Ask Code Switch: The Coronavirus Edition
Ask Code Switch: The Coronavirus Edition
We asked you to email us all of your questions about race and COVID-19, and you sent us some great ones. We went through the inbox and narrowed them down to six we wanted to sink our teeth into.
On this week's episode, Karen Grigsby Bates and Gene Demby respond to a white woman who's concerned about being an ally to an Asian friend who is worried about harassment. And we take on the question of why Native American communities are so vulnerable to COVID-19 — and why so little is being done about it.
And here, we've got answers to four more of your questions. First up, a related question about Native Americans:
The news is focused on African Americans and COVID-19, but my impression is that Native Americans face the same problems. Are the statistics similar for Native Americans? — Marian Moore, New Orleans
In an ideal world, the answer to this question would be straightforward; we would be able to look at national statistics about COVID-19 cases and deaths in different racial groups and compare the outcomes of African Americans outcomes with Native Americans.
Unfortunately, as Alexis Madrigal of the COVID Tracking Project pointed out in a recent episode, no such standard national statistics on race and the coronavirus exist. It's up to each state's public health department to report its own statistics, and while most regions — except for Nevada, Nebraska, North Dakota and four U.S. territories — are reporting some kind of racial or ethnic breakdown of cases and/or deaths, it's extremely scattered. For example, it's not possible to get a complete picture of the racial demographics of COVID-19 deaths for all 50 states and five major U.S. territories, because only 41 of those regions report those statistics.
To make matters worse, Native Americans often aren't counted at all in states' coronavirus racial trackers; instead, they're counted as "other." Rebecca Nagle, a writer and citizen of the Cherokee Nation, wrote about this problem for The Guardian, finding that about half the states reporting racial data are lumping indigenous folks into the "other" category.
That's a huge problem when trying to figure out how Native Americans are being affected, Nagle says. She has seen that several states, including Michigan, have opted to lump Native people into "other" because they make up less than 1% of the state's population. But those small numbers are a result of centuries of genocide of Native peoples, as Abigail Echo-Hawk, the chief research officer of the Seattle Indian Health Board, told Nagle. And despite making up a small share of the total population, the community often sees disproportionately bad public health outcomes, Nagle argues.
"A lot of times, when you look at the impact of things in our communities, you see that we're being impacted by things two to three to five to 10 times what the rest of the United States is," Nagle says.
Those disproportionate impacts are playing out right now at their most extreme in New Mexico, where Native Americans make up a little over 10% of the total population, but over half of the coronavirus deaths, according to the state's public health department. And the Navajo Nation, whose land spans Arizona, New Mexico and Utah, has seen a huge number of cases. The Indian Health Service reports that, as of May 10, 3,363 of the Nation's residents have tested positive, accounting for more than half of all the estimated COVID cases in Indian country.
So far, from the available data, we've seen that COVID-19 has impacted Native Americans at disproportionate rates, similar to African Americans. But that data is woefully incomplete, and it's unclear whether epidemiologists will ever get good nationwide data about the disease's impact on Native people.
I am concerned about the disproportionately high rate of maternal mortality of African American women and what this virus might mean for them. I am also concerned about the recommendations of not letting a support person into hospitals with a laboring person. I feel like this is a recipe for disaster. — Jenny Gaskell, Wisconsin
Unfortunately, Jenny is right to be concerned. Although there's no hard data on how people giving birth in the U.S. have been affected by the coronavirus, medical experts told us that they're concerned about pregnant women during this time. After all, women in the United States are dying in childbirth at a rate higher than any other "developed" country, and it's the only country where the rate has been rising.
But for years, we've known that black women are significantly more likely to die during childbirth than white women; to be exact, the CDC found in 2019 that black women were 3.3 times more likely to die. Their babies are twice as likely to die during infancy than white babies. A study in 2016 found that black women with a college degree were still more likely to die than a white woman who never graduated high school.
"The reason we're dying is because we've been put in harm's way for generations," says Dr. Joia Crear-Perry, founder and president of the National Birth Equity Collaborative. "The consequences of being put in harm's way, of being devalued, being seen as less than worthy, comes out in our policy and our outcomes. And it really ultimately shows up being overrepresented in death."
Crear-Perry notes that added safety precautions at hospitals have restricted delivery-room access for support people, such as doulas. And for black women, a support person is often the only other person in the room advocating for them when doctors dismiss their concerns, she says.
"You want, as a health care provider, the person to have support because it makes their birth better. It makes their outcomes better. It makes them calm. They're not an ancillary part," Crear-Perry added.
So, the short answer to this question? Birth advocates are worrying and thinking about this problem, too.
To me, it feels like we don't have much of a social safety net and that much of what we do have is tied into schools —meals, laundry, emotional support, even health care to an extent. How are we seeing kids of different races being impacted by this lack of protection differently? — Ama Kwabia, North Carolina
That's a correct hunch. Schools in the United States have come to represent essential places for many families, and not just because they're where children go to learn.
Michelle Burris with the Century Foundation, a progressive think tank tackling research around subjects including education and the economy, has been finding concerning outcomes during the ongoing pandemic. Black, Latino and indigenous youth are the most affected by a lack of a social net in school, she told us, because "unfortunately this country has not been able to decouple race and poverty."
Burris noted that all parents have lost the child care schools provided. But, with 37.7 percent of black workers employed in essential industries, black workers 50% more likely to work in the health care industry and 40% more likely to work in hospitals, the loss of child care is forcing many parents to leave their children at home without supervision.
She's worried about two things in particular: food insecurity and a lack of Internet access. In the United States, 1 in 5 children rely on food stamp assistance and over 50 percent of students qualify for free or reduced-price lunches. It's a problem persistent in communities of color.
Many schools are aware of the fact that for many children, schools are the one place they can receive daily meals, as our colleagues on NPR's education team have reported. Many have opened grab-and-go food centers or opted to deliver meals via school bus.
And the shift to online learning has highlighted similar disparities in Internet access. The percentage of students with limited or no access is highest in American Indian/Alaska Native students (27 percent) followed by black students (19 percent). In rural neighborhoods, 41 percent of black students and 26 percent of Hispanic students reported having no Internet.
"Internet is not a luxury. It's a civil right, because students need the Internet in order to complete their homework [and classwork]," Burris says.
Burris recently interviewed teachers across the country about what they were seeing in their own classrooms in regards to the digital divide. One teacher in St. Louis reported that, in her nearly all-black classroom, only about 20 percent of her students log into Zoom classes.
In Massachusetts, one teacher saw that before the pandemic, 7% of her students had C's or D's. "Now," Burris says, "almost 60% of her kids are failing because the kids don't have a laptop."
Many of my black and Latinx family members are having trouble believing the severity of COVID-19. There is very little trust for the government and medicine. With the context of our history, I understand their feelings and share them too. However, I also believe social distancing is required to get through this pandemic. I have watched so many of my people out and about like NOTHING is happening. Now this week several close family members have been hospitalized with COVID-19 Can we convince them to stay home? —Altinay Cortes, Philadelphia
Here's a suggestion: Help your family; don't lecture them. They might be confused about what's safe, because every state has different guidelines, and there's a lot of conflicting information out there. Even for people who are following the news closely, the guidance has changed so much: Remember when the Centers for Disease Control and Prevention said wearing masks wasn't necessary to stop the spread, and then changed that guidance in April?
So there's conflicting advice out there, combined with the long history of government and medical officials not doing right by people of color. Medical racism is as old as modernity itself; and so you can understand why some families aren't hanging on every word from the CDC.
Try this with your loved one: Tell them it's better to be supersafe than sorry. If you think they might read (and take seriously) articles by leading science writers like Ed Yong or Caroline Chen, send them along. And help them get the personal protective gear that they might need, like the masks, hand sanitizer and disinfecting wipes. That way, it doesn't sound like you're scolding them.
One more thing: Make sure your folks are following fact-based, reputable news sources. One pundit saying that social distancing is unnecessary can do a lot of damage.