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Support inclusive wildfire relief.
As wildfires rage through California again this fall, the disparity in media coverage is affecting relief efforts for residents of color. Media coverage and public pressure can affect which communities are prioritized for relief, with attention often focusing on more affluent white areas. But in fact, research has shown that communities of color are disproportionately affected by environmental disasters due to socioeconomic factors, structural racism in housing practices, and citizenship status (UW News). Wildfires are no exception.
TAKE ACTION
Diversify your news sources by reading news specific to the western United States from Indigenous perspectives such as High Country News.
Support the Indigenous People’s Burning Network and learn about tribal burning practices.
Donate to the Unete Center for Farm Workers and Immigrant Advocacy Fire Relief Fund.
GET EDUCATED
As wildfires rage through California again this fall, the disparity in media coverage is affecting relief efforts for residents of color. Media coverage and public pressure can affect which communities are prioritized for relief, with attention often focusing on more affluent white areas. But in fact, research has shown that communities of color are disproportionately affected by environmental disasters due to socioeconomic factors, structural racism in housing practices, and citizenship status (UW News). Wildfires are no exception. As covered previously, mainstream conservation practices are rooted in colonialism and white supremacy. Consequently, they’re ill-equipped to address the particular needs of residents most at risk (Anti-Racism Daily). Undocumented farmworkers are disproportionately affected by wildfires, and Indigenous people live on land that is, on average, six times more prone to wildfires than others (UW News). However, people of color are vastly underrepresented in coverage of environmental disasters (Louisiana Weekly). While representation in the media has been under scrutiny as of late, the exclusion of these narratives could be directly affecting the distribution of aid. For these already vulnerable communities, a lack of media attention further increases their capacity to recover (UW News). Due to the lack of federal resources, on the ground community-led efforts are attempting to fill in the gap (OPB).
Research demonstrates that wealthier, white areas are more likely to receive aid, though predominantly Black, Latinx, and Indigenous communities are at 50% greater risk of wildfires (UW News). Matthew Wibbenmeyer, an economist and researcher at Resources for the Future says, “certain communities are more able to rally government support” (NYTimes). With organized and widely available resources, affluent, suburban communities are receiving the brunt of wildfire relief and media attention. The communities most at risk lack basic necessities like health insurance and vehicle access. These resources would make it more feasible to recover from environmental disasters such as wildfires. For instance, federal fuel treatment projects are largely implemented in predominantly white communities whose residents were over the poverty line. These projects reduce the amount of flammable vegetation in the area, drastically reducing the start and spread of wildfires. In the absence of fuel treatment programs, government assistance advises residents to invest in prohibitively expensive air conditioning or air purifying units, placing a heavy burden on individuals to compensate for structural shortcomings.
Alternatively, within some Indigenous communities affected by wildfires, there is a practice known as tribal burning. This can often mitigate the risk of wildfires. For years, it had been banned in California. But, as new policy seeks to form relationships with Indigenous communities, research is being done to show how the cultural practice can help to not only reduce the risk of wildfire but foster new growth in the affected areas (The Nature Conservancy). It is not enough for policy to allow the practice of tribal burning though, as Beth Rose Middleton Manning, a professor of Native American studies, observes, “I think it's really important that we don't think about traditional burning as: what information can we learn from native people and then exclude people and move on with non-natives managing the land”. She hopes to see indigenous leaders at the forefront of any tribal burning practice (NPR).
Similarly, much of the organized relief work has fallen on the shoulders of local organizers and BIPOC-led relief efforts. Activists such as Dagoberto Morales identified that one of the best ways to provide wildfire relief is to double down on community building. Through his organization Unete Center for Farm Workers and Immigrant Advocacy, he believes in long-term disaster relief through empowerment (OPB, Unete). While community members have organized their own aid networks, attention to those efforts alone would go a long way to furthering their cause. As effective as on-the-ground aid efforts can be, many residents are still vastly reliant on federal aid which has been diverted due to a lack of updated policies and understanding. News and media coverage for marginalized communities most at risk from wildfires could generate help for the grassroots organizations but also change misconceptions that hinder federal aid.
Sindhu Nallapareddy is a new transplant to Philadelphia who enjoys creating spreadsheets to track her reading habits, running and caring for her beloved chihuahua. You can find her on Instagram @reddysteadygo.
KEY TAKEAWAYS
Research shows that communities of color are among the most at-risk populations during the current wildfires in California.
News coverage can determine which communities receive federal aid, and BIPOC narratives are largely missing in the reporting on these wildfires.
On-the-ground relief efforts by grassroots organizations are bearing the brunt of providing relief and aid to the communities of color most affected by this environmental disaster.
PLEDGE YOUR SUPPORT
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Demand universal sick leave.
The pandemic has only deepened existing fault lines of class, race, and gender oppression. The ubiquity of the coronavirus has highlighted these structural inequalities, producing disparate effects on different populations. “Essential workers” were briefly lauded as “heroes” last year. Many of these workers, essential to maintaining community health and sustenance during a pandemic, would not typically receive paid sick days themselves.
TAKE ACTION
Demand that Congress mandate paid sick leave for all workers.
Follow Paid Leave for All on Twitter.
Support campaigns for expansive paid sick leave at the municipal level, like this one from Philadelphia.
GET EDUCATED
By Andrew Lee (he/him)
The pandemic has only deepened existing fault lines of class, race, and gender oppression. The ubiquity of the coronavirus has highlighted these structural inequalities, producing disparate effects on different populations. “Essential workers” were briefly lauded as “heroes” last year. Many of these workers, essential to maintaining community health and sustenance during a pandemic, would not typically receive paid sick days themselves.
Some people talk about the United States lagging behind other “developed countries” when it comes to offering paid sick leave, but this actually undersells the problem. 93% of all countries offer paid sick leave to all workers (P.R.I.). The U.S., both the richest and most inequitable country in the world (N.Y. Times), is part of the 7% which fails to do so. The United States also fails to mandate paid parental leave, unlike countries such as Germany, Mexico, and Niger. And U.S. workers aren’t required to receive paid vacation days. In contrast, workers in Algeria receive about a month every year. (Yahoo! News). The U.S. Family and Medical Leave Act mandates that employers provide unpaid leave for certain conditions but leaves out common diseases like the flu. This excludes millions of workers who are new hires or employees of small businesses (Department of Labor).
Since employers in the United States aren’t required to provide any paid sick leave to their employees, many do not. About 32 million workers have no sick leave whatsoever, with less lucrative jobs less likely to offer sick days (Pew). Such workers are three times more likely to forgo medical care than those who would be paid during their absence (Health Affairs).
The absence of mandatory paid sick leave means people have to choose between working while sick or missing pay and potentially putting their job at risk. 63% of Americans are living paycheck-to-paycheck, and almost half were spending beyond their means even before COVID (CNBC). For many, the choice between working while sick and losing income by calling out is no choice at all. Out of economic necessity, they are forced to risk worsening their own health and the health of coworkers or customers.
One survey found that 90% of office workers go into work while ill, with 33% reporting that they never call out sick (Robert Half). 12% of food service workers said they’ve worked while experiencing vomiting or diarrhea (CDC). Companies like Instacart and DoorDash promised COVID sick time for delivery drivers, but in practice, it was “onerous” to even apply (CNET). Since gig workers get paid by the job, some were seen wading through waste-deep sewage water (Gothamist) to deliver food as the remnants of Hurricane Ida flooded NYC (USA Today). All in all, a pre-COVID survey found that 39% of workers went to work with flu-like symptoms (N.Y. Times). And though the federal government provided paid sick leave for workers with COVID, few knew it existed (US News).
And when companies do offer paid sick leave, it’s often inadequate. Many times, workers receive just a handful of days each year (Yahoo! News). Paid Time Off (PTO) policies, which combine vacation and sick days, ensure that employees with medical conditions receive less vacation time than their colleagues (USA Today). Other companies offer inadequate sick leave but allow employees to “donate” sick days to a coworker, leading one Florida teacher to go viral for begging his coworkers for sick days to finish chemotherapy (MarketWatch).
The result? A “near-guarantee that workers will defy public health warnings and trudge into their workplaces, regardless of symptoms” (Inverse). Low-wage jobs where people of color are overrepresented are the least likely to offer paid sick leave, compounding with other racial disparities in health and healthcare (CDC).
Every worker should accrue paid time to recover from illness as a condition of employment. Unionized workers are dramatically more likely to receive paid sick leave than non-union workers. Sick leave and employer-provided health insurance, which union workers almost universally receive (Pew, EPI), are often priorities when unions fight for concessions from employers. Scores of organizations like the NAACP are calling for federal legislation to mandate sick leave for all employees (NAACP), while other focus on just sick leave policies at the state and local levels. Workers shouldn’t have to choose between a paycheck and their health.
KEY TAKEAWAYS
93% of countries mandate paid sick leave for employees. The U.S. does not.
Because of this, nine out of ten U.S. workers work while sick.
Local, state, and federal initiatives, along with workplace organizing, bring us closer to universal paid sick leave.
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
Subscribe on Patreon | Give one-time on PayPal | Venmo @nicoleacardoza
Take action on the IPCC report.
This week, the Intergovernmental Panel on Climate Change released a sobering report predicting that global temperatures will exceed the 2015 Paris Climate Accords’s limits in just 20 years regardless of government action. The Arctic is expected to be free of ice in the summer at least once by mid-century. In the worst-case scenario, the ocean will rise over six feet by century’s end (New Scientist).
TAKE ACTION
Review the action items below, curated in part by youth environmental activists of color.
GET EDUCATED
This week, the Intergovernmental Panel on Climate Change released a sobering report predicting that global temperatures will exceed the 2015 Paris Climate Accords’s limits in just 20 years regardless of government action. The Arctic is expected to be free of ice in the summer at least once by mid-century. In the worst-case scenario, the ocean will rise over six feet by century’s end (New Scientist).
We’ve compiled some of our previous coverage highlighting the disproportionate effects environmental degradation has on communities of color in the United States and around the world. But our reporting also highlights that climate disaster isn’t inevitable. People are coming together to resist and transform the oppressive, extractive systems propelling the destruction of the ecological systems that sustain us all. Many of those at the forefront of these movements are from the marginalized communities who bear the brunt of climate change, pollution, and environmental degradation. As recent news demonstrates the urgency of taking action to preserve our world, these are the organizations we should all take time to support.
1. Confront Rising Temperatures
“To preserve a habitable world for all of us and our descendants may require a fundamental shift in how we produce things and structure social and international relations. In the short term, a blanket approach to environmentalism will not suffice. Even major philanthropic foundations are starting to recognize that environmental racism and climate change affect poor nations and communities of color first (AP). Supporting the leadership of these communities in opposing the destructive systems that threaten life as we know it is a human imperative.”
Take Action
Understand the impact of environmental racism.
Support frontline community organizations like Memphis Community Against Pollution and Stop General Iron.
2. Quannah ChasingHorse on Generational Change
“Back when I was ten years old, we would get about 60 fish a day in our net or fish wheel. Now we only get, like, eight, and half of them aren't good to eat because of how toxic the waters have become due to the oil and gas development up North, and the mining… So that’s why I push for advocacy. I think sometimes I’m a rude awakening because not many people accept the fact that the climate crisis affects our way of life and our future generations. I’m afraid that our future generations won’t get the opportunity to learn hands-on, just from books and pictures.”
Take Action
Donate to the Indigenous Environmental Network, an alliance of grassroots Indigenous Peoples whose mission is to protect the sacredness of Mother Earth.
“Saving the Earth isn’t a single-focus issue. Progress lies at the intersection of nearly every human rights issue. Incarceration, immigration, disability justice, global security, landback initiatives – we can’t address any of these until we are willing to analyze how climate change encourages and exacerbates each. In addition, we must understand that the brunt of the adverse impact of climate change will be felt by those most marginalized – not necessarily those that forget to recycle – creating a never-ending cycle of cause and effect. The voices most impacted are often left out of the conversation, developing policies and practices that don’t center those most harmed.”
Take Action
Join a local chapter of a youth-driven organization addressing climate change, including Sunrise Movement, Fridays for Future and Extinction Rebellion.
4. Anya Dillard on Effective Organizing
“I would say that racism and climate change have a lot in common. People love to debate both of their existences, people love to say how either does or doesn’t affect one group, when in reality it affects everyone in the long term. It’s interesting to think about it this way because when we think about racism, we think we’ll be good after we fix our law enforcement system and initiate a reparation system. But in reality, there are a lot of trickle-down effects of racism, and at least one of those falls under the umbrella of environmental change.”
Take Action
Donate to WeGotNext, which amplifies individual stories of adventure and activism from communities that have been underrepresented in outdoor and environmental spaces.
5. Jana Jandal Alrifai on Intersectional Change
“We don't just need to reverse climate change and the climate crisis. We need to make sure that it doesn't happen again. We have to tackle environmental racism, that everyone is not equally impacted by climate change, and that BIPOC communities often have factories and machinery located in their neighborhoods, affecting their health. Their neighborhoods are more likely to flood.”
Take Action
Sign the petition advocating for No More Empty Summits, urging the Biden administration to take more action to address climate change.
“Importantly, climate justice is a grassroots movement. Climate Justice Alliance, for example, comprises frontline organizations. Engagement centered in the communities— not top-down policies created by disengaged congressmen—is necessary. But for BIPOC activists, it can also be dangerous. Jayce Chiblow, a leader at the Canadian organization Indigenous Climate Actions, noted that while ‘Youth are leading us and taking on frontline activity,” many of them experienced violence and were arrested and removed as a result of their activism (Resilience.org). Read some profiles of Indigenous activists here.”
Take Action
Join or support climate justice organizations, such as PODER (@poder.sf), the Environmental Transformation Movement of Flint, or the Center for Earth Energy and Democracy.
7. Alexis Saenz and Community Care
“Our mission is to protect land and water, and to help Indigenous youth become leaders of their communities. We are the International Indigenous Youth Council, which means we include Indigenous people from everywhere, from Mexico, from Panama, from Guatemala, all over. And the goal is to eventually have IIYC chapters across Unči Maka, Mother Earth. Initially, we were focused on frontline non-violent direct action. That's how we started at Standing Rock.”
Take Action
Follow and support the International Indigenous Youth Council.
8. Mohammad Ahmadi on Environmental Activism
“I'm hoping to leave behind a world that is not ravaged by the climate crisis. So we avoid 1.5 degrees Celsius or two degrees of warming each year. I’m just trying to leave behind a more educated population. The youth is the next generation, so if we can educate them, they will demand change from the government faster when they’re older – whether it’s climate justice, racial justice, or anything else.”
Take Action
Donate to Earth Uprising, a nonprofit organization providing resources and opportunities to support the youth climate movement.
Join Earth Uprising as an organizer by filling out this form.
Key Takeaways
43% of white Americans say that they are “very confident” in their tap water, while only 24% of Black Americans and 19% of Hispanic Americans indicate the same degree of confidence.
Corporations are often allowed to bottle and resell municipal tap water at a high mark-up, skirting rules and regulations that disproportionately affect lower-income communities.
We need to mobilize around protecting the source of clean water, and center Indigenous communities who steward the land and waters.
Protect access to drinking water.
The pandemic only accelerated a growing market: bottled water is a trending beverage, fueled by not just water skepticism, but a rise in health-conscious consumer habits. Michael C. Bellas, chairman and CEO of Beverage Marketing Corporation noted that the pandemic “showed how consumers have come to depend on bottled water for healthy, calorie-free hydration and refreshment” (Beverage Marketing). But is it fair that so many people are forced to rely on buying bottled water for their well-being?
TAKE ACTION
Donate to the Lowndes County Unincorporated Wastewater Project to fund onsite wastewater systems.
Take action to stop Line 3 by sending a letter to call for a full federal environmental impact statement regarding the threats of this pipeline. Please customize the letter before sending.
Tell your senators and representatives to support federal investment in getting lead out of our drinking water.
GET EDUCATED
By Nicole Cardoza (she/her)
The pandemic only accelerated a growing market: bottled water is a trending beverage, fueled by not just water skepticism, but a rise in health-conscious consumer habits. Michael C. Bellas, chairman and CEO of Beverage Marketing Corporation noted that the pandemic “showed how consumers have come to depend on bottled water for healthy, calorie-free hydration and refreshment” (Beverage Marketing). But is it fair that so many people are forced to rely on buying bottled water for their well-being?
According to a survey by SOURCE Global PBC, 43% of white Americans say that they are “very confident” in their tap water, while only 24% of Black Americans and 19% of Hispanic Americans indicate the same degree of confidence. And this sentiment was only enforced by the onset of the pandemic. In March 2020, bottled water sales increased by 57% as people stocked up – whether preparing for water shut-offs, stockpiling in the face of uncertainty, or as a result of worsening infrastructure. 25% of Black Americans indicate that they’ve been drinking more bottled water since the pandemic started. In contrast, 62% of white Americans state they haven’t changed their consumption at all (Forbes).
This sharp difference in bottled water consumption is rooted in the systemic inequities found in access to clean water. According to environmental advocacy group, Clean Water Action, 75% of Black Americans are more likely to live near polluting facilities than the general population. In addition, Hispanic American people are twice as likely to live in communities where the drinking water violates contamination laws (Forbes). These communities are often crippled by poor infrastructure that’s only worsening due to the impact of the pandemic.
In Lowndes County, Alabama, there are dozens of residents that have septic tanks in disrepair, with no ability to connect to municipal sewer lines. As a result, raw sewage is backing up into local homes or flowing directly into open-air pits, contaminating drinking water and spreading E. Coli and hookworm. Lowndes County’s Perman Hardy spent “hundreds of hours” advocating for her community until she finally got almost $3 million pledged for wastewater treatment (AL). But a technicality at the County Commission level caused the grant money to be returned in its entirety, leaving residents without recourse (AL). Earlier this year, we also highlighted the issues that homes in Jackson, MS are experiencing; to this day, they are still undergoing boil alerts.
As a result, corporations get to profit off of skepticism and scarcity. Initially, most of the bottled water sold in the U.S. came from natural springs. But as purification processes improved and demand grew, many brands moved to selling bottled tap water collected from the plant’s local utilities provider. Today, most of the bottled water in the U.S. is actually bottled from tap water (The Guardian). When residents in Detroit started to fall behind on their utilities bills during the pandemic, their water was shut off, forcing many to buy bottled water as a fallback. But Coca-Cola, who bottles Dasani water at the company’s Detroit plant, was allowed to rack up past-due bills while they bottled and sold the same water to citizens at a 133x markup (The Guardian). Although major bottled water distributors have been lauded for donating bottled water for those in need, it’s worth scrutinizing the business practices that enable them to be that generous.
The latest infrastructure bill currently under consideration in the Senate includes $15 billion dedicated to improving water quality over the next five years, with some funds specifically allocated to “small and disadvantaged communities” (NYTimes). This bill will be the largest federal investment in clean water in our nation’s history, and designed to address some of the major infrastructure issues affecting people across the U.S. (PBS). But we also need to see more action from the federal government on creating more equity with how major companies can hoard this resource.
We also need more concerted efforts to protect the sources of our water supply, which is increasingly under threat. Consider the current initiative to stop the Line 3 Pipeline, which is expected to funnel nearly a million barrels of tar sands (one of the dirtiest fossil fuels) through Indigenous lands between Alberta, Canada and Wisconsin, trampling through untouched wetlands and the Mississippi River headwaters (Stop Line 3). If we continue to allow corporations to control our relationship to water, rather than listening to the wisdom of Indigenous people that steward our land and water, it’s likely we will have nothing left.
When we talk about the rise of bottled water consumption, the onus is often placed on the individual, blaming them for the environmental impact of all that plastic “going to waste”. Yes, we can all do our part to minimize plastic consumption, and there’s a clear environmental impact (The Guardian). But all that attention is shielding ourselves from the real issue – that significant environmental issues contribute to the consumption of bottled water, not simply caused by them. And it’s going to take significant policy work – both on the local, state and federal level – to address the underlying issues that make clean water inaccessible.
We also need to work on shifting the deep distrust that these disparities have created. My grandmother was raised in a city where they didn’t trust tap water. As a result, she didn’t encourage her children to drink water. Consequently, mom didn’t encourage it with us (while we were young, at least. Her habits have since changed). All this despite the fact that we moved to a rural environment where the water is more trustworthy. In Flint, MI, the lack of trust between residents and city leader after willful neglect during their water crisis influenced public perception of the vaccine (NBC News).
As we continue to advocate for proper infrastructure, support local individuals and organizations doing their best to provide others with clean water, and protect this precious resource. Many of these efforts are grassroots, mutual-aid driven initiatives, organized by brave people uncompromising for change. Maybe you can be that person for your community.
Key Takeaways
43% of white Americans say that they are “very confident” in their tap water, while only 24% of Black Americans and 19% of Hispanic Americans indicate the same degree of confidence.
Corporations are often allowed to bottle and resell municipal tap water at a high mark-up, skirting rules and regulations that disproportionately affect lower-income communities.
We need to mobilize around protecting the source of clean water, and center Indigenous communities who steward the land and waters.
Ensure access to PrEP.
The first HIV/AIDS case was officially reported by the CDC a little more than forty years ago (NBC News). Since then, there have been incredible advancements in HIV treatment options. Today, antiretroviral therapies can suppress the HIV virus enough to help HIV-positive people live with undetectable amounts of the virus.
Good morning and happy Wednesday! Preventative treatments for HIV can save countless lives, but disparities exist for who can easily gain access to these medications. Today, Tiffany explains the historical discrimination in HIV/AIDS treatment and how we can advocate for equitable access to PrEP.
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Have a great day!
Nicole
TAKE ACTION
Support the Transinclusive Group (Instagram), a Black trans-led group offering HIV services in South Florida.
Educate yourself about AIDS history and Black efforts to address historical inequities. AIDS 1969: HIV, History, and Race.
Spread the word about resources such as Ready, Set, PrEP which help individuals interested in PrEP access to the medication at a low or no cost.
GET EDUCATED
By Tiffany Onyejiaka (she/her)
The first HIV/AIDS case was officially reported by the CDC a little more than forty years ago (NBC News). Since then, there have been incredible advancements in HIV treatment options. Today, antiretroviral therapies can suppress the HIV virus enough to help HIV-positive people live with undetectable amounts of the virus.
HIV prevention options have greatly expanded as well. Pre-Exposure Prophylaxis (PrEP) medication can reduce a person’s risk of contracting HIV through sex by 99% and their risk of contracting it through intravenous drug use by 74% (CDC).
But communities with the highest rates of HIV actually use PrEP the least. Men who have sex with men (MSM) – including gay and bisexual men as well as those who don’t identify as either – are at higher risk of contracting HIV. Though Black and Latinx MSM are five to ten times more likely to contract HIV than white MSM, white MSM both know about and use PrEP at higher rates than men of color (CDC). One reason for this discrepancy is the barriers people of color face in accessing care.
PrEP medication access is hardest for patients to access in the South, where 56% of Black Americans live (Pew Research). 38% of Affordable Care Act Marketplace health plans in southern states require prior authorization before individuals receive PrEP, a rate significantly higher than anywhere else in the country (JAMA). Requiring prior authorization means treatment will only be covered by the insurance company if the company approves it before the treatment is prescribed (TikTok). This increases the burden on doctor’s offices and causes delays in treatment. “Prior authorizations have been cited by clinicians as being one of the biggest barriers for PrEP uptake,” according to Dr. Kathleen McManus, who researched the subject (UVA). 90% of physicians stated prior authorizations delayed patient’s access to care and 75% stated they can lead patients to abandon treatments. (AMA).
Each year, 50% of new HIV cases occur in the South (CDC). Out of those new HIV cases in Southern states, Black women comprise 67% of cases in women, Black men are 70% of cases in men, and out of men who have sex with men, 50% of new cases are Black men (CDC). Insurance company policies create unnecessary hurdles for accessing crucial HIV prevention measures in a high-risk region where Black people are at disproportionate risk. This constitutes a deadly form of structural racism.
The government and medical establishment’s approach to HIV/AIDS has always been rooted in discrimination. Ronald Reagan’s administration refused to prioritize AIDS research and treatment in the 1980s since it was viewed as a “gay plague” (NBC News). It took years of activism and pressure from groups like ACT UP for the passage of the Ryan White Cares Act in 1990 to mandate serious federal funding and attention to HIV care and treatment (Hornet, History). Despite the historical framing of HIV as a virus that primarily affected gay white men, Black and Brown people have always been overrepresented in the HIV-positive population. They also long been central to AIDS activism and resistance (Drain).
In the words of Raniyah Copeland of the Black AIDS Institute, “HIV is a disease that affects the most marginalized: Black and brown people, LGBTQ people, people living in poverty, people who don’t have housing, people experiencing substance addiction, and so many others who aren’t able to thrive simply because of who they are, who they love, or where they live” (Black Aids Institute) The prior authorizations that delay access to HIV prevention medication are the product of a healthcare corporations and government policies that place little emphasis on HIV and other health conditions that disproportionately affect Black and Brown people and members of other oppressed and marginalized communities.
Southern state governments have the power to create laws that require their state healthcare plans on the exchange to include coverage of PrEP medications without requiring prior authorization. They must act. In the meantime, organizations like South Florida’s Transinclusive Group are acting to ensure HIV prevention isn’t pushed to the side for Black and Brown folks (Instagram). We must fix a system where discriminatory barriers block entire communities from life-changing treatments.
Key Takeaways
PrEP dramatically reduces the risk of HIV-negative people contracting HIV.
Black people in the South are at high risk of contracting HIV, but many ACA insurance plans in southern states require an additional step, prior authorization, before getting PrEP.
The government has long neglected HIV research and HIV-positive people because of systemic discrimination against queer people, people of color, poor people, and drug users.
RELATED ISSUES
5/18/2021 | End “race norming” in healthcare.
1/19/2021 | Advocate for universal healthcare.
8/14/2020 | Support Black mental health.
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
Subscribe on Patreon | Give one-time on PayPal | Venmo @nicoleacardoza
Demand global vaccine justice.
On Thursday, President Joe Biden announced that the U.S. would share 75% of its unused COVID-19 vaccine supply, releasing 80 million doses to other countries by the end of the month. “These are doses that are being given, donated free and clear to these countries, for the sole purpose of improving the public health situation and helping end the pandemic,” said U.S. National Security Advisor Jake Sullivan, though he clarified that the U.S. government “will retain the say” on where exactly they go (MSN). As the State Department’s Twitter account declared, “No country is safe until all countries are safe” (Twitter).
Happy Monday and welcome back! The inequities of vaccine access, both domestically and abroad, deserve more scrutiny. Today, Andrew shares more about the role the U.S. plays in global vaccine distribution and how we can support.
Thank you for keeping this independent platform going. In honor of our anniversary, become a monthly subscriber on our website or Patreon this week and we'll send you some swag! You can also give one-time on Venmo (@nicoleacardoza), PayPal or our website.
– Nicole
TAKE ACTION
Read about U.S. vaccine hoarding and its fatal results.
Support the Progressive International (Instagram) and the Summit for Vaccine Internationalism.
Donate to CODEPINK and Global Health Partners’ campaign to provide syringes for people in Cuba.
GET EDUCATED
By Andrew Lee (he/him)
On Thursday, President Joe Biden announced that the U.S. would share 75% of its unused COVID-19 vaccine supply, releasing 80 million doses to other countries by the end of the month. “These are doses that are being given, donated free and clear to these countries, for the sole purpose of improving the public health situation and helping end the pandemic,” said U.S. National Security Advisor Jake Sullivan, though he clarified that the U.S. government “will retain the say” on where exactly they go (MSN). As the State Department’s Twitter account declared, “No country is safe until all countries are safe” (Twitter).
The United States will immediately give 25 million doses to the United Nations’ COVAX vaccine sharing program (AP). It seems like an incredible number, but only until you do the math. Africa, which saw a 20% increase in cases over the last two weeks, will receive 5 million vaccines, enough for less than 4% of the continent’s residents (AP). 6 million doses will go to Latin America, fewer doses than people in El Salvador, the region’s 17th most populous country. 7 million will go to South and Southeast Asia, a quantity less than 3% of the population of Indonesia alone.
This development comes after months of vaccine hoarding by the United States and other rich nations. In February, U.N. Secretary General Antonio Guterres announced that, while 75% of all vaccines had been administered by just 10 countries, 130 nations had not received a single vaccine at all (MSN). In the words of Georgetown Law’s Lawrence Gostin, “Rich countries have signed pre-purchase agreements with vaccine manufacturers. So [they] have bought up most of the world’s vaccine supplies.”
The United States government bought 1.2 billion vaccine doses, despite having a population of only 330 million (Salon). If everyone in the U.S. received two doses, a half billion shots would be left over, property of the U.S. government. In fact, the U.S. bought purchase options on enough vaccines to vaccinate the entire U.S. population five times (NBC).
American vaccine “charity” comes too late for thousands of people who died because the United States blocked their countries from importing vaccines.
Aside from appearing benevolent with its “gift” of hoarded vaccines, the U.S. government also gets to use vaccine donations as a political weapon, rewarding “friends like the Republic of Korea, where our military shares a command” (White House) while maintaining an embargo that prevents Cuba from importing syringes necessary for full vaccination (Code Pink).
That fact that the U.S. government prevented life-saving vaccines from reaching desperate people for weeks on end is not the only reason for its complicity. Despite racist paranoias about immigrants and Asian people as disease vectors, American business travelers and tourists have played a crucial role in spreading coronavirus around the world.
Last March, 44 University of Texas students tested positive for COVID after returning from Cabo San Lucas (KXAN). Four months later, Today published a list of countries still open to American tourism “for those trying to capitalize on less expensive plane tickets” (Today). In November, an American teen in the Cayman Islands escaped from mandatory quarantine to attend her boyfriend’s jet ski event maskless (People). One of the hardest-hit areas in Mexico is Cancún, which has actually seen more tourists this year than last (USA Today). One Pittsburgh police officer whined “we’re being held hostage down here” after he and his wife were forced to stay in their luxury resort room after testing positive for COVID during a mid-pandemic trip to Cancún last month (WPXI). Mexico ranks fourth in total deaths from COVID (CNN).
Many countries and regions are reluctant to impose stricter entry controls since their economies are almost entirely dependent on tourism, “mainly as a result of their history under Western imperialism” (Skift). American tourists felt entitled to go on vacations that turned their destinations as petri dishes. Their government hoarded vaccines to save for them upon their return home. Thousands of people, mostly working-class people of color in poor nations, have lost their lives as a result. The Biden administration’s “charity” is too little, too late.
Fortunately, community organizations around the world are coming together to demand more. The Progressive International is organizing a global Summit for Vaccine Internationalism (Progressive International) while groups like CODEPINK are providing medical supplies internationally (CODEPINK). When the American government positions itself as a compassionate donor of its hoarded goods, we should remember Dr. King’s words: “True compassion is more than flinging a coin at a beggar. It comes to see that an edifice which produces beggars needs restructuring” (American Rhetoric).
Key Takeaways
The Biden administration's vaccine sharing announcement comes after the U.S. blocked poor countries from vaccine access for months, costing untold numbers of lives.
The U.S. government bought over half a billion more vaccine doses than would be necessary to vaccinate the entire population.
American citizens played an outsized role in spreading COVID to countries dependent on U.S. tourism.
RELATED ISSUES
2/11/2021 | Support an equitable vaccine rollout.
9/16/2020 | Fight for paid sick leave.
8/23/2020 | Support those incarcerated and impacted by COVID-19.
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
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End “race norming” in healthcare.
Over the past year, the global pandemic has highlighted the vast racial disparities in medical treatment in the U.S. Many of its elements are more subtle; difficult to see if you don’t experience it first-hand. But some are more blatant – like racial correction factors. In medicine, equations and algorithms can often be used to diagnose or screen patients. Racial correction factors are when physicians adjust the measurements or risk calculations for patients based on their race. Despite the fact that race is a social construct, many medical providers hold on to the idea of race as a biological variable. This has a severe, sometimes fatal impact on people of color.
Happy Tuesday, and welcome back to the Anti-Racism Daily!
Right now, thousands of retired Black professional football players and their families are fighting to end the racial bias that determines which players are eligible for payouts for brain injury claims. The bias embedded in testing process makes it more difficult for Black players to demonstrate signs of dementia than white players, making them less likely to receive the $1B in settlements from the NFL (ESPN). Today, Tiffany shares other ways that racial bias influences the health and wellbeing of Black and Asian people.
Thank you to everyone that gives a little when they can to keep this newsletter going! If you can, consider giving $7/month on Patreon. Or you can give one-time on our website or PayPal. You can also support us by joining our curated digital community. This newsletter will continue to be a free resource because of this collective support.
Nicole
TAKE ACTION
Read Towards the Abolition of Biological Race in Medicine and Public Health which details the history of medical racism, particularly for hypertension.
Watch Dr. Vanessa Grubb’s video segment on Racism and Race: The Use of Race in Medicine and Implications for Health Equity
Empower and educate people around you about racial correction factors so they can advocate for themselves in medical situations where doctors choose to delay treatment.
Consider: How does your racial identity influence your experience at the doctor’s office? What do or don’t you have to consider? How may this change based on your gender identity, or other factors of your identity?
GET EDUCATED
By Tiffany Onyejiaka (she/her)
Over the past year, the global pandemic has highlighted the vast racial disparities in medical treatment in the U.S. Many of its elements are more subtle; difficult to see if you don’t experience it first-hand. But some are more blatant – like racial correction factors. In medicine, equations and algorithms can often be used to diagnose or screen patients. Racial correction factors are when physicians adjust the measurements or risk calculations for patients based on their race. Despite the fact that race is a social construct, many medical providers hold on to the idea of race as a biological variable. This has a severe, sometimes fatal impact on people of color.
One of the most commonly used and widely discussed racial correction factors exists with estimated glomerular filtration rates (eGFR) in the kidneys, which assesses the level of kidney functioning. Medical providers measure eGFR by using a mathematical calculation that compares the creatinine measured in a person’s blood, with their size, age, sex, and race (Kaiser Permanente). Many medical institutions utilize a racial correction factor of approximately 1.2 for Black people (Nature).
“With the correction, Black patients' estimated kidney function is about 16-21% higher (depending upon the equation used) than all other races in this country”, according to Dr. Vanessa Grubbs, nephrologist and author of Hundreds of Interlaced Fingers: A Kidney Doctor's Search for the Perfect Match.
Medical providers use eGFR values to deduce what stage of chronic kidney disease a patient is at (National Kidney Foundation). The lower the eGFR value, the lower the kidney functioning, and the higher stage of kidney disease a patient is diagnosed with (Kidney). The correction factors that inflate Black patient’s eGFR measurements, could potentially have them diagnosed with an incorrect stage of kidney disease and delay needed treatment.
“This means that Black patients—even though they reach end-stage kidney disease nearly 4x faster than White patients—are referred later to nephrology specialty care and transplant evaluation”, recounts Grubbs. “I would not have referred one of my patients to kidney transplant at least a year later had I believed the race correction was indeed correct. And he lost kidney function faster than expected,” she adds. Grubbs recommends that patient’s request cyastain C blood tests to estimate their kidney functioning without the inclusion of race.
Another commonly used correction factors exists in in the use of spirometers in pulmonology. Spirometers directly measure the amount of air you can inhale and exhale, and the rate at which you exhale (Mayo Clinic). Medical providers use this tool to assess the strength of lungs and to diagnose for respiratory conditions such as chronic obstructive pulmonary disease (COPD) (Mayo Clinic). Spirometers measure two main values: FEV1 (how much air you can force out of your lungs in 1 second) and FVC (greatest amount of air you can breath out after brething in very deeply) (Healthline). Provider diagnose certain respiratory conditions such as by comparing patient’s FEV1, FCV and FEV1/FCV ratio to predicted normal values.
“So every age group has a different measurement of what normal means. At the same time, differences in gender, and race, at this moment is still added as part of the metrics,” explains Dr. Panagis Galiatsatos, MD, MHS pulmonologist and Assistant Professor, Division of Pulmonary & Critical Care Medicine at Johns Hopkins School of Medicine.
Many spirometers have a built-in racial correction factor that automatically assumes a 10-15% smaller lung capacity for Black patients and a 4-6% smaller lung capacity for Asian patients when computing measurements (NIH). Medical providers typically diagnose COPD when a patient’s FEV1/FVC ratio is less than 70% of an estimated normal value (NIH). The lower adjusted values for Black and Asian patients could potentially lead to these patients not being diagnosed as having COPD when measured as having similar spirometry values or physical symptoms as white patients who are diagnosed with COPD.
“There’s a great number of studies that show fewer diagnoses of COPD in Black/African-America patients, even though they have much more symptoms,” explains Galiatsatos. “Spirometry is used for diagnostic purposes. So if you can’t diagnose [COPD], because you have this racial bias, then you’re going to delay these patients from getting the interventions that they need” he adds. He recommends patients ask medical providers to look at their flow volume curve results, which is not influenced by race when looking for an assessment or diagnosis.
The idea that Black people have different medical needs stems back from the times of slavery and was built from racist scientific ideas.
During slavery, people believed that Black folks had inferior lung capacities to white people. In 1832, Thomas Jefferson referenced differences in lung function between slaves and colonizers (Google Books). In the 1800s, physician (and slave owner) Samuel Cartwright used the spirometer to compare the lung capacities of enslaved Africans to the slaveholding white masters (NIH). He concluded that enslaved Africans had inferior lungs.
The racial correction factor for eGFR, however, was introduced later in the 1990s because Black people were observed to have higher creatinine levels in their blood (Nature). Researchers concluded that Black people’s higher creatinine levels were due to Black people having higher muscle mass than white people (Scientific American). This study failed to truly consider other explanations for why the Black patients had higher creatinine levels. This idea of all Black people being stronger than other people is reminiscent of stereotypes used to justify the animalization and enslaving of Black people for profit (NIH)
“There is no real science behind it,” believes Grubbs. “Most doctors still do it because they don't know why race was included in the first place and are just following along blindly. Others still do it because they are upholding White supremacy ideology that Black people are inherently different than all other humans.”.
Racial correction factors for eGFR are especially harmful because Black people are 3-4 times as likely to develop kidney failure compared to white people (NIH). 32% of kidney failures occur in Black people, despite only making up 13% of the population (NIH). In addition, Black people are three times as likely to die from asthma and Black men are 50% more likely to get lung cancer than white men (Lavaca Medical Center). Black and Asian people are both at a higher risk for being hospitalized for asthma compared to white people (NIH). It’s devastating to imagine how many people of color were delayed or denied life-saving treatment because of an outdated correction factor.
The movement to end the use of racial correction factors is picking up across medical institutions across the country (STAT News). Vanderbilt, University of Washington, and the University of California, San Francisco have moved to end the use of race-based correction factors in their medical institutions (Vanderbilt, UW, UCSF). Students like Noor Chadha at the joint UCSF Medicine and UC Berkeley program created a report titled Towards the Abolition of Biological Race in Medicine which examines the many explicit racist issues, including racial correction factors, in modern medicine.
We need to abolish racial correction factors to ensure that all people can equally get a chance to get life-saving medical treatments.
Key Takeaways
Many healthcare providers still utilize racial correction factors that require Black and Asian people to have lower kidney function and lower lung capacity to get diagnosed and get needed treatment.
Many racial correction factors are rooted in racist scientific ideas.
Many institutions are now making a push to remove racial correction factors.
RELATED ISSUES
2/24/2021 | Advocate for end-of-life care.
8/14/2020 | Support Black mental health.
8/18/2020 | Support athletes in taking action.
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
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Close the life expectancy gap.
In the United States, great expectations within the healthcare sector are not endowed to everyone. Black and Brown populations have continued to fall behind the average life expectancy of white populations—a chasm that has widened considerably in the wake of COVID-19. Though recent years saw a shrink in the gap between Black and white lifespans in the U.S., the pandemic brought the difference to its widest breadth since 1998 (Intelligencer). In 2020, the average life expectancy for white Americans decreased by 0.8 years, but Latino and Black populations dipped more notably, losing 1.9 years and 2.7 years, respectively (NPR). This shocking statistic does not boil down to genetics or biological fitness, but rather economics.
Happy Friday and welcome back to the Anti-Racism Daily. A year ago yesterday, the World Health Organization declared coronavirus as a global pandemic (NPR). Since then, so much of our lives have forever changed. Its impact in the U.S. didn't just exacerbate the existing disparities in our country, but create new and distinct issues that directly affected our wellbeing. And it's evident in the latest data on life expectancy. Hannah shares more in today's newsletter.
And just a quick personal note – grief is not linear. Give yourself grace with any feelings or sensations that might be arriving with the one-year marker of an event that turned our lives around. There's no right way to heal from this, only the way that is right for you. I'm sending you all the love for what's been lost this year, and all that there is to discover in the days ahead.
This newsletter is a free resource made possible by our paying subscribers. Consider giving $7/month on Patreon. Or you can give one-time on our website, PayPal, or Venmo (@nicoleacardoza). You can also support us by joining our curated digital community. Thank you to all those that have contributed!
Nicole
TAKE ACTION
Explore the Kaiser Family Foundation to advocate for health reform; push for medicaid expansion and learn about the causes of the life expectancy gap and what is needed to reverse it in your state through the Health Resources & Services Administration and the Office of Minority Health at the Centers for Medicare and Medicaid Services.
Use resources from the Equal Justice Initiative website to dissect America’s racist roots and learn how to be engaged in the current fight for equal rights.
Support the People’s Institute for Survival and Beyond with a charitable contribution, and attend one of their community workshops—whether in person or virtually. The Institute seeks to organize diverse networks of people in order to understand and undo racism on a personal and global level.
Watch The Essentials documentary that addresses health equity and immigrant health at the Center for Health Progress website.
GET EDUCATED
By Hannah Edmondson (she/her)
In the United States, great expectations within the healthcare sector are not endowed to everyone. Black and Brown populations have continued to fall behind the average life expectancy of white populations—a chasm that has widened considerably in the wake of COVID-19. Though recent years saw a shrink in the gap between Black and white lifespans in the U.S., the pandemic brought the difference to its widest breadth since 1998 (Intelligencer). In 2020, the average life expectancy for white Americans decreased by 0.8 years, but Latino and Black populations dipped more notably, losing 1.9 years and 2.7 years, respectively (NPR). This shocking statistic does not boil down to genetics or biological fitness, but rather economics.
The pandemic has killed one in every 645 Black Americans, but as of March 1, only seven percent of COVID-19 vaccine recipients have been Black (Now This News). This goes to show that access to medical care is not dictated by actual need; instead, it is a matter of privilege, leaving Black and Brown Americans to scramble for resources that should be readily available. There are several factors behind the burgeoning lifespan disparity throughout the pandemic, but they each share a common denominator: racism. Insufficient access to healthcare in the United States is bemoaned by working-class citizens across the board, but the brunt of its effects are absorbed by Black and Brown families.
Sickle cell disease sheds a light on the deeply entrenched prejudice that plagues the U.S. healthcare system. The disease predominantly affects Black individuals; on average, one in thirteen Black children are born with the sickle cell trait (CDC). The disease is inherited and requires intensive, regular care in order to be treated properly. In this way, it is similar to cystic fibrosis, a disease which occurs most commonly among white Americans. However, cystic fibrosis receives significantly more funding and national attention, with new treatments being approved regularly over the past decade. The issue at hand is proven to be a matter of access rather than intel as a majority of sickle cell patients are forced to go without even the earliest sickle cell treatments (KHN).
According to a study conducted in 2009, the average life expectancy of Black men and women was seventy-five years of age, mirroring the average life expectancy of white populations in 1979 (Business Insider). The fact that Black American lives are set back nearly thirty years when compared to the well-being of white counterparts is telling. The gap in life expectancy cannot be chalked up to violence or mere coincidence, though, as this lag in Black survival is largely a product of the U.S. healthcare system. The evidence shows a marked swell in the gap between Black and white life expectancy during the 1980s, demonstrating the dramatic impact of the AIDS crisis on communities of color. The latest national health crisis—the COVID-19 pandemic—has similarly ravaged BIPOC while leaving white populations with significantly fewer fatalities.
While the difference in life expectancy between ethnic groups has gradually grown less severe, the underlying cause remains. Black and Brown communities are too often barred from receiving quality care on account of financial setbacks and discriminatory legislation. Residential segregation leaves Black and Hispanic neighborhoods without conveniently-located hospitals and healthcare facilities (TCF). Most U.S. cities and suburbs reflect the racist tactics of city planners throughout the twentieth century. Nonetheless, these geographic barriers stand strong to this day, effectively keeping white communities comfortably within their privilege.
The economic inequality that has plagued BIPOC since America’s origination ultimately leads to health inequality, perpetuating the lower life expectancy among non-white persons (Intelligencer). Adequate healthcare requires ample funding, and Medicaid patients are rarely prioritized over wealthy clients able to fully cover their medical expenses. The United States continually shirks the possibility of socialized healthcare in favor of maintaining privatized, for-profit institutions, making it exceedingly difficult for low-income patients to receive proper care. On average, Black families devote twenty percent of their annual household income to medical expenses; that portion is only half as much for most white families (TCF). Systemic racism in the U.S. works to ensure that the nation’s lowest-income communities are disproportionately Black and Brown. Until this economic inequality is dissolved, non-white citizens seeking decent healthcare will be consigned to the bottom of the waitlist.
The economic challenges facing BIPOC undoubtedly heighten the risk of health issues, as proper nutrition and safe housing are simply not affordable. The dog-eat-dog ideology that has come to undergird the American Dream serves only those who are currently in power—namely, affluent white people. Furthermore, unemployment insurance rates are significantly lower in Southern states with high concentrations of Black inhabitants. This practice of state-controlled unemployment benefits dates back to the New Deal; Southern politicians rallied to keep Black workers within their home states oppressed, crafting their unemployment rates to withhold vital government funds from non-white laborers (RAND). This long-standing power imbalance leaves people of color with little upward mobility. Proper healthcare, then, is a luxury reserved for those at the top. This discrepancy is why Black women are three times more likely to die of pregnancy-related causes than white women (TCF). Non-white lives are treated with less reverence because the racist foundation of the United States insists upon the preservation of one population at the expense of all others.
Statistics continue to prove that this antiquated, bigoted ideology is not yet weeded out of the healthcare system; moreover, it steals Black and Brown lives in staggering numbers. In spite of the grim reality, the Affordable Care Act has made a noteworthy stride towards equality. The ACA extended coverage to over twenty million Americans, 2.8 million of whom are Black (AJPH). While this shows a step toward improved medical access regardless of race or class, it is only one minor victory amid a war that will likely drag on for decades to come. Major changes are required in order for society to represent and protect all of its members equally. Privilege should not determine one’s right to survival, but in America it certainly seems to be the case.
KEY TAKEAWAYS
COVID-19 has brought attention to the inequality of U.S. healthcare–a system which has never adequately served minority populations.
The life expectancy gap between BIPOC and white Americans is a result of the social and economic policies that have oppressed non-white citizens for centuries. This gap, contrary to popular belief, cannot be shrunk by the determination of working class individuals alone.
In order to wage a social contract that protects people of every race and economic standing, the existing institutions that govern American society should be deconstructed and purged of their racist tactics.
A healthcare system that benefits all people equally will not be implemented without major political action.
RELATED ISSUES
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
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Advocate for end-of-life care.
Of all the hospice patients in the United States, only 14% of enrollees are people of color (The National Academies of Sciences, Engineering, and Medicine). While communities of color and low-income communities face the brunt of COVID-19, they also face a myriad of hurdles when navigating and accessing end-of-life care. According to the Centers for Disease Control and Prevention, people of color are up to 2.8 times more likely to die from the virus, underscoring the importance of end-of-life and hospice care for this population (CDC).
Happy Wednesday, and welcome back to the Anti-Racism Daily. With over 500,000 lives lost to COVID-19 in less than a year, along with the compounding impact of natural disasters and economic woes that threaten our wellbeing, end-of-life care should be prioritized and centered for all. However, there are clear disparities in the opportunities granted for ourselves to care for one another. Today, Kayla shares more on what we can do to change that.
This newsletter is a free resource and that's made possible by our paying subscribers. Consider giving $7/month on Patreon. Or you can give one-time on our website, PayPal, or Venmo (@nicoleacardoza). You can also support us by joining our curated digital community. Thank you to all those that support!
Nicole
TAKE ACTION
Advocate for hospice care using the advocacy resources provided by the National Hospice and Palliative Care Organization.
Encourage your elected officials to address disparities in end-of-life-care in Medicare and Medicaid.
Read Atul Gawande’s Being Mortal to learn more about the unnecessary suffering in America’s hospitals, hospice, nursing home systems.
GET EDUCATED
By Kayla Hui (she/her)
Of all the hospice patients in the United States, only 14% of enrollees are people of color (The National Academies of Sciences, Engineering, and Medicine). While communities of color and low-income communities face the brunt of COVID-19, they also face a myriad of hurdles when navigating and accessing end-of-life care. According to the Centers for Disease Control and Prevention, people of color are up to 2.8 times more likely to die from the virus, underscoring the importance of end-of-life and hospice care for this population (CDC).
Hospice care is a service that provides professional caregiving and the coordination of care for people who have chosen to discontinue disease-fighting treatments (Mayo Clinic). Having access to hospice care, especially that which meets the cultural, physical, and social needs of the patient, can be all the difference between a painful versus dignified death. Unfortunately, humane hospice care is often inaccessible to low-income and BIPOC patients (The National Academies of Sciences, Engineering, and Medicine).
In the United States, there are two main public systems responsible for funding hospice care: Medicare and Medicaid. Medicare is a government insurance program that serves people over sixty-five years of age and younger individuals with disabilities. Two million Medicare beneficiaries die every year representing roughly 80 percent of deaths in the U.S. (Kaiser Family Foundation). Meanwhile, Medicaid provides government insurance to low-income people, no matter their age (U.S. Department of Health & Human Services). Approximately 70,588,000 individuals were enrolled in the Medicaid program in 2020 and 44 million beneficiaries enrolled in Medicare, making these systems some of the largest payers for hospice services (Medicaid, AARP).
But when public hospice care is underfunded, it disproportionately impacts BIPOC communities who are more likely to face greater disparities in end-of-life care (Journal of Palliative Medicine). That’s why some state’s stringent laws on eligibility are problematic. In Texas and Kentucky, only those with a life expectancy of six months or less are eligible for hospice care, and in New York, hospice patients only will be admitted if they have a life expectancy of one year (U.S. News). Other states, like Oklahoma and Louisiana, have excluded hospice coverage from their plans completely (Oklahoma Human Services, 4WWL).
Medicaid also is likely to be underfunded in facilities where Black patients are enrolled (JAMA Health Forum). Studies show that there are higher rates of disenrollment of hospice programs and more concerns about the quality of care and communication among Black patients (Journal of Palliative Medicine).
Other communities of color also face barriers when navigating end-of-life care. Over eleven million undocumented immigrants are not covered by the Medicare Hospice Benefit, and one in three hospice programs refuses to treat this population (JAMA Internal Medicine). This leaves undocumented people reliant on the exorbitant costs of emergency services which can drive up their costs for end-of-life care. These people are more likely to have fewer private insurance options due to nationality status (JAMA Health Forum).
Hospice and palliative care are inaccessible for Native people. Today, there are only fourteen tribal nursing homes still in operation that allow visitors and cultural practices such as greeting the sun every morning,a Navajo tradition, in end-of-life care (Indian Health Services). But in order for Native communities to provide hospice services under Medicaid, tribal health organizations have to meet a great number of logistical and bureaucratic requirements, which can serve as a deterrent.
When tribal health organizations are not able to meet these requirements, it leaves Native patients reliant on private or outside hospice programs that often are culturally insensitive to tribal end-of-life practices (JAMA Health Forum). Medicare and Medicaid need to make hospice certification accessible for such facilities. If the certification process was streamlined for Native-run hospice care organizations, it would allow these clinics to incorporate tribal practices into the fold of their work.
Hospice coverage under Medicare and Medicaid is systematically flawed and requires policy-level changes. If these programs made a concentrated effort to increase enrollment, not only would Medicare save $6,430 for each patient enrolled in hospice care, but increase the quality of life of patients, especially those who are vulnerable to COVID-19 (Indian Journal of Palliative Care, National Library of Medicine).
A successful end-of-life is one that delivers care at the right time and according to the patient's preferences. It is a system that values life and quality of life over money and profit. The folks nearing end-of-life deserve healthcare. The underfunding of Medicare and Medicaid disproportionately impacts BIPOC communities leaving them without health insurance, hospice care coverage, and access to culturally sensitive hospice programs. We need to push for investment in Medicare and Medicaid programs to better support marginalized people until the very end of their lives.
KEY TAKEAWAYS
Medicare beneficiaries represent 80 percent of deaths in the U.S., underscoring the need to include hospice coverage within the Medicare and Medicaid programs.
While some states have made efforts to include hospice care under Medicaid and Medicare coverage, others have excluded it from funding, leaving low-income populations without care to navigate end-of-life.
The underfunding of Medicaid disproportionately impacts BIPOC communities leaving them without health insurance, hospice care coverage, and access to culturally sensitive hospice programs.
RELATED ISSUES
2/11/2021 | Support an equitable vaccine rollout.
1/19/2021 | Advocate for universal healthcare.
11/4/2020 | Understand intergenerational trauma.
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
Subscribe on Patreon | Give one-time on PayPal | Venmo @nicoleacardoza
Support an equitable vaccine rollout.
Over the past few weeks, valiant efforts to increase vaccination rates have been lauded by the press. Tuesday, White House officials announced a program to ship doses of the vaccine directly to a network of federally funded clinics in underserved areas (NYTimes). Pfizer expects to cut COVID-19 vaccine production time by close to 50%, promising more accessibility (USA Today).
Happy Thursday, and welcome back. We started covering COVID-19 in the newsletter each week back in June. Many of our articles have the same theme: this pandemic is disproportionately affecting communities of color, and there are inadequate resources to support their wellbeing. Unfortunately, the same narrative is unfolding with access to the vaccine. Take action today to support those in your community.
Thank you all for your contributions! This newsletter is made possible by our subscribers. Consider giving $7/month on Patreon. Or you can give one-time on our website or PayPal. You can also support us by joining our curated digital community.
Nicole
Ps – The latest news released during the impeachment trials are harrowing. Be sure to review and amplify the Black Lives Matter movement's list of demands in response to those events. Details here.
TAKE ACTION
Urge your elected officials to improve your state’s COVID-19 race and ethnicity data reporting by using the resources on The COVID Tracking Project.
Search for petitions and other action items to ensure an equitable rollout of the vaccine in your state. Here are example actions to take in North Carolina and Georgia.
Contact your local mutual aid network to see how you can support those eligible for vaccinations in your community. You may be able to offer transportation or schedule appointments on behalf of others.
Individuals across the country are designing their own websites, Google docs, and social media accounts to make vaccine testing information more accessible (MIT Technology). Find the latest for your community and share/support where needed.
GET EDUCATED
By Nicole Cardoza (she/her)
Over the past few weeks, valiant efforts to increase vaccination rates have been lauded by the press. Tuesday, White House officials announced a program to ship doses of the vaccine directly to a network of federally funded clinics in underserved areas (NYTimes). Pfizer expects to cut COVID-19 vaccine production time by close to 50%, promising more accessibility (USA Today).
But so far, the federal government has gathered race and ethnicity data for just 52% of all vaccine recipients. Among those, just 11% were given to recipients identified as Latino/Latina, and 5% were given to those identified as Black Americans (Politico). Although public health experts believe delivering vaccines directly to underserved communities is helpful, they note that the absence of comprehensive data makes it impossible to know whether vaccine distribution is truly equitable (NYTimes).
The lack of data on COVID-19 contraction and treatment’s racial disparities has been a persistent issue since the pandemic began in the U.S. last March. A study from the John Hopkins' Coronavirus Research Center published last June noted that racial and ethnic information was available for only about 35% of the total deaths in the U.S. during that time. Various advocacy organizations, including the Black Lives Matter movement, demanded accountability. While data have improved over time, they continue to have significant gaps and limitations, particularly on a state-by-state level (KFF). These discrepancies have made it difficult to understand its effects across communities and respond appropriately.
And now that we’re rigorously attempting to distribute the vaccine, the same challenges apply. In the NYTimes, Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, notes that the lack of data is alarming.
“
The race and ethnicity data is important because we know who’s bearing the brunt of the pandemic, so there is a fairness and an empathy issue. But there is also a disease control issue. If those are the groups most likely to get affected and die, those are the groups we need to make sure we are reaching with the vaccine.
Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, NYTimes
Even with limited data, the differences are apparent. NPR studied the locations of vaccination sites in major cities across the Southern U.S. and found that most are based in whiter neighborhoods (NPR). This data mirrors the organization’s previous reporting last May, which analyzed COVID-19 testing facilities (NPR). This continued disparity has immediate and urgent implications. Residents express their frustration with finding transportation to facilities for an available vaccine. But it also indicates a broader issue. Most vaccine distribution and tests are hosted in existing health care facilities, and those, too, are inequitably distributed. It’s a reminder that COVID-19 doesn’t just cause these disparities but exacerbates them.
And the South isn’t a unique case. Similar studies in other major cities show that vaccine accessibility prioritizes whiter neighborhoods (NPR). As Grist notes while analyzing Chicago data, these disparities often mean that more polluted communities are left behind (Grist). Communities with higher rates of pollution tend to have compounding health issues that can worsen the impact of COVID-19.
But it will take more than presidential intervention and speedier production timelines to get those most vulnerable vaccinated. A significant barrier to ensuring vaccines are utilized is trust. The Black community – and other communities of color - have a deep distrust of the medical system, an issue we’ve written about frequently in previous newsletters. Organizations have rallied quickly to create cross-cultural awareness campaigns, but it’s likely insufficient for solving generational trauma alone (Ad Council).
As individuals, we have little control over the systemic and political forces in play that makes vaccine distribution inequitable. But we can do our part to ease access for those in our communities. As the rollout continues, consider how you can also advocate for changes that transform our healthcare system, making it more responsive in times of future emergencies.
KEY TAKEAWAYS
The vaccine rollout seems to favor white communities, with few people of color receiving the vaccine so far
Data on the vaccine rollout is limited due to constraints and disparities in state-by-state reporting
The lack of racial/ethnic data in the response to COVID-19 is a persistent issue that's affecting access to testing and treatment
Part of the issues in lack of accessibility stem from broader systemic disparities evident in healthcare
RELATED ISSUES
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Advocate for universal healthcare.
During the COVID-19 pandemic, as many as 7.7 million workers had lost their jobs (Commonwealth Fund). Health insurance had left with, leaving millions of people uninsured during a global pandemic (Business Insider). Not only has the pandemic exposed the inequitable healthcare system, but has underscored the need for universal healthcare, or medicare, for all.
Happy Tuesday and welcome back to the Anti-Racism Daily. Today we're diving into the importance of universal healthcare, one of several political changes we'll be advocating for this month during the political shift.
As the inauguration nears, please be sure to take care of yourself and your community. Revisit our election safety plan and learn more about the priorities of community organizers where you live.
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Nicole
TAKE ACTION
Advocate for healthcare reform on social media.
Participate in elections at all levels by educating yourself about and voting for candidates that want health care for all.
Support and consider donating to organizations that are advocating for universal healthcare policies and reform such as Healthcare-NOW and Community Catalyst.
GET EDUCATED
By Kayla Hui (she/her)
During the COVID-19 pandemic, as many as 7.7 million workers had lost their jobs (Commonwealth Fund). Health insurance had left with, leaving millions of people uninsured during a global pandemic (Business Insider). Not only has the pandemic exposed the inequitable healthcare system, but has underscored the need for universal healthcare, or medicare, for all.
Universal healthcare is a system that provides all people - regardless of financial need - access to health care services and resources such as preventative care, treatment, rehabilitation, and palliative care (World Health Organization). Over the past few decades, the United States has witnessed skyrocketing healthcare costs, which has prevented people from seeking or delaying care.
In 2018, the U.S. spent $3.6 trillion on healthcare, the highest of any other nation. These costs are expected to rise to $6.2 trillion by 2028 (Peter G. Peterson Foundation). Healthcare costs remain high because the U.S. relies on a free market where hospitals have the authority to set their prices. Because a free market relies on capitalism, when healthcare is in high demand, prices can surge. So access to medical care, especially during a pandemic, is strenuous, especially for those who can’t afford to see a doctor. “When a society is seriously concerned about its people having equitable access to care and about polling health risks efficiently, the free market is not a good choice,” Jui Fen, Rachel Lu, and William C. Hsiao state in an online article. (Health Affairs). The high healthcare costs – especially during a pandemic where a scarcity of resources exists – are what makes the U.S. healthcare system inequitable and systemically racist.
In 2019, BIPOC communities had the highest uninsured rates, leaving them vulnerable to existing health conditions prior to the pandemic (Kaiser Family Foundation). People who are uninsured are three times more likely than insured adults to say they have not had a doctor’s visit to discuss their health (Kaiser Family Foundation). They are also less likely to receive recommended screenings such as blood pressure, cholesterol, pap smears, mammograms, and colon cancer screenings (Kaiser Family Foundation). When a disease or health condition is left untreated, the health consequences can be dire especially for those with chronic illnesses.
When looking at the COVID-19 pandemic, Black, Indigenous, Latinx, and other people of color have been disproportionately impacted (The COVID Tracking Project and Boston University’s Center for Antiracist Research). Nationwide, Black people are dying at 1.7 times the rate of white people with Native and Hispanic and Latino people trailing not too far behind.
One of the main reasons why millions of people lost health insurance is because of a flaw in the system: employer-based insurance (EBI). EBI is a system where health insurance is tied to employment instead of being provided by the government. In the U.S., health is not a guaranteed right. Rather, it is a commodity, an “add on for an extra dollar” if you will expense, and only those most privileged to afford its exorbitant costs will reap the benefits and have healthier outcomes - preventative screenings to catch diseases early on, access to the medical care they need when they are sick, can afford to see a doctor any time of year, etc.
Historically, the use of preventative health services has been low, especially among BIPOC, the uninsured, and low-income communities (Center for Disease Control and Prevention). It’s not that people don’t want to get these screenings, it's that they can’t afford to. Nearly one in four people in the U.S. are skipping medical care because of the cost (CNBC). If the U.S. adopted preventative measures such as cancer screenings, approximately 100,000 lives could be saved each year (Center for Disease Control and Prevention).
So how did EBI come to be? In 1943, the Internal Revenue Service (IRS) ruled that employer-based health care should be tax-free (National Public Radio). However, by the 1950s, after a decade of growth, the Eisenhower administration reserved tax-free status for employers only. Since then, employer contributions to health insurance would be tax-free. By the mid-1960s, people started to equate a good job with health care benefits. Thus, EBI was born.
This decision created a burdensome challenge when the pandemic forced a national shutdown, especially for those working jobs that require in-person contact. While grocery and essential workers were allowed to remain open through plexiglass installation and COVID-19 safety guidelines, other workers were not as lucky, including my parents (NPR). The banquet halls where my mother and grandmother worked, shut down indefinitely. Pre-pandemic, my mother and popo (grandmother in Chinese) would carry plates of catered food to hundreds of guests during proms, weddings, and business conferences. As those functions got canceled, so did my family’s health insurance.
“Dear Diane, the table below shows the last day you and/or your dependent(s) have healthcare coverage,” I read to my parents. While the letter was highly-anticipated, the gravity of our situation didn’t sink in until I processed what the lack of health insurance would mean for me and my family. Because my two sisters and I were dependents under our mother’s insurance, we too, had lost coverage, leaving five members in my immediate family without health insurance. I was most worried about my popo, who lives with chronic respiratory illness and asthma. The stress and uncertainty of our health insurance coverage doesn’t just affect my family but millions of BIPOC and low-income households.
In 2018, 66% of U.S. adults had stated that the cost of health insurance was a stressor for themselves and loved ones (American Psychological Association). If the U.S. adopted universal healthcare coverage, 137 million people would not have to face medical hardship, struggle to pay their medical bills, or incur medical debt (Medpage Today). In addition, the country would save 13% in national healthcare expenditures which totals $450 billion annually. (U.S. News). Patients would have the freedom to choose their doctors and hospitals without bearing the cost of high premiums, copayments, and deductibles.
Adopting universal health care would require a redesign of the U.S.health care payment infrastructure. It would require a mix of private insurance (for those who can afford it) and quality public services while weighing cost, access, quality, and equity (ProPublica). In the beginning of 2020, 43.4% of U.S. adults were inadequately insured (The Commonwealth Fund). While some argue that universal healthcare would look like medicare for all, we know that the current system we have does not work and the cost of human life is at stake without health insurance coverage.
The fight to expand healthcare for all has been a debate that predated COVID-19. In order to achieve “good” health, people must have access to the resources that will keep them healthy. Universal healthcare shouldn’t be a controversial issue because healthcare is a human right and it is the basis for which people can live and lead healthy and happier lives.
KEY TAKEAWAYS
Employer-based insurance is a flawed component of the United States healthcare system, only benefiting those who are able to access “good” jobs.
By implementing universal healthcare in the U.S., everyone, regardless of financial status, would be offered essential healthcare services.
BIPOC and low-income communities bear the burden of disease and health disparities in the United States. They are more likely than white people to be uninsured.
RELATED ISSUES
6/28/2020 | Understand disparities in healthcare treatment.
11/11/2020 | Support the disability community through COVID-19.
6/14/2020 | Learn how racism is a public health crisis.
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Combat food deserts.
Food deserts— defined as “an impoverished area where residents lack access to healthy foods” (Britannica)— are yet another factor that contributes to the health disparities between white people and people of color. Due to economic and social factors, supermarkets and farmer’s markets can be much harder to access in underserved areas, leading civilians to rely on unhealthy food options as their primary source of nutrition. Food deserts generally exist in urban areas— predominantly inhabited by nonwhite people— which is why Black people are disproportionately affected by diet-related health conditions (American Progress).
Happy Wednesday and welcome back to the Anti-Racism Daily. More people in the U.S. (and likely around the world) are shoplifting from grocery stores to support themselves during these difficult times. Today's article looks at some of the underlying causes of food inequity that are only exacerbated, not just created, by COVID-19. It's important to remember that we're navigating difficult times because of current conditions and a legacy of oppression that created them. It will take much more than immediate relief to create comprehensive change, but we should do the best we can to help one another – today and tomorrow.
We've officially launched our virtual community! This space is designed for you to connect with others, share resources, hold conversations around our newsletters, and sign up for events. All proceeds support our work, and flexible payment options are available. Patreon subscribers: check Patreon for an access link using your existing subscription.
Thank you so much for making this work possible. If you have the capacity, consider supporting our work by making a one-time gift on our website or PayPal, or subscribe for $7/month on Patreon. You can also Venmo (@nicoleacardoza).
Nicole
TAKE ACTION
Volunteer at local soup kitchens and initiatives that combat food insecurity. Click this link to access a list of initiatives.
Advocate for improved SNAP and WIC benefits that increase monthly spending for individuals to purchase fruits and vegetables.
Find local food banks using this link and donate to nearby food banks or soup kitchens.
GET EDUCATED
By Sydney Cobb (she/her)
Food deserts— defined as “an impoverished area where residents lack access to healthy foods” (Britannica)— are yet another factor that contributes to the health disparities between white people and people of color. Due to economic and social factors, supermarkets and farmer’s markets can be much harder to access in underserved areas, leading civilians to rely on unhealthy food options as their primary source of nutrition. Food deserts generally exist in urban areas— predominantly inhabited by nonwhite people— which is why Black people are disproportionately affected by diet-related health conditions (American Progress).
Redlining—a leading factor in the creation of food deserts—is defined as an “illegal discriminatory practice in which a mortgage lender denies loans or an insurance provider restricts services to certain areas of a community, often because of the racial characteristics of the applicant’s neighbourhood” (Britannica). Not only did redlining make the process of buying and renting homes more difficult, but it also prevented businesses like grocery stores and restaurants from opening, leaving redlined neighborhoods with little-to-no healthy food options. While the practice of redlining may have been made illegal by the Fair Housing Act in 1968, its effects are still present to this day (Anti-Racism Daily). Redlined neighborhoods— mainly occupied by people of color— are not given the same resources as more affluent communities because they generally house lower-income families. Healthier, more costly grocery stores like Trader Joe’s and Whole Foods are less likely to open stores in low-income neighborhoods, forcing redlined communities to shop at less expensive, unhealthy food retailers.
📰 The introduction of grocery stroes like these also indicates that the property values will increase quickly, contributing to gentrification and perpetuating a cyclical process of inequity. Read more in our previous newsletter >
Many urban and rural communities have more convenience stores than supermarkets. Generally speaking, convenience stores tend to sell high-calorie, low-nutrient foods, and do not offer a selection of althernative options like vegetables, fruits, and grains. The distance between food deserts and grocery stores serves as a barrier to members of urban and rural communities who lack transportation options; therefore, they may rely on local convenience stores or fast food restaurants for most of their household food purchases.
While diet-related conditions like hypertension (high blood pressure) are a concern for all racial and ethnic groups, statistics prove that they especially affect minority communities.: “The population attributable risk for hypertension and 30-year mortality among white men was 23.8% compared with 45.2% among black men and 18.3% for white women compared with 39.5% for black women” (The American Journal of the Medical Sciences). Hypertension, which increases an individual’s risk of heart disease and stroke, can be largely impacted by one’s diet. Because consuming large amounts of sodium and fats can contribute to the development of hypertension, it is especially concerning that many food deserts— predominantly occupied by people of color—are more likely to sell unhealthy and salty food options. According to a study evaluating the relationship between food deserts and cardiovascular (CV) risk factors, hypertension was much more prevalent among participants living in food deserts than those not living in food deserts (American College of Cardiology).
Because many families living in food deserts lack healthy food options, they often have no choice but to feed their families insubstantial, unwholesome food. As a result, the children may eventually develop unhealthy eating habits that become harder to abandon with age, raising the rates of dietary issues within the Black community.
The Supplemental Nutrition Assistance Program (SNAP) serves as the largest food assistance program in the United States. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) specifically aims to help women and children’s nutritional needs. Intended to provide low-income families with better food access, SNAP is the primary source of nutrition and nourishment for millions of Americans. While SNAP does increase food-insecure families’ access to food, it generally does not provide enough support for people to maintain a healthy diet. According to the Center on Budget and Policy Priorities, “researchers have estimated that SNAP benefits fall about $11 short per person of the weekly cost of a nutritious meal plan” (CBPP). By increasing SNAP benefits, food desert residents, who are generally a part of the low-income population, will be able to purchase much healthier and more nutritious food.
It's important to note that, as digital grocery shopping becomes more commonplace in the pandemic, many do not accept SNAP. Learn more >
The mere existence of food deserts serves as another example of how systemic racism affects all aspects of life for minorities. Food— one of the human body’s fundamental physiological needs— has been weaponized against people of color (especially Black and Latino individuals). Not only does systemic racism’s connection to food deserts affect adults, who are more susceptible to diet-related health conditions, but it also impacts youth. Children who develop poor eating habits may struggle to participate in physical activities and could ultimately suffer from mental and emotional stress. Children who struggle with serious health conditions tend to display signs of lower self-esteem. In some cases, the intense emotional strain may lead a child to become anxious or depressed.
The coronavirus pandemic has brought more attention to health disparities between racial groups— especially highlighting the effects that underlying health conditions have on an individual’s bodily reaction to the virus. As the world continues to fight the pandemic, people must have access to the fuel they need to stay healthy. More than ever, the country needs to rally together to ensure that communities deemed food deserts have access to nutritious food
KEY TAKEAWAYS
Food deserts are a result of systemic racism and redlining.
Food deserts are directly linked to higher rates of diet-related health conditions, affecting the Black community, and contributing to higher mortality rates.
The rapid spread of the coronavirus makes it even more necessary for people to have trusted and reliable access to diverse food options.
RELATED ISSUES
11/23/2020 | Fight food insecurity.
8/16/2020 | Think before eating out.
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Fight inhumane medical care at ICE facilities.
As of November 11, 2020, the U.S. Immigration and Customs Enforcement have deported six of the women who came forward with claims of having been coerced into sterilization at Irwin County Detention Center in Georgia and will potentially deport at least seven others, says NBC. Dawn Wooten, a registered nurse who previously worked at the detention center, came forward in September, alleging that forced sterilization procedures were widespread at Irwin. Read more about this case in our previous newsletter on the subject.
Happy Tuesday and welcome back to the Anti-Racism Daily! Can you believe it's already December? Because 'tis the season, you can now gift the Anti-Racism Daily to a friend. It's pay-what-you-wish and I'm happy to send a holiday greetings at no cost too – just reply to this email.
Today we're rallying around the ongoing atrocities happening at ICE detention facilities. This email, written by Bianca, focuses on inhumane medical care, but it's just one of many reasons to take action.
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Nicole
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GET EDUCATED
By Bianca Gonzalez (she/her)
As of November 11, 2020, the U.S. Immigration and Customs Enforcement have deported six of the women who came forward with claims of having been coerced into sterilization at Irwin County Detention Center in Georgia and will potentially deport at least seven others, says NBC. Dawn Wooten, a registered nurse who previously worked at the detention center, came forward in September, alleging that forced sterilization procedures were widespread at Irwin. Read more about this case in our previous newsletter on the subject.
Jackelin (who asked to be identified by her middle name) is a 33-year-old Hondorian immigrant and mother of five who is married to a US citizen. She has been living in the U.S. for more than five years. Jackelin was one of the 16 women who wanted to testify against Dr. Amin after receiving care four months prior. After coming forward, she was “scheduled for a … deportation flight, until a last-minute order came for her to remain at the rural Georgia facility.” (LA Times)
Even though, according to ice.gov, “it is against ICE policy to initiate removal proceedings against an individual known to be the immediate victim or witness to a crime,” ICE has taken that same action in light of recent legal pursuits.
Yanira, who has been a detainee for about a year, said after almost boarding the deportation flight, said that “they used to take their sweet time on deporting women, letting us stay here extra time to make us learn their lesson,” until the whistleblower came forward. “Then [nearly] everybody started getting deported so fast, everyone who’d had surgeries or something performed on them. There’s only a few of us left in here” (LA Times).
Columbia University law professor Elora Mukherjee is currently working with several of the detainees. She believes that “ICE is destroying the evidence needed for this investigation” by targeting these women for deportation (The Hill). While the women who have already been deported or who will be deported before they have a chance to speak with legal professionals might still be able to serve as witnesses in a case, those working on the issue will have an increased difficulty at maintaining contact.
Moreover, one report that looked into the death of 18 detainees from 2012 to 2015 found that “substandard care was evident in 16 out of 18 deaths, and subpar care contributed to the deaths of at least 7 of these individuals” as well as finding “numerous incidents of substandard and dangerous medical care,” which included “sluggish emergency responses” as well as “failure to follow up on symptoms that required attention” and “severely inadequate mental health care (Freedom for Immigrants).
Advocates have been expressing concerns over ICE practices for years. Eleven different independent human rights monitoring bodies have sent formal complaints to the US government over the past few years, expressing concerns for human rights violations at the Irwin County Detention Center and the Stewart Detention Center, which is also in Georgia run by a for-profit corporation (Aljazeera).
In May 2018, Project South and the Penn Law Transnational Legal Clinic sent a letter to the Office of the United Nations High Commissioner for Human Rights (OHCHR), citing extensive use of solitary confinement as a form of punishment and control, exploitation of immigrants’ labor, extremely negligent medical care, poor sanitation, denial of due process, and race-based discrimination as their evidence (Aljazeera).
While the neglect at ICE detention centers in Georgia is devastating and needs to be addressed immediately, other states are taking steps to improve conditions at their detention centers. Texan Congresswoman Veronica Escobar came together with Representatives Jason Crow, and Sylvia Garcia introduced the End Transfers of Detained Immigrants Act on November 20th, 2020 (Escobar).
This bill was introduced as a companion to Senators Michael Bennet and Jeff Merkley’s bill, the End Transfers of Detained Immigrants Act, released in late September 2020. It immediately prevents ICE from transferring immigrant detainees between ICE facilities or to any prison during the pandemic, as well as immediately releasing detainees whenever social distancing according to the CDC’s recommendations was not possible (Bennet). Read Bennet and Merkley’s bill here.
While we’re making progress in the fight for immigration reform in America when it comes to developing policies that protect human rights, we have more than enough evidence of medical negligence and abuse in detention centers to advocate for the immediate widespread release of detainees and to advocate for defunding ICE.
KEY TAKEAWAYS
The detainees who came forward claiming to have received medically unnecessary procedures by doctors have become targets for deportation.
States are making strides to advocate against inhuman practices at ICE detention centers, but we still need reform at the federal level.
ICE has an extensive history of medical neglect.
RELATED ISSUES
7/27/2020 | Support Asian Americans through COVID-19.
7/28/2020 | Denounce anti-Semitism.
11/4/2020 | Understand intergenerational trauma.
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Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
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Understand intergenerational trauma.
The body always remembers. Like other children of Vietnamese war refugees, I understand how hardships and inconceivable loss leave marks. Psychologists in the 1990s found roughly half of Holocaust survivors were still suffering from post-traumatic stress disorder (Dialogues in Clinical Neuroscience). Emerging studies show that, in communities of survivors, trauma may also be passed onto subsequent generations through epigenetic changes, where the mechanism by which our body reads DNA – not DNA itself – is altered (Stanford University). This intergenerational transfer can also be behavioral; parents with severe anxiety may model detrimental patterns of thinking and feeling.
Hello and happy Wednesday. Many of us are waiting expectantly for the U.S. Presidential election results. Yet regardless of who wins, we have to acknowledge the harm that political decisions create. As Georgina emphasizes in today's newsletter, the body keeps the score. Whatever we choose to rally for after this election, healing needs to be at the top of the list.
Because what we do know about this election is that racism is not a dealbreaker for how our country shows up at the polls.
This is the Anti-Racism Daily, where we send one email each day to dismantle white supremacy. You can support our work by giving one time on our website, PayPal or Venmo (@nicoleacardoza). You can also donate monthly or annually on Patreon. If this email was forwarded to you, you could subscribe at antiracismdaily.com.
TAKE ACTION
Advocate for bilingual mental health support: support and donate to grassroots organizations such as Viet-CARE or sign up to volunteer.
Participate in and share the Asian, Pacific Islander, and South Asian American (APISAA) therapist web directory with your peers and connections – you never know who may need it.
Follow @asianmentalhealthcollective and @asiansformentalhealth to broaden your understanding of the individual mental health needs of immigrants and their children.
Encourage compassionate dialogue about mental health.
GET EDUCATED
By Georgina Quach (she/her)
The body always remembers. Like other children of Vietnamese war refugees, I understand how hardships and inconceivable loss leave marks. Psychologists in the 1990s found roughly half of Holocaust survivors were still suffering from post-traumatic stress disorder (Dialogues in Clinical Neuroscience). Emerging studies show that, in communities of survivors, trauma may also be passed onto subsequent generations through epigenetic changes, where the mechanism by which our body reads DNA – not DNA itself – is altered (Stanford University). This intergenerational transfer can also be behavioral; parents with severe anxiety may model detrimental patterns of thinking and feeling.
Intergenerational trauma is manifest amongst Southeast Asian refugees of the Vietnam-American war – a conflict that accounted for three million Vietnamese deaths and more than two million Laotian and Cambodian deaths. A 2015 follow-up study of Cambodian refugees in America found that 97% met the criteria for PTSD (Psychiatric Services). Despite the en masse resettlement of Boat People to the United States after the war, Southeast Asian communities face an ongoing struggle for access to culturally sensitive healthcare.
After the war ended in 1975, the southern capital, Saigon, had fallen to the North Vietnamese communists, who forced thousands of South Vietnamese civilians – including my family – to surrender their homes and possessions. Facing persecution and incarceration in one of the severe “re-education” camps, thousands of Vietnamese fled by makeshift boats to safer states. Many civilians confronted pirate attacks, starvation, drowning and rape, so their children could have a chance at freedom and a future. This generation of Southeast Asian refugees, known as the "Boat People,” constituted the largest mass resettlement of refugees in America. Over 1.1 million arrived between the 1970s and 1990s (SEARAC). Their stories are punctuated by loss, separation, and survival, reminding us that a psychological battle within the Vietnamese diaspora persists long after the physical wounds have healed.
Due to the lack of a unified resettlement infrastructure at the time, Boat People were scattered across isolated areas in the US. Without long-term support, they were expected to achieve economic self-sufficiency and independence quickly (SEARAC). Access to higher education and healthcare for these communities is still blighted by institutional inequities. But these issues have largely been overlooked and masked behind the Asian-American model minority myth, which we covered in a previous newsletter. Past traumas have been compounded by the rise in deportations amongst Vietnamese and Cambodians under Trump’s administration. Between 2017 and 2018, Cambodians saw a 279% climb in deportations (ICE).
Suppressed below the surface, traumatic memories endure not only within survivors, but also within the second generation that they helped save.
Along with ache for the homeland, a paralyzing fear of being judged and rejected by their newfound society can be passed from refugee parents to children. Paul Hoang, founder of the mental health nonprofit Viet-CARE, says children often inherit refugee parents’ anxieties around police (LA Times). In his memoir Sigh, Gone, Phuc Tran grapples with entrenched racial tensions that afflict many Asian-Americans. Despite all his efforts to “fit in” when his family moved to Pennsylvania, Tran was constantly reminded that he wasn’t like everyone else. Sitting inside a McDonald’s to eat – rather than hiding out in the car – could attract racist slurs, or the discomforting attention from Vietnam veterans. "That was my inheritance. The anxiety of being stared at," Tran writes.
While all of us minority settlers have a unique humor and voice, we often feel that we can only speak our mind within family homes. Outside those ethnic walls, the immigrant and the refugee are racially straitjacketed – an ‘othered’ status that even our children struggle to shed.
Therefore it is vital to offer emotional, long-term support that recognizes the complex journey of Southeast Asians, unique from other immigrant groups. Southeast Asian refugees still face many structural barriers to mental healthcare access, including language barriers. In my family, older relatives need my parents to accompany them to hospital appointments.
45% of Southeast Asians have limited English proficiency (SEARAC), and 95% of Cambodian refugees who had seen a psychiatrist had used an interpreter supplied by the provider or clinic (Psychiatric Services). Patients with limited English proficiency experience a lower quality of care, higher rates of medical errors, and worse clinical outcomes than those who are English proficient (American Medical Association Journal of Ethics). This highlights the need for tailored communication methods – fundamental to accessible, effective therapy.
Additionally, while 21% of Vietnamese Americans report depression and anxiety (compared with 10% of whites), mental health remains stigmatized in these communities (UC Irvine Center). In Orange County, home to the largest Vietnamese population outside Vietnam, specialists have observed that Vietnamese Americans take a “morality view” of mental health, where mental illness reflects a person’s character (LA Times). We don’t even have a word for “depression” in the Vietnamese language.
However, in recent years, more Vietnamese and Khmer-focused counseling organizations have gained momentum. Orange County Health Care Agency provides funding for community groups like the Cambodian Family to ensure accessible health knowledge and support. The Nhan Hoa Comprehensive Health Care Clinic, designed for underserved Vietnamese Americans, started a mental health program in 2006 after seeing a need for Vietnamese-targeted programs in the county.
Healing the traumas of our ancestors has implications for the wider community, and our nuanced appreciation of self-care and therapy. I have embraced the responsibility – and honor – of voicing my historically marginalized community. Archiving the “boat people” journey has sparked difficult conversations with my older relatives about intergenerational trauma, which, in turn, helps me preserve and convey Vietnamese stories, in all their complexity.
Georgina Quach is a British-born Vietnamese journalist. Coming from a family of refugees, she gravitates towards the history of movements and exploring ideas of home. Core to her current scholarship granted by The Guardian, her ultimate aim is to foster greater diversity within our newsrooms and media landscape, whilst helping the hardest-to-reach communities get access to independent, fact-checked and inclusive news. She graduated from Oxford University with a BA English Literature degree, and her thesis was on 18th century witchcraft in the West Indies. You can find her on Twitter at @georginaquach and read her writing at georginaquach.com – which also serves as her ever-expanding archive of stories from Vietnamese refugees and camp fieldworkers.
KEY TAKEAWAYS
The Vietnam-American War and Khmer Rouge Regime resulted in trauma that lasts across generations. A 2015 study found 97% of Cambodian refugees in America met the criteria for PTSD, though many still struggle to access culturally competent healthcare (Psychiatric Services).
After the Vietnam-American war, thousands of Vietnamese, known as “Boat People,” escaped the country on boats to flee communist persecution.
Funding bilingual and bicultural therapy will help ensure all refugees have access to healthcare services regardless of their English proficiency.
RELATED ISSUES
10/28/2020 | Unpack the history of social work.
9/16/2020 | Fight for paid sick leave.
9/13/2020 | Understand representation in vaccine trials.
9/6/2020 | Protect the aging population from COVID-19.
9/3/2020 | Support mental health response services.
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
Subscribe on Patreon | Give one-time on PayPal | Venmo @nicoleacardoza
Unpack the history of social work.
After a summer of protests and uprisings around anti-Blackness in America, many people are looking for solutions to police violence and killings. A popular suggestion is having social workers respond to a crisis instead of police (The Guardian). Because they are unarmed and trained in de-escalation and crisis management, social workers can seem like the perfect solution.
In theory, this makes sense, but propping up social workers as the solution to systemic racism ignores the past and present role of social workers as the implementers of racist policies in America (National Association of Social Workers).
Hi. It's Wednesday. 6 days until the U.S. election. Welcome back to the Anti-Racism Daily, where we send one email each day to dismantle white supremacy. You can support our work by giving one-time or monthly (you can also support via PayPal or Venmo @nicoleacardoza).
Yesterday, the Texas Behavioral Health Executive Council effectively reversed a rule that allowed social workers to turn away clients who are LGBTQ or have a disability. Although many in the state are breathing a sigh of relief, it's indicative of a larger narrative of how the social work industry has helped and harmed throughout the years. Today, Deana shares their perspective on where the social work industry can improve and unpacks their racial roots.
Nicole
TAKE ACTION
Follow @SWCARES2, @socialjusticedoula, and @SSWUChicago to learn from social workers that oppose social work oppression.
After reading this article, reflect on the following: How does policing show up in different professions? What media / history informs a narrative that social workers are inherently good? How can we support our own communities *before* a social services intervention is needed?
GET EDUCATED
By Nicole Cardoza (she/her)
After a summer of protests and uprisings around anti-Blackness in America, many people are looking for solutions to police violence and killings. A popular suggestion is having social workers respond to a crisis instead of police (The Guardian). Because they are unarmed and trained in de-escalation and crisis management, social workers can seem like the perfect solution.
In theory, this makes sense, but propping up social workers as the solution to systemic racism ignores the past and present role of social workers as the implementers of racist policies in America (National Association of Social Workers). During my time in a Bachelor of Social Work program, I experienced firsthand how the profession focused on legality over morality. Conversations about reporting hypothetical undocumented immigrants to ICE revealed how many future social workers were willing to turn away those most in need. Beyond that, stereotypes about welfare queens and Black students with no drive to succeed ran rampant in the classroom. Social work students, professors, and practitioners create and perpetuate environments that overlook blatant racism every day.
To fully understand the extent of social workers participation in racist policies and programs, we need to look at the roots of the profession in America. What we think of as “social work” in the United States began with Jane Addams and her fellow wealthy white women providing charity via the Hull House, a home and community space provided for those in need (Jade Addams Papers Project). Despite the success social workers saw in providing housing, education, and social opportunities, there were gaps in what they achieved. For one, Hull House was racially (but not ethnically) segregated from the day doors opened in 1889 into the late 1930s (Jade Addams Papers Project). These social workers also failed to challenge the systems that created poverty and racial inequity. Instead, they focused on systems of charity that did not challenge their own social or financial statuses. As a result, their client’s needs were met but the root of the problems they faced are still plaguing us today.
This was the beginning of social workers partnering with federal, state, and local governments (GovLoop). Whether they are providing social welfare or enforcing social policing, social workers are part of the bureaucracy of government bodies on all levels. Too often, this has manifested in social workers perpetuating policies and actions that are racist and inhumane.
As early into the profession as the 1920s, social workers were involved in restricting the reproductive freedoms of marginalized communities. Even the mother of social work, Jane Addams, embraced eugenics as a policy solution to social problems (Affilia). Social workers and other medical professionals agreed that forced sterilization of Black people, poor people, those without an education, single mothers, and mentally disabled people was good for society. In North Carolina, this practice continued up into 1974, with at least 7,600 victims on the record (MSNBC).
And while social workers are largely responsible for child welfare policies and programs in America, that history is also rooted in racism and violence. In 1958, the Bureau of Indian Affairs, a federal agency responsible for administration of Indigenous land (American Resources on the Net), created the Indian Adoption Project to break up Indigenous families. Predominantly white social workers would visit families on reservations and convince parents that it was in their children's best interests to sign away their parental rights (Upstander Project). When parents refused to allow their children to be adopted by white parents in eastern states, the coercion and manipulation began. Social workers showed up unannounced when children were in hospitals or being babysat to remove them without consent (MPR).
"We can't be afraid to use words like genocide," Anita Fineday, a former chief judge at White Earth Tribal Nation, told Indian Country Today. “The endgame [of the removals], the official federal policy, was that the tribes wouldn’t exist” (Indian Country Today).
Even today, the child welfare system is a tool that the government can use to surveil, regulate, and punish poor Black and Brown families. Black children make up nearly 25% of children in foster care (Administration for Children and Families), and Black parents are more likely to have their parental rights terminated than white parents (The Appeal). These statistics do not exist in a vacuum; like many systems in the United States, social work is designed to fail Black and Brown families..
Often, the social work profession is portrayed as completely heroic, progressive, or even effective. This is an example of white saviorism, the idea that white people can “rescue people of color from their own situation” (Medium). The history of this profession is barely touched upon in social work education. The seemingly positive influence of rich, racist white women like Jane Addams is prioritized over the harm they inflicted. Social workers are often used as the tools of racist governments, enacting that racism in their own work.
Luckily, today there are social work collectives that are acknowledging these problems and proposing solutions. Social Service Workers United-Chicago has called out the National Association of Social Workers for their history of racism. In July, SSWU drafted a petition demanding an investment in abolitionist and anti-racist practice, and a divestment from collaborating with racist government agencies like local police and ICE. The petition gained 1,700 individual signatures (Medium).
Social work has value—but it will never be the quick fix to systemic racism, white supremacy, and anti-Blackness that some people want it to be. Luckily, young Black and Brown people with social work degrees, like me, are stepping up to transform the profession. This has come in the form of recognizing Black organizers from history as social workers (Black Social Work History), lending our skills to liberation movements (Doin' The Work), and focusing on community education around the profession (University of Houston). As these actions and movements gain more support, social work could shift into a position of fighting oppression of all forms rather than enabling it.
KEY TAKEAWAYS
Texas legislators recently attempted to allow social workers to discriminate against their clients
The social work field was often used to carry out racist agendas by the government
Although social work has value, and efforts are being made to transform the industry, there's more to be done to align its efforts with its image
RELATED ISSUES
9/18/2020 | Reject racial gaslighting.
9/3/2020 | Support mental health response services.
8/14/2020 | Support Black mental health.
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Fight for paid sick leave.
It's Wednesday!
And we're unpacking the importance of paid sick leave as we head into fall in the midst of a pandemic. Ebony shares more about the importance of paid sick leave, particularly for marginalized communities. Luckily, recent legislation has passed for Philadelphia and California, showing that local advocacy efforts are generating results. Join in by examination paid sick leave legislation in your city and state, and consider how you can encourage the same policies at your workplace.
If you're enjoying these newsletters, consider making a contribution to support our work. You can give one-time on our website, PayPal or Venmo (@nicoleacardoza), or subscribe for $5/mo on our Patreon.
– Nicole
TAKE ACTION
Support the Healthy Families Act by signing this petition, which urges Congress to pass a national sick leave policy.
If you live in a state or city that has enacted a paid sick leave law, know your rights by researching how you are protected as an employee. Use this resource to get started.
Reach out to your local politicians and ask them to create a paid sick leave law for your city/state.
GET EDUCATED
By Ebony Bellamy (she/her)
As COVID-19 cases continue to rise and flu season quickly creeps upon us, the Center for Disease Control and Prevention has emphasized that reducing the spread of germs and respiratory illnesses is extremely important this fall and winter (CDC). And the best way to reduce the spread of both is for individuals to stay home when they’re feeling sick. However, this isn’t a luxury many workers have since there is no national sick leave policy in place.
The workers who are most affected by this are people of color and immigrants. For immigrants, only 50% have paid sick days compared to 60% of their native-born counterparts (The Center for Law and Policy). At the same time, more than 7.3 million Black workers can’t earn a single paid sick day (National Partnership for Women and Families). That’s roughly 40% of Black employees, and of those workers, 41% are Black men, and 36% are Black women (National Partnership for Women and Families).
And these numbers are even higher within the Latinx community. Despite them having the “highest labor force participation rate of any racial or ethnic group in the US and the fastest-growing segment of the workforce,” almost 15 million Latinx workers are unable to earn a single paid sick day (National Partnership for Women and Families). This includes 55% of Latinx men and 51% of Latinx women (National Partnership for Women and Families).
With Black and Latinx people primarily being paid less than their white and Asian counterparts, they can’t afford to take a day off. The median weekly earnings, in 2020, for full-time Black workers are $806 and $786 for Latinx workers while full-time white workers earn about $1,018 (Bureau of Labor Statistics).
Compared to 83% of full-time workers who receive paid sick days, only 43% of part-time workers have paid sick leave (The Center for Law and Policy). With over 4 million people working fewer hours than they’d like and having to work multiple part-time jobs to support themselves and their families, they’re less likely to have guaranteed paid sick leave (The Center for Law and Policy).
Unfortunately, workers with low-wage jobs are more likely to deal with financial burdens. For example, more than 30% of black households have no savings or assets to utilize if a family member unexpectedly loses their job (National Partnership for Women and Families). And as of 2015, more than one in five black families were living in poverty (National Partnership for Women and Families). The same is true for Latinx families. Approximately 27% of Latinx households have no savings or assets to utilize during an unexpected loss of income. As of 2018, more than one in six Latinx families was living in poverty (National Partnership for Women and Families).
For low-income families, missing a few days of work can equate to losing a month’s worth of groceries, missing a rent payment, or not being able to pay a majority of their bills. But, maintaining perfect attendance at work means being able to feed their family, not being homeless, and not going into debt.
A lack of sick leave is extremely devastating to those who also serve as caregivers. Not only are they risking their health, but they’re risking the health of family members since they don’t have time to attend or prioritize medical appointments and emergencies (Essence). One in five Black people act as a caregiver to an adult family member or someone close to them, and 52% of these caregivers work full time (National Partnership for Women and Families). While more than one-quarter of Latinx individuals live in multigenerational households, so about 20% of them are caregivers for loved ones (National Partnership for Women and Families).
People of color need paid sick leave so that they can take care of themselves and their families. Yet, only 13 states and Washington D.C. have enacted laws that require employers to offer paid sick leaves. Depending on the state, you can receive one hour of sick leave for every 30, 35, or 40 hours of work. Some states require more, and those hours equate to three to seven paid sick days (National Conference of State Legislature). Unfortunately, each state has specific guidelines that determine who qualifies for paid sick leave, so do your research because not all employees are covered.
Even though some states have a paid sick leave policy in place, people of color are often reluctant to take advantage of it. A Pew Research study found that 69% of employees took less sick leaves because they couldn’t afford to lose money, while 47% were afraid they would risk losing their job if they asked for a sick day (Essence).
And some people don’t even know paid sick leave is an option for them. About one in five people don’t know if their employers offer any form of paid leave for situations such as routine doctor appointments, minor illnesses, and vacations (Essence). To fix this, employers need to let their employees know paid time off is available to them. They should have their policies posted in highly visible places around the office and ensure it’s written so that employees can understand them, which means posting the sick day policies in various languages (Essence).
To ensure all employees can take advantage of paid sick leave, we need to support the Healthy Families Act. This legislation ensures all American employees can earn up to seven days of paid sick time per year. Employees earn this by gaining an hour of sick leave for every 30 hours they work, and these sick days can be carried over to the next calendar year if they’re not used (The Center for Law and Policy). Sick days can be used for a multitude of reasons such as caring for their own physical or mental illness, caring for an injury or medical condition, obtaining a medical diagnosis, receiving preventive care, and caring for a family member, child, spouse, or loved one (The Center for Law and Policy). Read the National Partnership for Women and Families Fact Sheet to learn more about the Healthy Families Act.
There are over 32 million workers, who can’t earn paid sick leave, and we need to change that. No one should feel forced to choose between their health, their families’ health, and their financial security when they’re feeling sick.
Key Takeaways
Approximately 7.3 million Black workers and 15 million Latinx workers can’t earn a single day of paid sick leave (National Partnership for Women and Families).
People of color make less than their white counterparts, which hinders their ability to take a day off.
83% of full-time workers receive paid sick days, while only 43% of part-time workers have paid sick leave (The Center for Law and Policy).
Only 13 states and Washington D.C. have laws that require employers to offer paid sick leave (National Conference of State Legislature).
69% of employees took less sick leaves because they couldn’t afford to lose money, while 47% were afraid they would risk losing their job if they asked for a sick day (Essence).
The Healthy Families Act is a legislation that aims to create a national paid sick leave policy.
RELATED ISSUES
9/9/2020 | Make the census count.
8/9/2020 | Understand the unemployment gap | COVID-19
7/23/2020 | Know our racist presidential history.
7/21/2020 | Honor the legacy of Rep. John Lewis.
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
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Understand representation in vaccine trials.
Happy Sunday!
Today marks our weekly review of the racial disparities of COVID-19. It's important to remember that this virus doesn't discriminate. But our systems do. And we're trying to respond swiftly to its catastrophic impact while reckoning with our deep history of oppression and harm. Today's topic – the fight for representation in vaccine trials – is a good example of this. As you read, consider how much our mistakes from the past affect our ability to respond equitably in the present – and its implications for the future.
Thank you all for your contributions. To support our work, you can give one-time on our website, PayPal or Venmo (@nicoleacardoza), or subscribe for $5/mo on our Patreon.
Nicole
TAKE ACTION
Support the Black Doctors COVID19 Consortium, which is building trust in their community by offering free COVID-19 testing in Philadelphia, New Jersey and New York
Respect the racial and historical context that may make people wary of a vaccine
Consider: how may your racial identity influence your perception of vaccine trials? What privilege(s) may have helped you build trust in the healthcare system?
GET EDUCATED
The U.S. is moving at an unprecedented pace to create a vaccine to respond to COVID-19. The Trump administration has dubbed these efforts “Operation Warp Speed,” with the hopes to deliver “initial doses of a safe and effective vaccine” by January 2021 — shortening the development time from years to months (NPR). More recently, Trump has hinted that a vaccine may be ready by the election (what a coincidence), which is highly unlikely. And part of that is because of a lack of representation in testing groups.
350,000 people have registered online for a coronavirus clinical trial, but only 10% are Black or Latino, according to Dr. Jim Kublin, executive director of operations for the Covid-19 Prevention Network (CNN). An additional 8% represent Indigenous communities. This isn’t nearly enough, considering over half the COVID-19 in the U.S. have been in the Black and Latino communities (CNN). And beyond that, 1.3% of reported cases are from Indigenous groups, despite only representing .7% of the population (CDC).
In fact, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, expressed his desire to see non-white communities enrolled in coronavirus vaccine trials at levels at least double their percentages in the population, which would mean 66.4% of participants need to identify as "Black or African American, Latin, American Indian, and Alaskan Native” (CNN). Scientists, doctors, and advocates are urging both pharmaceutical companies and the government to increase their efforts to enroll a diverse group of volunteers.
As we discussed in last week’s newsletter, communities of color have a deep distrust of the U.S. health care system, and for good reason.
📰 Read more about the history of medical violence against communities of color >
Also, the U.S. (and other parts of the world) have a long history of using people of color as trial subjects for vaccines. Thomas Jefferson tested what would become a successful smallpox vaccine on enslaved people before extending it to his family (Smithsonian). A British doctor serving as a plantation physician in rural Jamaica subjected enslaved people to trial tests without consent (Futurist).
As a result, people of color are historically underrepresented in clinical trials of new drugs, even when the treatment is aimed at an ailment that disproportionately affects them (ProPublica). Data from the FDA shows that Black people are the least likely to participate in drug trials – and that participation by people of color decreased between 2018 and 2019 (Outsourcing-Pharma).
“The absence of significant participation by Black patients creates not only a hole in the data, but can contribute to less effective treatments with little data on the impact on that specific population.”
Dr. Valerie Montgomery Rice, president and dean of the Morehouse School of Medicine, via Governing
One outreach effort includes reaching out to historically Black colleges and universities, encouraging students to participate in the trials, and engage medical staff and students in the process. Advocates believe this can grow trust in the community and encourage more Black people to join (NYTimes). Here’s an example of a letter from Xavier University. But this initiative, paired with efforts to increase testing across campuses, is garnering mixed feedback (Twitter).
📰 Read why it’s essential to have more representation of people of color in research >
Also, the COVID-19 Prevention Network, a group created by the National Institute of Allergy and Infectious Diseases, created an advertising campaign urging Black and Latino people to get involved. The ads center the voices of essential workers, grandparents, food industry workers, and other groups within communities of color that have been disproportionately impacted by COVID-19 (NBC News).
📰 Read more about the impact of COVID-19 on essential workers, the elderly, and workers in the food industry.
And leaders from the communities are doing their part to build trust. A group of faith-based leaders has joined together to enhance trust and engagement with people of color (Newswise). And the Navajo Nation has announced its participation in a Pfizer-BioNTech COVID-19 vaccine trial on a patient-volunteer basis (Indian Country Today).
“I would encourage people, but I know everybody won’t. It’s like ingrained in the mindset of Black people when you consider the syphilis injections. Black folks don’t want to be guinea pigs and we have been. Even in light of that, if the data is transparent, if the information makes sense, if the research is credible, then I think we can overcome that particular fear.”
Rev. Kenneth L. Samuel, senior pastor of Victory for the World Church in Stone Mountain, via Governing
Regardless of the accelerated timeline for finding a vaccine, there’s “no shortcut” to authentically engaging communities of color for trials, emphasizes Dr. Dominic Mack of Morehouse School of Medicine in Atlanta (NPR). It will take a long time to repair a history of discrimination and harm, but that work has to start now.
RELATED ISSUES
8/29/2020 | Study Hall! The trauma of police brutality videos, active bystander trainings.
8/15/2020 | Study Hall! Affirmative action, sliding scale pricing, and the right intentions.
8/8/2020 | Study Hall! Emoji blackface, the "family card," and starting conversations.
8/1/2020 | Study Hall! Racist actions, doulas, and intersectional change.
7/25/2020 | Study Hall! How to be a better ally, petitions, and plastics.
7/18/2020 | Study Hall! Ebonics, capitalizations and cultural appropriation.
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
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Protect the aging population from COVID-19.
Today’s Anti-Racism Daily is inspired by my grandmother, who, unlike me, has been relatively even-keeled with the events of the past few months. It’s not because she, as an African American woman, feels impassive to recent events. She’s just been here before; rallying during the Civil Rights movement, watched her family survive sickness and disease. For her, fighting for justice and overcoming the odds is a daily practice. I think about the challenges she could face as COVID-19 persists, and researched the disproportionate impact of this pandemic on aging communities of color as part of our weekly series. I’d love to know your thoughts.
As always, your support is greatly appreciated. These contributions are our only source of funding and help us pay writers and develop new resources. You can give one-time on our website, PayPal or Venmo (@nicoleacardoza), or subscribe for $5/mo on our Patreon.
Nicole
TAKE ACTION
Find a local program in your community that's supporting the aging population with groceries, funds and companionship. Here's a list for starters.
Sign up to join the Mon Ami Phone Bank and help seniors isolated by COVID-19.
GET EDUCATED
Our country is working to maintain a sense of normalcy as COVID-19 persists. But as we do, we can’t forget about the racial disparities of its impact, especially how these disparities intersect with other marginalized groups. One that is particularly vulnerable is the aging population.
A KHN analysis of data from the Centers for Disease Control and Prevention found that African Americans ages 65 to 74 are 5x more likely to die from COVID-19 than white people. In the 75-to-84 group, the death rate for Black people was 3.5x greater. Among those 85 and older, Black people died twice as often. In all three age groups, death rates for Hispanics were higher than for whites but lower than for Black people (KHN).
“People are talking about the race disparity in COVID deaths, they're talking about the age disparity, but they're not talking about how race and age disparities interact: They're not talking about older black adults.”
Robert Joseph Taylor, director of the Program for Research on Black Americans at the University of Michigan's Institute for Social Research, for KHN.
Some of the health outcomes for older people of color can be attributed to a lifetime of stress related to racism. People of color have historically endured more stress and anxiety throughout their lives than their white counterparts while navigating racism and discrimination. As a result, we accumulate this tension in our bodies, leading to a wide variety of adverse health implications. This concept is called “weathering,” coined by Arline Geronimus, and can occur from a wide range of stressors, from experiencing police brutality to microaggressions, and everything in between (NPR).
In the scientific community, weathering is identified as “allostatic load,” which measures the substances the body releases after periods of stress. When our bodies are called into “fight or flight” mode, our stress-related neurotransmitters, called catecholamines, quickly release corticotropin, which in turn triggers the release of cortisol, giving our body a jolt of adrenaline to respond to the stressor. Although it can be useful in short situations, the lives of people of color are filled with stress-inducing events. Over time, this allostatic load accumulates. A study that compared the average allostatic loads for Black people and white people found that the mean score for Blacks was roughly comparable to that of Whites who were a full ten years older, demonstrating that people of color age more rapidly than their white peers (Science Direct).
After a lifetime of wear and tear from chronic stress and anxiety, it’s no wonder that aging communities of color are more likely to have pre-existing medical conditions that make them more susceptible to contracting the disease (CDC). Communities of color, particularly Black people, are more likely to have complications like diabetes, chronic kidney disease, obesity, heart failure and pulmonary hypertension (KHN).
But aging communities of color are also more likely to distrust medical care, which means that they're less likely to listen to precautions for contracting COVID-19 and interact with the healthcare system for testing and treatment. And for good reason. As discussed in a previous newsletter, our healthcare system has a legacy of providing inequitable treatment across racial groups. But beyond this, there’s are a series of gross acts of medical violence against communities of color throughout history. These have forced these communities to be wary, disenfranchising them from the care they deserve.
One reason for this is the forced sterilization of communities of color. Over 60,000 women – and some men – were sterilized without their consent across the U.S. between the 1930s and the 1970s (Huffington Post). These people were disproportionately Mexican, and many were Japanese. Similarly, in the 1960s and 1970s, thousands of Native American women were sterilized without consent (NYTimes). In Puerto Rico, nearly one-third of Puerto Rican women of childbearing age were sterilized, the world’s highest rate (University of Wisconsin-Madison). In the U.S., this violence were justified by a Supreme Court decision that actively sought to "breed out" traits that were considered undesirable (NPR). It’s fitting to believe that the medical system may be biased as a result.
In 1932, 600 men were invited to participate in a research study with the U.S. Public Health Service (PHS) to find a cure for syphilis. Participants were offered free medical care for their participation – and many participants, sharecroppers who had never had the chance to receive medical care before, signed up eagerly. Throughout their lifetime, men were monitored regularly by health officials and were assured they were being treated. But in reality, they were part of a sick experiment: the PHS was only watching to track the disease’s full progression untreated. The men were told they had “bad blood” but not that they had syphilis. They were only given placebos, like aspirin and mineral supplements, despite the fact that penicillin was widely available as a recommended treatment in 1947 (History). Researchers provided no effective care as the men “died, went blind or insane or experienced other severe health problems” until an outraged researcher leaked the story to the press in 1972, which prompted the study to be shut down. By that time, 28 participants had died from the disease. One hundred more passed away from related complications, at least 40 spouses had been diagnosed with it, and the disease had been passed to 19 children at birth (History).
This study alone is noted as creating deep distrust between Black patients that remember the story from their lifetime. Tuskegee Study alone is responsible for “over a third of the life expectancy gap between older black men and white men in 1980” (The Atlantic).
There’s also a significant percentage of our aging population of color that live in spaces where COVID-19 is rampant. Of the 1.5 million adults currently in state and federal prisons, 12% are over the age of 55, and the majority are people of color, which means that these pre-existing health conditions and distrust of the medical system are facing tight, unsanitary living conditions on top of everything else (JSTOR). But these numbers are rising; our aging. According to a 2012 report from the ACLU, the number of elderly prisoners is expected to double by 2030, calling for a more critical look at protecting our aging population from future pandemics behind bars (JSTOR).
We must invest in protecting the senior communities around us today. And, we need to create more policies and practices that foster a more equitable tomorrow. The U.S. is getting older; by 2035, there’s expected to be more people over the age of 65 than children under the age of 18 (Census). If we can’t count some of the historical biases and disparities that prevent some of us from being well now, there’s no guarantee we can support all of us later.
key takeaways
Aging communities of color are more likely to die from COVID-19 than white communities.
Weathering, or the accumulation of “fight and flight” response of the body because of racism and discrimination, leads to adverse health outcomes for people of color – particularly aging populations.
A series of acts of medical violence throughout history have created a deep distrust of the healthcare system in older communities of color.
RELATED ISSUES
8/23/2020 | Support those incarcerated and impacted by COVID-19.
8/17/2020 | Fight for equity in remote learning.
8/16/2020 | Think before eating out.
8/9/2020 | Understand the unemployment gap | COVID-19
8/2/2020 | Protect those vulnerable to extreme heat during COVID-19.
7/27/2020 | Support Asian Americans through COVID-19.
7/19/2020 | Rally for representation in science and research: COVID-19 and CDC.
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
Subscribe on Patreon | Give one-time on PayPal | Venmo @nicoleacardoza
Support mental health response services.
Happy Thursday!
And a special three month anniversary to the Anti-Racism Daily! How long have you been on this journey with us? Take a look back and reflect on what you've learned. Do you have a story about how you've put the ARD into action? Let me know by replying to this email – we might feature you on our podcast launching next week! 🎉
But first, be sure to read today's call to advocate for alternative mental health response services in your community. Our criminal justice system wasn't designed for this, and as we demand justice for Daniel Prude we must also create more accountability for the safety of those most vulnerable.
As always, your contributions are so appreciated! You can give on our website, PayPal, or Venmo (@nicoleacardoza), or subscribe monthly on our Patreon.
Nicole
TAKE ACTION
Research: What are the alternatives to calling 911 in your city?
Are there none? Learn what your city council is planning for future budget spending related to law enforcement. Fight for an alternative.
Donate to the GoFundMe to support the family of Daniel Prude.
GET EDUCATED
On March 23, Joe Prude noticed his brother, Daniel Prude, acting strangely and called the police for help. Officers found Daniel Prude naked and unarmed. He complied with officers’ demands and was quickly handcuffed. The officers then placed a spit sock – a mesh device used to shield police officers from spit and blood from the victim – over Prude’s head, one asking him whether or not he had AIDS. The officers then pin Prude down on the ground for over two minutes, ignoring Prude’s cries for help and continue to kneel on him as he appears to stop breathing. The family took Prude off of life support the following week. The medical examiner determined Prude’s death was a homicide. The police body camera footage was recently released as the family and local activists demand justice. Full story on The Appeal.
“I placed the phone call for my brother to get help, not for my brother to get lynched. When I say get lynched, that was full fledged, murder, cold-blooded — nothing other than cold-blooded murder. The man is defenseless, naked on the ground, cuffed up already. I mean come on, how many brothers got to die for society to understand that this needs to stop? You killed a defenseless black man, a father’s son, a brother’s brother, a nephew’s uncle.”
Joe Prude, the brother of Daniel Prude, for Rochester First
Ashley Gantt, a community organizer from Free the People Roc and the New York Civil Liberties Union, spoke with the family and other activists yesterday demanding justice. Their speech noted that "the Rochester Police Department has shown time and again that they are not trained to deal with mental health crises. These officers are trained to kill and not to de-escalate” (Democrat and Chronicle). This story, unfortunately, isn’t distinct to just Rochester. Across the country, individuals with mental health conditions are disproportionately impacted by the police.
One in four people killed by police in 2015 had a severe mental health condition (Washington Post). And beyond this, 40% of people with serious mental health conditions will interact with the criminal justice system in their lifetimes. 2 million are booked in jails each year (Washington Post). Most of these individuals haven’t been convicted of a crime, but if they have, they’re more likely to have been charged with a minor offense than something series (NAMI).
What’s more? They:
Remain in jail 4x to 8x longer than people without mental health conditions charged with the same crime
Cost 7x more than other inmates in jail
Are less likely to make bail
Are more likely to gain new charges while incarcerated
In fact, there are more people with mental health conditions in prisons than hospitals (Washington Post).
And communities of color, particularly Black people, are especially at risk, as they’re already disproportionately impacted by police brutality (Time). As we discussed in an earlier newsletter, Black people are more likely to have mental health issues and other disabilities, and less likely to receive diagnosis and treatment (Time).
This is why the conversation surrounding “defund the police” is so critical. Our law enforcement often acts as first responders for mental health crises. John Snook, the executive director of the Treatment Advocacy Center, emphasizes that mental health crises is the only medical illness that we allow the police to respond to. “Someone has a heart attack, a stroke—we don't send the police to help them. Law enforcement aren't trained to be mental health professionals” (Vice).
Part of this is because of a historical shift to defund mental health, accelerated in the 1960s with the passage of Medicaid (Mother Jones). From there, a series of mental health funding cuts caused state mental health services to dwindle nationwide. The Sentencing Project found that 6 out of 10 states with the least access to care have the highest rates of incarceration. Learn more about the history of deinstitutionalization and defunding the police in-depth over at Vice.
But another part of this is a history of intentionally deeming Black people as mentally ill to justify enslavement and dehumanization, which Ebony explained in detail in an earlier newsletter on Black mental health. Not only has this bias become reinforced throughout history, it becomes cemented within our criminal justice system when a Black person experiencing a mental health crises become synonymous with danger and threat.
Mental health response organizations across the country are providing that alternative forms of support are possible, and effective in supporting citizens in need without violence. CAHOOTS, or Crisis Assistance Helping Out on the Streets, is a non-profit organization working alongside local police in Eugene, OR to support mental health 911 calls, meeting those in need wtih medical resources nad trained professionals (Vice). Austin has a Expanded Mobile Crisis Outreach Team which does the same, and is expanding into telehealth care (Gov 1). More initiatives like this are expanding across the country (Vice) and could effectively reallocate funding from law enforcement while keeping these vulnerable communities safe.
And all of the news about police brutality is creating more mental health strain, exacerbating the problem at hand. A study published in The Lancet in 2018 found that stories of police killings have adverse effects on mental health among Black American adults who were not directly affected by the incident (Penn Today). Another study published in 2019 found that viewing viral videos of police killings, beatings, and arrests — and seeing images of immigrants in cages — was associated with symptoms of depression and PTSD in adolescents (Journal of Adolescent Health). According to the lead researcher Brendesha Tynes, this is especially insidious, as it can “make these kids feel worse about their racial identity, and make them internalize some of that dehumanization” (The Verge). We frequently write about why we don’t share graphic videos of brutality, and this is part of the reason why.
The Lancet study recommends that communities should have, in part, adequate mental health resources to heal from the trauma of these incidents. As we collectively continue to watch the video footage and stories circulate in the media, we need to resource ourselves as best we can to make it through during this significant racial reckoning of our time.
key takeaways
Individuals with mental health conditions, particularly people of color, are more likely to be negatively impacted by the criminal justice system
There are more people with mental health conditions in prisons than hospitals
By investing in community-based mental health services crisis response services we can decrease police brutality
RELATED ISSUES
8/27/2020 | Help decriminalize drug possession.
8/26/2020 | Be an active bystander.
8/24/2020 | Demand justice for Jacob Blake.
8/23/2020 | Support those incarcerated and impacted by COVID-19.
8/12/2020 | Demand justice for Elijah McClain.
7/26/2020 | Pay attention to the Portland protests.
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Good morning!
Each Sunday we analyze the racial disparities of COVID-19 and how you can help. Today, Renée outlines the crisis happening in prisons and jails across America. As we continue to rally to transform our criminal justice system, we cannot forget about how so many are suffering right here, right now. Read more stories on criminal justice here.
Thank you for everyone that makes this newsletter possible. If you haven't already, consider giving one-time on our website, PayPal, or Venmo (@nicoleacardoza). Or, you can contribute monthly on our Patreon.
Nicole
TAKE ACTION
Stay informed with The Marshall Project as it collects data on COVID-19 infections in state and federal prisons. You can view the website here.
Do you know your local or state prison? Are they allowing incarcerated people to make phone calls free of cost? If not, send an email using this template and customize it to your local or state prison.
GET EDUCATED
By Renée Cherez
As COVID-19 began making its way across America in March, the country came to the standstill of the century. Universities and schools closed their doors, nursing homes, and hospitals suspended visitation, restaurants, retail stores, and movie theaters stopped all operations to prevent the spread of this invisible virus.
Public health and safety seemed to be the utmost priority but not for the incarcerated. America's carceral system is disgustingly unique: Holding only 4% of the world's population, the United States imprisons the highest rate (20%) of incarcerated people globally (Prison Policy Initiative).
Prisons and jails are like Petri dishes where bacteria and disease spread rapidly due to close living quarters, limited to no cleaning supplies, overcrowding, and the inability to socially distance. Not only is the COVID-19 death rate of incarcerated people higher than the overall national rate, but the incarcerated are also infected by coronavirus at 5.5 times higher than the overall national rate (JAMA Network).
So far, the country’s highest cluster can be found in California’s San Quentin State Prison, where over 2,600 incarcerated people and staff have been infected, and 26 incarcerated people have died (NYT).
“I am very concerned [...]. There’s no way to social distance. We all eat together. We have a communal bathroom. There’s no way to address a public health issue in an overcrowded facility.”
An incarcerated person at San Quentin State Prison for the NYTimes
In June, Texas began testing every incarcerated person to find that both the incarcerated and staff tested positive quadruples of the number of positive cases to 7,900, resulting in 25 deaths (Prison Policy Initiative). Even more shocking is 60% of the (785 men out of 1,400) incarcerated at Michigan Lakelands Correctional Facility tested positive for the virus (Detroit Metro Times).
Like the general public, at the start of the spread, testing for the virus in prisons and jails was limited. Prisons are now mass testing the incarcerated and staff regardless of their symptoms to help slow the spread of the virus (The Marshall Project).
With over 170,000 coronavirus cases affecting the incarcerated and staff across the country, prison activists are demanding the release of vulnerable populations like the elderly. After decades of extreme sentencing as a result of the “war on drugs” and the “tough on crime” era, a large portion of the incarcerated in state prisons are over fifty-five years old and are more likely to be in poor health (The Marshall Project).
Without access to quality medical care, coupled with the brutal conditions of prison, seniors suffer from chronic health conditions such as diabetes, asthma, and hypertension, all underlying conditions that exacerbate COVID-19 (NCBI).
Family members, lawyers, and advocates have placed calls to prisons to grant early-release to the elderly, and the infirm to prevent more deaths as well as decrease the population. Frustratingly, research shows that out of 668 jails being tracked, 71% of them saw an increase in population from May 1 to June 22, while 84 jails had more people locked away on July 22, then they did in March (Prison Policy Initiative).
There has also been a push for those in jail pre-trial, detained for parole or probation violations, or near the end of their sentences to be granted early release.
“For the most part, states are not even taking the simplest and least controversial steps, like refusing admissions for technical violations of probation and parole rules, and to release those that are already in confinement for those same technical violations. Similarly, other obvious places to start are releasing people nearing the end of their sentence, those who are in minimum-security facilities and on work-release, and those who are medically fragile or older” (Prison Policy Initiative Report).
By the end of August, California could see the early release of 8,000 incarcerated people to slow the spread of the virus (LA Times). The releases will occur for those 30 or older, not serving time for what can be deemed a violent crime under state law and are not involved with domestic violence.
During this crisis, we all share the desire to stay connected with our friends and family. Some prisons and jails have begun allowing visitors. Still, most have not, which can be challenging mentally for the incarcerated as they rely on those visits from family, friends, advocates, and lawyers to keep their morale high (The Marshall Project). Because prisons are also a for-profit business, some are charging for phone and video calls during a time where unemployment numbers are similar to or greater than the Great Depression (The Intercept).
When we think of vulnerable populations, we must be diligent in keeping the incarcerated in our minds because they are often forgotten. They are real people, with real stories and families, and their health and safety should be prioritized and valued. Society shouldn’t be judged on how they resolve what can be deemed a crime, but rather how they treat those who’ve committed said crime. Incarcerated people deserve our compassion and advocacy too.
Key Takeaways
Incarcerated people are infected by coronavirus at 5.5 times higher than the overall national rate.
Of the 668 jails tracked by the Prison Policy Initiative, 71% of them saw an increase in population from May 1 to June 22 rather than a decrease.
California’s San Quentin State Prison has the largest cluster of COVID-19 cases in America.
RELATED ISSUES
8/12/2020 | Demand justice for Elijah McClain.
7/26/2020 | Pay attention to the Portland protests.
7/20/2020 | Protect your community from the harm of gentrification.
7/6/2020 | Abolish qualified immunity.
7/2/2020 | Remove police from our public schools.
PLEDGE YOUR SUPPORT
Thank you for all your financial contributions! If you haven't already, consider making a monthly donation to this work. These funds will help me operationalize this work for greatest impact.
Subscribe on Patreon | Give one-time on PayPal | Venmo @nicoleacardoza