{"id":898,"date":"2020-12-07T04:08:12","date_gmt":"2020-12-07T09:08:12","guid":{"rendered":"https:\/\/nyujournalismprojects.org\/gdjfall20\/?p=898"},"modified":"2020-12-07T09:58:17","modified_gmt":"2020-12-07T14:58:17","slug":"catarinas-revised-story","status":"publish","type":"post","link":"https:\/\/nyujournalismprojects.org\/gdjfall20\/index.php\/2020\/12\/07\/catarinas-revised-story\/","title":{"rendered":"Catarina&#8217;s Revised Story"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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.<\/span><\/p>\n<p>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.<\/p>\n<div class='tableauPlaceholder' id='viz1607332694420' style='position: relative'><noscript><a href='#'><img alt=' ' src='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CO&#47;COVID-19DeathsinNewMexico&#47;COVID-19DeathsinNewMexico&#47;1_rss.png' style='border: none' \/><\/a><\/noscript><object class='tableauViz'  style='display:none;'><param name='host_url' value='https%3A%2F%2Fpublic.tableau.com%2F' \/><param name='embed_code_version' value='3' \/><param name='site_root' value='' \/><param name='name' value='COVID-19DeathsinNewMexico&#47;COVID-19DeathsinNewMexico' \/><param name='tabs' value='no' \/><param name='toolbar' value='yes' \/><param name='static_image' value='https:&#47;&#47;public.tableau.com&#47;static&#47;images&#47;CO&#47;COVID-19DeathsinNewMexico&#47;COVID-19DeathsinNewMexico&#47;1.png' \/><param name='animate_transition' value='yes' \/><param name='display_static_image' value='yes' \/><param name='display_spinner' value='yes' \/><param name='display_overlay' value='yes' \/><param name='display_count' value='yes' \/><param name='language' value='pt' \/><param name='filter' value='publish=yes' \/><\/object><\/div>\n<p>                <script type='text\/javascript'>                    var divElement = document.getElementById('viz1607332694420');                    var vizElement = divElement.getElementsByTagName('object')[0];                    vizElement.style.width='100%';vizElement.style.height=(divElement.offsetWidth*0.75)+'px';                    var scriptElement = document.createElement('script');                    scriptElement.src = 'https:\/\/public.tableau.com\/javascripts\/api\/viz_v1.js';                    vizElement.parentNode.insertBefore(scriptElement, vizElement);                <\/script><\/p>\n<p><span style=\"font-weight: 400;\">\u201cI feel like it\u2019s almost criminal to let them die at such a high rate,\u201d Jagdish Khubchandani, Professor of Public Health at New Mexico State University said.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cPandemics are not made in a day. Pandemics are made in decades. And preparedness is also not done in a day,\u201d Khubchandani said. \u201c[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\u2019t have the outreach, the extension, the messaging methodology.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cWe 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&#8217;t invest in public health,\u201d Echo-Hawk said. \u201cI 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.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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 \u201csignificant underestimates\u201d of mortality estimates within the AIAN population.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cSo 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,\u201d Echo-Hawk said. \u201cThere&#8217;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.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This underrepresentation is a result in part of faulty racial classification systems in place in hospitals, according to Echo-Hawk.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cPeople instead of asking race and ethnicity will look at somebody who&#8217;s checking into a clinic, who&#8217;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,\u201d she said.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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 \u2014 mixing all the rest together and doing so erasing the remaining ones from view.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cThe \u2018other\u2019 category effectively hides all other racial and ethnic groups,\u201d Echo-Hawk said. \u201cI call that a trash category. It is meaningless, it shows nothing and is an excuse for jurisdictions to say &#8216;well, we did our best&#8217;. That is effectively creating a category that hides the disparities of racial and ethnic groups.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cMuch of what\u2019s happening now with these populations and New Mexico is because of the historic underfunding and being historically marginalized,\u201d Khubchandani said. \u201cThese are people who have very poor air quality. They don\u2019t have water to wash their hands. They don\u2019t 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\u2026 which is related to poverty, the type of occupations.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These health disparities are directly connected to the pandemic outcomes.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cThese marginalized populations are more likely to not only contract Covid, but to have extreme complications and to die,\u201d Echo-Hawk said. \u201cHealth 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&#8217;s been gentrification in your neighbourhood, whether or not you&#8217;re homeless.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cImagine if you have fever right now and you have to go 15 miles to see a doctor, most likely we\u2019ll just let it go,\u201d Khubchandani said. \u201cMost of them seem to be living in areas where there\u2019s no healthcare. So it could be an urban neglected area or a tribal area where there\u2019s no health care. And then it\u2019s 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.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Communication is also a major issue, Khubchandani warned. \u201cNot everyone understands English. Not everyone understands the seriousness of the pandemic,\u201d he said, pointing out Texas \u2014 \u201ca state with a large proportion of Hispanic people\u201d \u2014 as an example. \u201cThey don\u2019t even care to translate messages into Spanish or other languages or plan special communication strategies.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cThey have tried to do some word of the mouth, local flyers and local info, but it\u2019s not been aggressive enough,\u201d Khubchandani said. \u201cThey have to be very aggressive. But that\u2019s a difficult population to reach out to.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Still, the professor believes that, while it\u2019s one of the poorest states in the country, New Mexico\u2019s overall response to the pandemic, on a larger scale has been exemplary when compared to other states \u2014 especially given that it\u2019s working with very limited responses. The governor\u2019s action has been stern, taking extreme measure when needed.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cI think New Mexico again is a role model, (\u2026) given so many pre existing disadvantages, whereas I think there are places that had so much advantage and they messed up,\u201d he said. \u201cWe have hard populations to reach out to. Navajo nations are not easy to deal with. But still they did what they could.\u201d<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>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. 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