over racial justice and is still in the process of joining the national NAACP organization, has mustered volunteers and funds to distribute groceries and provide places to quarantine, according to Faith Shields-Dixon, the group’s vice president.
But it’s been difficult to see the disease ravage immigrant communities across the state, she noted.
“We’ve seen some loss of life — some of the pillars of the community have passed away from COVID,” Shields-Dixon said. “Everywhere people are dying from this disease. But we know that being able to provide those extra resources can lift the load off of them, and be able to assist them during this tragic time.”
Death data by race is unavailable in the state because the number of deaths among people of color is so small that releasing it would potentially allow individuals to be identified, a violation of health privacy regulations, said Grace Njau, an epidemiologist at the North Dakota Department of Health. But she said that despite the high rate of COVID-19 cases among New Americans, the rate of deaths for this population tends to be low because they are often younger and healthier than other groups.
At the same time, Njau said steps taken by the state to combat the virus can benefit all who are impacted by it. On November 14, North Dakota Gov. Doug Burgum implemented a statewide mask mandate and announced new restrictions on social gatherings for the first time since the start of the pandemic, complementing requirements that already existed in larger cities like Fargo and Bismarck. Njau said she sees this as a positive sign, and that the rate of new infections has already begun to drop.
“For now, I’m a little bit more optimistic in terms of our outlook,” Njau said. “But how long it lasts depends on how long we can keep up our masking and social distancing. If things hold at a steady state of where we’re at currently, I would say we’re heading in a positive direction.”
But even if cases drop, challenges will remain for New American communities in particular. Dabar said the state needs to provide more assistance to small business owners — many of whom are immigrants — facing losses due to COVID-19, while Alier added that children of immigrants tend to struggle with distance learning because their parents may not be able to afford the technology or help them if they don’t speak English.
“New Americans are taxpayers, they go to work every day, and they’re not people who always depend on benefits,” Dabar said. “So they need to see them as neighbors. They’re a big part of the state of North Dakota, because they’re not going anywhere.”
Hispanics/Latinos represent only 9% of the population but account for 26% of all cases in the state. A lot of them work in the construction sector, one that was deemed ‘essential’ during the pandemic even though construction sites are considered “high-risk” settings for the disease
North Carolina’s construction sites have contributed to form one of the state’s most glaring disparities when it comes to ethnicity and Covid-19: the high prevalence of cases among the Hispanic community. Hispanics represent only 9% of the population but account for 26% of all Covid-19 cases in the state. One of the main factors that led to this situation is the fact that there are higher proportions of Hispanic workers in sectors that are considered essential, including the construction sector.
On its website, the North Carolina Department of Health’s Covid-19 Response team admits that “farms and meat and poultry processing plants along with construction sites throughout North Carolina appear to be high-risk settings for transmission of Covid-19 due to the nature of the work, the challenge for employees to practice social distancing and the continuous nature of the plant operations”.
According to Fiorella Horna, from El Centro Hispano, a Latino nonprofit organization dedicated to strengthening the community of Hispanics and Latinos in North Carolina, the big issue with construction workers is the transportation to construction sites. “A lot of those workers share transportation to and from sites, they are taken by the contractors or the employers and sometimes those vehicles are packed, so that is where a lot of the concern is.”
So far, North Carolina registered 18 reported clusters of Covid-19 in construction workplaces, according to state data. What officials consider a cluster is a minimum of five cases with illness onsets or initial positive results within a 14-day period and plausible epidemiologic linkage between cases. The manufacturing sector had the highest number of clusters in the state: 74. But what draws attention to the clusters in construction sites is that these happened mainly in places where the percentage of Hispanics is higher than the average.
A bubble of clusters in construction sites happened in Charlotte, the largest city of North Carolina, which belongs to Mecklenburg County. Hispanics represent 14% of the population in and 21% of all cases of Covid-19 in the county. Officials there also admit that at least a big part of that situation in Mecklenburg County is due to the fact that Hispanics work in jobs considered essential, mainly in the construction sector.
Besides practical worries about the logistics of the job, such as the means of transportation of these workers, another issue that has contributed to the clusters in construction sites is the financial insecurity that a lot of them struggle with. “Some workers are just worried that if they get sick, they will have to miss days of work and then get no payment”, said Fiorella Horna. “There are construction employers who provide healthcare and all the right warranties to workers, but there are some small businesses that just don’t do that. Then those employers tell workers that they should get tested if they feel symptoms, but some workers just don’t do that, because they actually don’t want to find out if they are sick.”
Besides contributing to the transmission of the disease, a scenario like this is also worrying because it means that even if those workers suspect they are sick, they will not look for a doctor until the aggravation of symptoms — which is extremely dangerous. In order to try to avoid clusters of Covid-19 in construction sites, the Charlotte Commercial Construction Coalition (4C), a coalition of more than 30 Charlotte-area general contractors defined in April a series of rules that employers and employees of the sector should follow. But those are not enough to tranquilize the workers.
Not a new problem
The thing is the worrying situation of Hispanics during the pandemic of Covid-19 in North Carolina is, of course, a 2020 issue. But being more affected by workplace injuries and illness unfortunately is nothing new to the Hispanic community. Data from “Death on the Job 2020”, a report from AFL-CIO (The American Federation of Labor and Congress of Industrial Organizations), shows that 67% of Latinos killed on the job were immigrants; their job fatality rate was higher than the national average. In 2018, there were 961 deaths of Hispanics because of fatal work injuries. Of those, 294 occurred within the construction industry.
The same document also shows that Hispanics represent the largest number of people affected by Covid-19 by population size: 3.5 million persons were living in the hotspot counties around the country that were examined by the research. The report highlights the responsibility of the agencies in charge of enforcing working conditions and the federal administration: there were simply no standard procedures regarding that to follow across the country during this pandemic.
According to CPWR (The Center for Construction Research and Training), a nonprofit dedicated to reducing occupational injuries, illnesses, and fatalities in the construction industry, in 2015 there were 2.8 million Hispanics working in construction in the United States. About 73% of them were born outside the U.S. Which brings its own set of challenges.
More concerns and barriers — and a few solutions
“Language barriers and the spread of misinformation are a huge problem in general, of course, but also one that worries a lot when we think about the situation of immigrants in North Carolina”, explained Alison Kuznitz, a journalist at the local newspaper The Observer who has been covering the pandemic in Mekclenburg County since the early days of the disease. She also said that she witnessed efforts by the government to reach those populations.“They are doing campaigns in Spanish and briefings with Spanish subtitles; actually not only Spanish but they are translating the campaigns to ten different languages because we have immigrants from other parts of the world who don’t speak English nor Spanish.”
Grassroots organizations and food pantries have also been of huge help on not only giving access to meals to families of workers who lost their jobs, but also on bridging the communication gap between the state, the health professionals and the immigrant communities. Fiorella Horna, from El Centro Hispano, said the organization used funds received from federal Covid-19 relief to hire what they call “promotoras de salud”: these are women who serve as community wellness workers. Their job is to be in close contact both with the healthcare professionals and with the Hispanic community to eliminate the language barrier and combat misinformation.
Although it is still high, the percentage of Covid-19 cases among the Hispanic community in North Carolina has already been higher — it reached 46% of all cases in the state in July. Fiorella said that while she recognizes that the work of the “promotoras” may have been one of the reasons behind the percentage going down, she likes to remind people that this is still a public health issue, so the state has responsibility over it. “We can help, but we can’t be solely responsible for shifting numbers, of course. We believe that is being done collectively.”
She also commented that the work that El Centro Hispano did was an example of North Carolina’s strategy of infusing money on non-profits across the state to reach the Latino community. The fight against Covid-19 is far from over yet, of course. But a new one has already begun: fighting to keep and expand the rights and benefits that were obtained during this health crisis.
“A lot of the reasons why this pandemic affected Latinos at a disproportionate rate are systemic reasons. So now we must continue to advocate, we must continue to inform the decision-makers about all the challenges this community faces always, not only during the pandemic”, said Fiorella Horna. “We want changes that are made now thinking about the future, not only in the face of an immediate threat.”
NOTE: I still need to revise my visuals. I wasn’t able to that this week because we had final work for our thesis in Studio 20.
North Carolina: how construction sites contributed to Covid-19 cases among Hispanics
Hispanics/Latinos represent only 9% of the population but account for 28% of all cases in the state. A lot of them work in the construction sector, one that was deemed ‘essential’ during the pandemic even though construction sites are considered “high-risk” settings for the disease
North Carolina’s construction sites have contributed to form one of the state’s most glaring disparities when it comes to ethnicity and Covid-19: the high prevalence of cases among the Hispanic community. Hispanics represent only 9% of the population but account for 28% of all Covid-19 cases in the state — and this percentage used to be even higher. In July, for example, Hispanics were 46% of all Covid-19 cases in North Carolina. One of the main factors that led to this situation is the fact that there are higher proportions of Hispanics working in essential jobs that make social distancing difficult. One of them is the construction sector, deemed ‘essential’ during the entire pandemic.
On its website, the North Carolina Department of Health’s Covid-19 Response team admits that “farms and meat and poultry processing plants along with construction sites throughout North Carolina appear to be high-risk settings for transmission of Covid-19 due to the nature of the work, the challenge for employees to practice social distancing and the continuous nature of the plant operations”.
According to Fiorella Horna, from El Centro Hispano, a Latino nonprofit organization dedicated to strengthening the community of Hispanics and Latinos in North Carolina, the big issue with construction workers was the transportation to construction sites. “A lot of those workers share transportation to and from sites, they are taken by the contractors or the employers and sometimes those vehicles are packed, so that is where a lot of the concern is.” Fiorella added that there was a bubble of clusters in construction sites in Charlotte, the largest city of North Carolina.
Charlotte is part of Mecklenburg County, one of the two main urban counties in the state. There, the percentage of Hispanics is bigger than the general in the state — Hispanics represent 14% of the population in the county and only 9% in the state. And in there, too, the rate of Covid-19 cases among them is disproportionate: 21% of all cases in the county are among the Hispanic community. County officials also admit that at least a big part of that is because Hispanics work in jobs considered essential, mainly in the construction sector.
Another issue that has contributed to clusters of Covid-19 among the Hispanic community is financial insecurity, workers who find themselves in a very difficult financial situation while afraid that they will get sick and have to miss work. “There are construction employers that provide healthcare and all the right warranties to workers, but there are some small businesses that just don’t do that,” explained Fiorella Horna. “Then those small businesses tell workers that they should get tested if they feel symptoms, but some workers just don’t do that, because if they are sick, they don’t want to find out. They don’t want to miss a day of work and get no payment.” Besides contributing to the transmission of the disease, a scenario like this is also worrying because it means that the patient won’t look for a doctor until the aggravation of symptoms, which is extremely dangerous.
Another factor for worry among Hispanics, according to the Mecklenburg County officials, are the household conditions. Essential workers who are more exposed to the virus can spread the disease to their immediate family members. If they live not only with their kids, but also with their parents or grandparents, that creates multigenerational transmission, which can be very dangerous.
In order to try to avoid construction sites becoming clusters of Covid-19, the Charlotte Commercial Construction Coalition (4C), a coalition of more than 30 Charlotte-area general contractors defined in April a series of rules that employers and employees of the sector should follow. But those are not enough to tranquilize the workers. So far, North Carolina registered 18 reported clusters in construction workplaces, according to state data. What they consider a cluster is a minimum of 5 cases with illness onsets or initial positive results within a 14-day period and plausible epidemiologic linkage between cases.
More concerns and barriers
The decision of considering construction workers as essential workers was, from the beginning, a source of safety concerns that ranged from household to transportation and workplace conditions. “Some people started to express their concerns that construction sites would transform into clusters because of transportation and workplace conditions. It’s not rare to see a lot of these workers sitting in a pickup truck together”, said Alison Kuznitz, a journalist at the local newspaper The Observer who has been covering the pandemic in Mecklenburg County since the beginning.
Kuznitz said she witnessed some efforts by the government to reaching the Hispanic population in the county. “They are doing campaigns in Spanish and briefings with Spanish subtitles; actually not only Spanish but they are translating the campaigns to ten different languages because we have immigrants from other parts of the world who don’t speak English nor Spanish.” According to her, grassroots organizations and food pantries have also been of huge help, since so many workers lost their jobs because of the pandemic or were unable to work due to the long-lasting effects of the disease.
Fiorella Horna, from El Centro Hispano, said the organization used funds received from federal Covid-19 relief to hire new community wellness workers, all women, known among the Hispanic community as “promotoras de salud”. These women work in close contact with the Hispanics bringing quality information and making the bridge between them and the health care services in the region. It is a way of eliminating the language barrier.
Fiorella said while she recognizes that the work of the “promotoras” may have been one of the reasons why the percentage of cases among the Hispanic community in North Carolina went down from 46% in July to 28% in November, it is still a public health issue — and the state has its responsibility over it. “We can help, but we can’t be solely responsible for shifting numbers, of course. We believe that was done collectively.”
She also commented that the work that El Centro Hispano did was an example of North Carolina’s strategy of infusing money on non-profits across the state to reach the Latino community. “Now we continue to advocate, we continue to inform the decision-makers about all the challenges we face so that changes are made now thinking about the future, not only in the face of an immediate threat.”
Not a New Problem
The worrying situation of Hispanics during the pandemic of Covid-19 in North Carolina is, of course, an issue specific to 2020. But suffering from workplace injuries and illnesses is nothing new to Hispanics. Data from “Death on the Job 2020”, a report from AFL-CIO (The American Federation of Labor and Congress of Industrial Organizations), shows that 67% of Latinos killed on the job were immigrants; their job fatality rate was higher than the national average. In 2018, there were 961 deaths of Hispanics because of fatal work injuries. Of those, 294 occurred within the construction industry.
The same document also shows that Hispanics represent the largest number of people affected by Covid-19 by population size: 3.5 million persons were living in the hotspot counties around the country that were examined by the research. The report highlights the responsibility of the agencies in charge of enforcing working conditions and the federal administration. There were no standard procedures regarding that to follow across the country during this pandemic.
According to CPWR (The Center for Construction Research and Training), a nonprofit dedicated to reducing occupational injuries, illnesses, and fatalities in the construction industry, in 2015 there were 2.8 million Hispanics working in construction in the United States. About 73% of them were born outside the U.S..
HEADLINE: Why White Americans are 41% Safer than Black Folks in Florida
INTRO: The current data on coronavirus infection and mortality rate has shown that the unequal burden for life among people of race and ethnicity is 100% real and an extremely diverse human society aiding the pandemic scourge strives in Florida. Excerpt.
That the black Americans are now more likely unsafe is a fact the deadly coronavirus pandemic has scaled up by 59% in Florida. This is at a time when the white Americans are 41% safer from being killed by the virus.
The data obtained over the weekend about the state from Covid-19 Tracking Project on Infection and Mortality by Race and Ethnicity showed people of color risk coronavirus complications more and disproportionately die than the rates for the white people appears not not unnoticed by people in the state.
“There is no clinical evidence that people of color have genetic or other biological factors that make them more likely to be affected by the deadly coronavirus pandemic,” saidWilliam Marshfield, a public health practitioner.
He fielded questions on why people of color get sick and die at disproportionate rates in Florida.
“They are more likely to have underlying health conditions,” he explained.
More updates on the Covid Tracking Project has also shown that while Hispanic/Latino people are more likely to have contracted the virus compared with other races, Black Americans are more likely to have died of COVID-19 in the state.
Covid Tracking Project, a reputable and independent research group, also revealed a likelihood of 5,138 cases per 100,000 Latino people in the state with a death case of 82 per 100,000 thousand among the group of people.
The dataset, which is often updated every two weeks, also revealed that 97 people die out of every 100,000 Black folks with covid infection. It also warned about the possibility of 3,840 cases of COVID-19 among every 100,000 individuals among the group of people.
In Florida, out of every 100,000 white people with the virus, unfortunately 59 people may not survive it. The number of deaths is 41% less than the percentage rate at which black people die of the same infection in the same state.
“Those numbers are scaled by how many numbers of each group live in the state,” Alice Goldfarb, CRDT Lead at Covid-19 Tracking Project confirmed in a chat.
As at the time of filing this report, the Covid Tracking Project data indicated that Florida has reported race data for 79% of cases and 96% for deaths, and it also has ethnicity data for 74% of cases and 92% of deaths through the first week of December.
“Having certain conditions, such as type 2 diabetes, increases your risk of severe illness with covid-19.”
Marshfield, the public health practitioner, has emphasized that where people live and work affects their health. And over time, these factors lead to different health risks among racial and ethnic minority groups.
“Where you live and who you live with can make it challenging to avoid getting sick with COVID-19 and be able to get treatment. For example, racial and ethnic minority members might be more likely to live in multi-generational homes, crowded conditions and densely populated areas, such as some part of Brooklyn in New York City and somewhere like Palatka in Florida and this can make social distancing difficult,” he said.
Palatka, unfortunately, ranks as the poorest place in Florida thanks to a combination of low pay and a lack of jobs. The city of 10,291 people averages the 1st lowest median household income in Florida and the first highest in poverty rate.
“More worrisome is the type of work most of the hardworking minorities do.” Marshfield said, stating that this also may contribute to balck/Africans risk of getting covid-19 than the white people who do most of their work in the confine of their safe and comfort zones.
“Many people of color have jobs that are considered essential or can’t be done remotely and involve interaction with the public. According to the Centre for Disease Control(CDC) nearly 25% of employed Hispanic and Black or African Americans work in the service industry, compared with 16% of non-Hispanic white workers.
“Black or African Americans also account for 30% of licensed practical and licensed vocational nurses. Many people of color also depend on public transportation to get to work. These factors can result in exposure to the virus,” he further explained.
Speaking further Marshfield noted that lack of access to health care is rampant among members of racial and ethnic minority groups and that this is not just common in Florida but likely in every other states in America.
He noted that the black Americans are more likely to encounter barriers to get access for health care, such as health insurance explaining that qualitative health care should right for all as every individuals would need to keep healthy status to guard against being covid19 sick.
According to the Centre for Disease Control only about 6% of non-Hispanic white people were uninsured, while the rate was nearly 18% for Hispanics and 10% for non-Hispanic black people.
Marshfield was of the view that racism may also play a role on health risks of the black communities stating that the stress of dealing with racial discrimination can take a toll on your body, causing early aging. “And this is a proof link to underlying conditions, which can increase the risk of severe illness with coronavirus.
“All of these factors — underlying health conditions, dense living conditions, employment in the service industry or as an essential worker, access to health care and racism — contribute to the impact of covid-19 on people of color.”
“But these are long-standing issues,” he added.
As much of the country was contemplating whether or not to have a Thanksgiving gathering, residents of New Mexico were once again bracing for a stay-at-home order, starting in the second half of November, as COVID cases soared and hospitals reached near capacity.
While the whole state is dealing with a second wave, the pandemic has affected native americans in New Mexico at an alarming rate. This population represents a total of about 11% of the state total, yet they account for 17.26% of all COVID-19 cases.
The numbers become even more chilling when looking at the total number of deaths, as the percentage of Native American and Alaska Natives (AIAN) is almost half. Even by national standards that is notably high: the US average number of COVID-19 AIAN deaths per 100 people is 85, but that number jumps to 290 when looking at New Mexico alone.
The chart below shows the total numbers of deaths by race in New Mexico. About 44.66% of were American Indian/ Alaskan Native. The second most significat category is Latinx, followed by white.
“I feel like it’s almost criminal to let them die at such a high rate,” Jagdish Khubchandani, Professor of Public Health at New Mexico State University said.
Systemic issues that lead to poor healthcare and lack of access to basic services have put these communities at a disadvantage from the outset of the COVID-19 pandemic.
“Pandemics are not made in a day. Pandemics are made in decades. And preparedness is also not done in a day,” Khubchandani said. “[New Mexico] was a poor state before the pandemic, one of the poorest with such a diverse population that had chronically underfunded health systems. I think what we have is the sin of the past punishing us now. We have never prepared to deal with the pandemic nationwide. And with these populations, we didn’t have the outreach, the extension, the messaging methodology.”
Abigail Echo-Hawk, M.A., Director of the Urban Indian Health Institute (UIHI) and chief research officer of Seattle Indian Health Board has been advocating for the importance of better systems of data collection pertaining to American Indian and Alaska Native communities.
“We have seen an underinvestment of public health systems and public health surveillance systems for many many years and we are seeing what happens when you don’t invest in public health,” Echo-Hawk said. “I feel like screaming about this for more than twenty years, because we knew this kind of impact was happening in our communities, and for the very first time people are finally acknowledging it.”
The data for New Mexico seems alarming, but Echo-Hawk says the situation may be even more dire. The actual amount of AIAN population affected might be even higher, because of racial misclassification resulting in underreporting of race and ethnicity data for American Indian Alaskan Native population. A 2014 study by the CDS and Indian Health Service (IHS) found just this: that there were “significant underestimates” of mortality estimates within the AIAN population.
“So when you talk about the incredible amount of death that is showing on the current data trackers what we have to know is that is actually in a very horrific way a gross underreporting, because we know that death certificates are very often racially misclassified,” Echo-Hawk said. “There’s a very common saying for those of us that work in Indian country on data is that we are born native and we die white, because we are racially misclassified on death certificates.”
This underrepresentation is a result in part of faulty racial classification systems in place in hospitals, according to Echo-Hawk.
“People instead of asking race and ethnicity will look at somebody who’s checking into a clinic, who’s come in for an appointment, being hospitalized or has died and decide what race or ethnicity they are without asking families and not asking the individual,” she said.
Even just generally, many counties and states fall short of collecting all the necessary health data in order to keep track of how different communities are affected. In some cases, only a few options will be available for race — mixing all the rest together and doing so erasing the remaining ones from view.
“The ‘other’ category effectively hides all other racial and ethnic groups,” Echo-Hawk said. “I call that a trash category. It is meaningless, it shows nothing and is an excuse for jurisdictions to say ‘well, we did our best’. That is effectively creating a category that hides the disparities of racial and ethnic groups.”
To understand the devastating effects of the pandemic on the AIAN population, Khubchandani says we have to look at both pre causation factors and pandemic response issues.
“Much of what’s happening now with these populations and New Mexico is because of the historic underfunding and being historically marginalized,” Khubchandani said. “These are people who have very poor air quality. They don’t have water to wash their hands. They don’t have the resources and the money to buy materials, and they are getting sicker at a younger age, dying at a younger age than the national average. In part, because they have so many medical complications: high amount of diabetes, hypertension… which is related to poverty, the type of occupations.”
These health disparities are directly connected to the pandemic outcomes.
“These marginalized populations are more likely to not only contract Covid, but to have extreme complications and to die,” Echo-Hawk said. “Health disparities are based on your socio-economic environment: Whether or not you have access to transportation, whether you have access to housing, whether or not there’s been gentrification in your neighbourhood, whether or not you’re homeless.”
Access to healthcare is harder, not only because of geographic factors, for many who live in more remote areas, but also cultural reasons. This means many of the COVID patients from AIAN communities who reach the hospital will already be in a more severe condition.
“Imagine if you have fever right now and you have to go 15 miles to see a doctor, most likely we’ll just let it go,” Khubchandani said. “Most of them seem to be living in areas where there’s no healthcare. So it could be an urban neglected area or a tribal area where there’s no health care. And then it’s hard to reach out to the community. They have their own clanship and clan systems where they heal each other. Traditional medicine outreach has been weak.”
Communication is also a major issue, Khubchandani warned. “Not everyone understands English. Not everyone understands the seriousness of the pandemic,” he said, pointing out Texas — “a state with a large proportion of Hispanic people” — as an example. “They don’t even care to translate messages into Spanish or other languages or plan special communication strategies.”
While Khubchandani believes New Mexico has fared somewhat good in terms of communication, there is still a lot to be desired, especially when it comes to reaching out to people living in remote areas, who for example might not have a cellphone or speak English.
Entities such as the Indian health service, which falls within the Department of Health and Human Services, play a crucial role in this outreach, but their jobs are hindered by the resources they lack.
“They have tried to do some word of the mouth, local flyers and local info, but it’s not been aggressive enough,” Khubchandani said. “They have to be very aggressive. But that’s a difficult population to reach out to.”
Still, the professor believes that, while it’s one of the poorest states in the country, New Mexico’s overall response to the pandemic, on a larger scale has been exemplary when compared to other states — especially given that it’s working with very limited responses. The governor’s action has been stern, taking extreme measure when needed.
“I think New Mexico again is a role model, (…) given so many pre existing disadvantages, whereas I think there are places that had so much advantage and they messed up,” he said. “We have hard populations to reach out to. Navajo nations are not easy to deal with. But still they did what they could.”
Why Latinx people are disproportionately affected by COVID-19 in Colorado.
Job loss, evictions, lack of access to mental health, and wellness support. These are all realities and consequences of COVID-19 for many families across the United States. Yet evidence shows that the virus continues to excessively affect people of color.
Data suggests that COVID-19 has disproportionately affected Latinx communities across the country. An average Latinx person is three times more likely to contract the deadly virus compared to a white person. The disproportionate rates of infection have been particularly obvious in the state of Colorado.
Even though Latinx people make up an estimated 22% of the population in Colorado, they make up 38% of the total coronavirus cases in the state. The graph below shows that cases among Latinx people in Colorado are comparable to cases among White people who make up to 87.1% of the population.
Cases are especially high in Latinx communities in Denver, where they make up over 52% of total cases. Latinx deaths are also disproportionately higher in Colorado, as indicated in the graph below.
When we look at deaths by ethnicity, we see a larger number of Hispanic deaths, as shown in the graph below.
According to Marisa Krueger, the Coordinator of Evaluation and Events at the Latino Community Foundation of Colorado, many Latinx people identify as being White.
“So there’s the white, non-Hispanic, and then there are the Hispanic all races and so that really muddles the data for Latinos as a whole,” Krueger said. “Our data gets a little muddled because a lot of Hispanic folks still identify as white as their main identifier.”
Latinx people are more likely to be essential workers
The high number of COVID-19 cases in Latinx communities could be attributed to the minimal work from home opportunities many Latinx people have. According to UnidosUS, The median household income for Latinx families in Colorado is almost $20,000 less than the state median of $71,953 at only $55,206 and the poverty rate for Latinx people sits at 12.9%, in comparison to the state average of 6.2%.
“It definitely exacerbated a lot of the disparities that already exist in the communities,” said Rachel Griego, the Vice President of Philanthropy for the Latino Community Foundation of Colorado. “It sort of lifted that veil that had been on for a very long time, and has been where people know there are issues and challenges but don’t really know them until they start seeing these large numbers come out.”
According to a survey conducted by Latino Decisions, more than 45% of Latinx workers in Colorado had experienced a cut in work hours or pay because of the coronavirus and 62% of respondents were worried about someone in their family or themselves losing their jobs.
“Economic assistance was the main need at first,” said Krueger. “People were losing their jobs and not being able to get funding for anything.”
According to the Pew Research Centre, an estimated 8 million Hispanic people in the United States were employed in essential services, including restaurants, hotels, and the service sector that put them at higher risk of job loss.
“A lot of them are what you call essential workers,” said Griego. “We’re talking about the people who are still continuing to put food on the table for our communities, whether they’re farmworkers or whether they are retail operators.”
Griego says that many people in the Latino community do not have the luxury to work from home, and are more likely to be exposed to getting COVID-19 due to their occupation.
“They’re not in those types of occupations that allow them to be at home and not to be exposed,” Griego said. “They’re also more likely to take public transportation, there were probably people who were getting COVID as a result of having to take the bus or having to take the metro, they had to make money.”
Cultural differences and language barriers
Another factor that plays a role in a large amount of COVID-19 cases among the Latinx community in Colorado can be related to their number of people who live in one household.
“Our community generally lives in multigenerational households. So you have young children, and you also have older adults in the same house,” said Griego. “It’s economic reasons, but a lot of it is just cultural reasons as well.”
A survey by Latino Decisions shows that the majority of Latinx Coloradan residents do not trust English media on information related to the Coronavirus. Griego believes that the existing messaging about COVID-19 has not been effective with the Latinx community and that it is important that the English speaking Latinx community is working together to make messaging more impactful for people who may have a language barrier.
“You’re trying to talk to someone and it’s not resonating with them, It’s a white person telling me to do X, Y and Z, I don’t know who you are, and I don’t trust you,” Griego said.
Griego believes that there is a lot of misinformation within the community about the coronavirus, which may have contributed to the high amount of cases.
“They don’t think that they’re going to get it, there’s misinformation out there through social media and other things,” Griego said. “There’s also cultural values and religion, I think that there’s some deep-rooted things that we fall back on, in terms of remedies and keeping our families safe, and for a pandemic and how COVID spreads, it just doesn’t work.”
Currently, the Latino Community Foundation of Colorado actively working on resources and ways to minimize the misinformation and send correct messaging on the COVID-19 outbreak.
“We worked to do some culturally responsive lists and making sure that people felt comfortable with where you send them to seek out these resources,” Krueger said. “ We know everyone is struggling, but if you go somewhere where the person can’t even speak the same language as you, you’re not going to have a good experience.
How COVID exacerbated the technical divide
A report by Colorado Future Centre estimated that there are almost 55,000 school-aged children in Colorado who do not have reliable internet connections in their homes, and more than 75% of them are from a Hispanic background. Many of these school-aged children, also have parents who work in companies that do not allow them to work from home. An estimated 57% of these parents are considered essential workers.
An executive order by Governor Polis asked all schools in Colorado to close on March 18th. Although schools had the opportunities later to open up, many districts had already decided to move their teaching completely online.
“So we have a single lady that was fired from her job in June, she couldn’t even have her kids go to school because she couldn’t pay the rent and she lives in a mobile home,” said Maria Gonzalez, the founder of the Adelante Community Development Team. “They shut down the internet, so no communication, and she could not afford to have a cell phone.”
In response to these technical barriers, Colorado state filed a petition which urged Federal Communications Commission to waive restrictions on federally funded broadband access in student homes. The petition hoped to extend the access of internet connectivity to student’s homes. Colorado’s Commissioner of Education, Katy Anthes, also announced in September that the state will invest $2 million in coronavirus relief funds to ensure that all students have access to the necessary resources which will allow them to study from home.
The state is also working closely with large telecommunications companies, to provide a free hotspot for families of students. T-mobile is working on providing 100GB of data a year for low-income families which will be available for the next five years.
For Gonzalez, she believes that the most important thing the state can do is to include Latinx people in decision making and conversations.
“People are making decisions where we are not a part of, and we’re not being acknowledged, we’re not being validated. It’s time we have a seat on the table and talks about it,” she said. “As members of the community, we contribute, we pay taxes we work, there is so much we contribute to, but where is our support?”