Doug Ford’s ‘stay home’ message is absurd. Workers in the hardest-hit areas can’t stay home — they’re essential

Seeing more of these kinds of articles, making the needed comparisons:

A retiree in Rosedale is vaccinated against a virus she’s highly unlikely to catch. Meanwhile, the 35-year-old warehouse worker from North Toronto who is boxing up the retiree’s water resistant throw pillows just in time for patio season is still awaiting his shot. 

Maybe the warehouse worker (who is far more likely than the retiree to catch COVID-19) isn’t eligible for a vaccine yet, or maybe he is eligible but he isn’t sure where or when to get jabbed because everything is so goddamned confusing.

He checked the provincial website but no luck. 

He heard something about vaccine pop-up clinics emerging in his area, but the details are vague. He lives in a so-called “hot spot” but he isn’t involved in community groups; he doesn’t belong to a church or a mosque that would advertise such a clinic. If one pops up, unless he’s lucky, he may miss it. 

The good news is that the Rosedale retiree’s pillows will arrive at her house ahead of schedule. Saturday’s physically distanced backyard tea party will be lovely. 

The above is not an excerpt from the “Hunger Games,” or some Toronto-themed dystopia novel. It’s the reality of the COVID-19 vaccine rollout in Canada’s most populous city, one that despite city officials’ efforts has produced the following uneven result: those least likely to get the virus are vaccinated in large numbers while those most likely to get it are not. 

According to recent reporting by Olivia Bowden and May Warren, affluent Moore Park is “the most vaccinated neighbourhood in Toronto” (22 per cent of residents have received one shot), while Jane and Finch “where more than half the residents do not speak English as a first language, and where thousands of essential workers live, had the lowest vaccination rate” (5.5 per cent of residents have received one shot).

But this disparity isn’t just glaring in terms of vaccination rates. It’s glaring in terms of mobility too: how much time Torontonians are spending at home vs. out of the house. 

According to data presented at a Toronto Board of Health meeting Monday morning, Torontonians who live in the city’s northwest end — where essential workers tend to live — are leaving their homes more often than those in neighbourhoods where infection rates are lower. 

What’s more, between late March and early April when Premier Doug Ford pulled the “emergency brake,” time spent at home for Torontonians who live in some essential worker enclaves appears to have actually decreased slightly.

Toronto’s top doctor, Dr. Eileen de Villa, presented a map highlighting the disparity at Monday’s meeting. “What we have seen recently is a reduced mobility overall in the city but not equally experienced in all parts of the city,” she said. “We’re seeing more mobility in the northwest of the city which we know has had disproportionate impact of COVID-19.” 

This isn’t a coincidence says Toronto Board of Health chair Joe Cressy. “What’s critical to understand here is that as the people who aren’t staying home, they’re not going out partying — they’re going to their essential jobs. Since the stay-at-home order was issued, people are staying home more often, but not in those hard-hit neighbourhoods.” 

People are staying home more often, but not in those hard-hit neighbourhoods.

If ever there was a statement that defined the urgency of vaccinating essential workers immediately, this is it. If ever there was a statement that defined the urgency of easy to access paid sick leave, this is it. And if ever there was a statement that defined the absurdity of politicians’ repeated directives to “stay home” this is it. 

“Stay-at-home orders only work for people who can stay at home,” says Cressy. And yet, leaders like Ford continue to hammer home the “stay home” message to people who are already complying, or who can’t comply because they have essential jobs. 

On April 7, Ford tweeted the following: “Stay home. Stay safe. Save lives.” On April 10 he tweeted: “Gardening is a great way to enjoy the outdoors while staying at home.” Earlier this year, the premier butchered about a dozen languages asking Ontarians to stay home. 

The problem is that when people have to go to work it doesn’t matter if you ask them nicely in their native tongue not to. 

It doesn’t matter how many empty directives our leaders give. Until vaccines pick up dramatically in Toronto’s inner suburbs and essential workers get paid sick leave that is effective immediately, the cycle will continue. 

The vaccinated will sit safe at home awaiting the contactless delivery of throw pillows. The people who make that life possible will get sick. Contactless delivery is not contactless for everyone. 


Working from home is here to stay — and for some Canadians, that’s a big problem

Good highlighting of the inequalities between those able to work from home and those not, mainly younger, visible minority or immigrant workers with lower income. Working from home appears to be a good overall proxy for privilege and class:

Working from home has a bright side for a lot of us, and we really hope it will outlast the pandemic.

No morning commute, no mad scramble out the door with packed lunches and wet laundry left in the machine to grow mildew all day, no race at the end of the day to tie up all the loose ends before rushing home to make dinner.

But that’s not the case for everyone, and new research shows working from home over the long term is often far less than ideal for young workers, immigrants, racialized workers and people living with disabilities.

In other words, the very same people who have been at the sharp end of the stick during the pandemic now risk being thrust into a precarious situation yet again in a post-pandemic world where working from home becomes a norm.

We can decide right now not to do that.

The Environics Institute teamed up with the Future Skills Centre and Ryerson University’s Diversity Institute to figure out what the workforce of the future looks like and how COVID-19 has disrupted so much. They surveyed almost 5,400 people across the country on what their work-from-home experience has been like, and they also dug down into how age, race, immigrant history and income make a difference. 

And they do make a difference — both during the pandemic and, if the survey is a good indication, afterwards too.

Generally, those of us who are working from home are content with the way things are going, and hope to be able to continue spending at least a couple of days a week in our home offices when the pandemic winds down.

“There’s no going back,” says Andrew Parkin, executive director of the Environics Institute.

The stigma of working from home from time to time has dissipated now that so many people have shown it can be done without compromising quality, he added, and employers will need to figure out how to incorporate work-from-home arrangements over the long term.

Of course, not everyone has shared in that experience during the pandemic. As we know, it’s been mainly white-collar workers who have been able to set up shop at their kitchen tables. About half of us have been going into the workplace regularly throughout the pandemic, while 36 per cent of us have been able to work from home full time, according to a report published last week by the Canadian Chamber of Commerce and Abacus Data. 

Low-income workers, people of colour and young people have been more likely to have to keep going into their traditional workplaces. They’ve also been most likely to lose their jobs during the pandemic, according to employment data over the past few months. They’ve had a harder time getting back into the workforce. And they’ve also been more likely to be on the front lines of contagion, holding down essential jobs in taking care of the rest of us.

And now, because their jobs are more precarious, they face more uncertainty about how a work-from-home culture that outlasts the pandemic will benefit them. Doing without frequent face time with colleagues, bosses and networks does not sit well with those who have a fragile connection to their workplaces.

“While it’s reassuring to confirm that many workers in Canada have altered their work arrangement in order to minimize the risk of contracting and spreading COVID-19, these survey results serve as an important reminder that the ability to do so is closely tied to one’s socio-economic situation,” states the Environics report obtained by the Star.

Young people, for example, say they like working from home and can maintain the quality of their work there. But they’re also more worried than others that working from home will hurt their career prospects — which are already hurting because the pandemic has knocked their employment levels severely.

The same fear is expressed by first- or second-generation immigrants as well as racialized workers, and they, too, have seen more of their jobs disappear during the pandemic.

On top of that, immigrants and racialized workers also say, more than others, that they aren’t properly equipped to work from home, and they’re worried the quality of their work has deteriorated.

Workers with disabilities are also far more likely to say they don’t have the right equipment to work from home.

The implications for post-pandemic work are far-reaching. Business groups have emphasized the need to make sure workplaces are safe to return to, with whatever personal protective equipment and health measures are needed to assure employees aren’t going to get sick.

But the new research shows it’s a lot more complex than that. Some people won’t want to come back, but at the same time, a full embrace of a work-from-home culture will penalize those who are already facing intimidating barriers to their careers and futures.

“The key word is flexibility,” says Parkin, pointing to a need to rethink office space and work flow to make sure a range of needs are accommodated.

We have a few months left of lockdown, constraint and forced work-from-home conditions before we have more options open to us in the world of work. Let’s use them to ensure the reopening is done carefully, giving a fair opportunity to those workers who have already paid such a steep price.


[CDC] Studies Confirm Racial, Ethnic Disparities In COVID-19 Hospitalizations And Visits

More evidence:

Days after declaring racism a serious public health threat, the Centers for Disease Control and Prevention released a pair of studies further quantifying the disproportionate impact of COVID-19 on communities of color.

The studies, published Monday in Morbidity and Mortality Weekly Report, examine trends in racial and ethnic disparities in hospitalizations and emergency room visits associated with COVID-19 in 2020.

CDC Director Rochelle Walensky said at a regular White House COVID-19 Response Team briefing that the new literature underscores the need to prioritize health equity, including in the country’s accelerating vaccine rollout.

“These disparities were not caused by the pandemic, but they were certainly exacerbated by [it],” Walensky said. “The COVID-19 pandemic and its disproportional impact on communities of color is just the most recent and glaring example of health inequities that threaten the health of our nation.”

After assessing administrative discharge data from March to December 2020, the CDC found that the proportion of hospitalized patients with COVID-19 was highest for Hispanic and Latino patients in all four census regions of the U.S.

Racial and ethnic disparities were most pronounced between May and July, it said, and declined over the course of the pandemic as hospitalizations increased among non-Hispanic white people. But such disparities persisted across the country as of December, most notably among Hispanic patients in the West.

The findings build on earlier studies about racial and ethnic disparities in COVID-19 hospitalizations by showing how they shifted over time and between regions.

Researchers point to two driving factors for the disproportionate hospitalizations among these minority groups: a higher risk of exposure to the virus and a higher risk for severe disease. They said differences in exposure risk associated with occupational and housing conditions, as well as socioeconomic status, are likely behind the demographic patterns they observed.

“Identification of the specific social determinants of health (e.g., access to health care, occupation and job conditions, housing instability, and transportation challenges) that contribute to geographic and temporal differences in racial and ethnic disparities in COVID-19 infection and poor health outcomes is critical,” they said, adding that a better understanding of these factors at the local level can help tailor strategies to prevent illness and allocate resources.

The second study examined COVID-19-related emergency department visits in 13 states between October and December, and found similar disparities between racial and ethnic groups.

During that period, Hispanic and American Indian or Alaska Native people were 1.7 times more likely to seek care than white people, and Black individuals 1.4 times more likely.

Researchers noted that these racial and ethnic groups are also impacted by long-standing and systemic inequities that affect their health, such as limited access to quality health care and disproportionate representation in “essential” jobs with less flexibility to take leave or work remotely.

“Racism and discrimination shape these factors that influence health risks; racism, rather than a person’s race or ethnicity, is a key driver of these health inequities,” they explained.

Such inequities can increase the risk of exposure and delayed medical attention, further heightening the risks for severe disease outcomes and the need to seek emergency care.

Looking ahead, researchers said their findings could be used to prioritize vaccines and other resources for disproportionately affected communities in an effort to reduce the need for emergency care. Walensky also emphasized the implications of the new studies on and beyond the country’s pandemic response.

“This information and the ongoing surveillance data we see daily from states across the country underscore the critical need and an important opportunity to address health equity as a core element in all of our public health efforts,” she said.

A renewed push to address such inequity is now underway at the CDC, which late last week declared racism a “serious public health threat that directly affects the well-being of millions of Americans.”

Walensky has directed the agency’s departments to develop interventions and measure health outcomes in the next year. It’s also provided $3 billion to support efforts to expand equity and access to vaccines, in addition to $2.25 billion previously allocated for COVID-19 testing in high-risk and underserved communities. The CDC has also launched a Racism and Health web portal to promote education and dialogue on the subject.

One area of particular focus is making sure the distribution of COVID-19 vaccines across the U.S. reaches the communities that have been hit hardest.

Data so far indicate that Black individuals make up roughly 12% of the country’s population but just 8.4% of those who have received at least one dose, Walensky said. And while 18% of the country identifies as Hispanic or Latino, she said, they make up only 10.7% of those who have been vaccinated.

Officials at Monday’s briefing highlighted further progress in the race to get shots into arms, noting that 120 million Americans have been vaccinated — 46% of adults have had at least one dose and 28% are fully vaccinated. And in exactly one week, all adults will be eligible to sign up for an appointment.

“This means that there has never been a better time than now for seniors and those eligible to get their shots,” said Andy Slavitt, senior advisor on the White House COVID-19 Response Team. “Make an appointment today. And if you have someone in your life, particularly a senior, who has not gotten a shot yet, reach out and see what help they need.”

Source: Studies Confirm Racial, Ethnic Disparities In COVID-19 Hospitalizations And Visits

CDC: COVID-19 Was 3rd Leading Cause Of Death In 2020, People Of Color Hit Hardest

More confirmation of COVID-19 racial disparities:

COVID-19 was the third-underlying cause of death in 2020 after heart disease and cancer, the Centers for Disease Control and Prevention confirmed on Wednesday.

A pair of reports published in the CDC’s Morbidity and Mortality WeeklyReport sheds new light on the approximately 375,000 U.S. deaths attributed to COVID-19 last year, and highlights the pandemic’s disproportionate impact on communities of color — a point CDC Director Rochelle Walensky emphasized at a White House COVID-19 Response Team briefing on Wednesday.

She said deaths related to COVID-19 were higher among American Indian and Alaskan Native persons, Hispanics, Blacks and Native Hawaiian and Pacific Islander persons than whites. She added that “among nearly all of these ethnic and racial minority groups, the COVID-19 related deaths were more than double the death rate of non-Hispanic white persons.”

“The data should serve again as a catalyst for each of us [to] continue to do our part to drive down cases and reduce the spread of COVID-19, and get people vaccinated as soon as possible,” she said.

The reports examine data from U.S. death certificates and the National Vital Statistics System to draw conclusions about the accuracy of the country’s mortality surveillance and shifts in mortality trends.

One found that the age-adjusted death rate rose by 15.9% in 2020, its first increase in three years.

Overall death rates were highest among Black and American Indian/Alaska Native people, and higher for elderly people than younger people, according to the report. Age-adjusted death rates were higher among males than females.

COVID-19 was reported as either the underlying cause of death or a contributing cause of death for some 11.3% of U.S. fatalities, and replaced suicide as one of the top 10 leading causes of death.

Similarly, COVID-19 death rates were highest among individuals ages 85 and older, with the age-adjusted death rate higher among males than females. The COVID-19 death rate was highest among Hispanic and American Indian/ Alaska Native people.

Researchers emphasized that these death estimates are provisional, as the final annual mortality data for a given year are typically released 11 months after the year ends. Still, they said early estimates can give researchers and policymakers an early indication of changing trends and other “actionable information.”

“These data can guide public health policies and interventions aimed at reducing numbers of deaths that are directly or indirectly associated with the COVID-19 pandemic and among persons most affected, including those who are older, male, or from disproportionately affected racial/ethnic minority groups,” they added.

The other study examined 378,048 death certificates from 2020 that listed COVID-19 as a cause of death. Researchers said their findings “support the accuracy of COVID-19 mortality surveillance” using official death certificates, noting the importance of high-quality documentation and countering concerns about deaths being improperly attributed to the pandemic.

Among the death certificates reviewed, just 5.5% listed COVID-19 and no other conditions. Among those that included at least one other condition, 97% had either a co-occurring diagnosis of a “plausible chain-of-event” condition such as pneumonia or respiratory failure, a “significant contributing” condition such as hypertension or diabetes, or both.

“Continued messaging and training for professionals who complete death certificates remains important as the pandemic progresses,” researchers said. “Accurate mortality surveillance is critical for understanding the impact of variants of SARS-CoV-2, the virus that causes COVID-19, and of COVID-19 vaccination and for guiding public health action.”

Officials at the Wednesday briefing continued to call on Americans to practice mitigation measures and do their part to keep themselves and others safe, noting that COVID-19 cases continue to rise even as the country’s vaccine rollout accelerates.

The 7-day average of new cases is just under 62,000 cases per day, Walensky said, marking a nearly 12% increase from the previous 7-day period. Hospitalizations are also up at about 4,900 admissions per day, she added, with the 7-day average of deaths remaining slightly above 900 per day.

Dr. Celine Gounder, an infectious disease specialist at New York University who served as a COVID-19 adviser on the Biden transition team, told NPR’s Morning Edition on Wednesday that she remains concerned about the rate of new infections, even as the country has made considerable progress with its vaccination rollout.

She compared vaccines to a raincoat and an umbrella, noting they provide protection during a rainstorm but not in a hurricane

“And we’re really still in a COVID hurricane,” Gounder said. “Transmission rates are extremely high. And so even if you’ve been vaccinated, you really do need to continue to be careful, avoid crowds and wear masks in public.”

Source: CDC: COVID-19 Was 3rd Leading Cause Of Death In 2020, People Of Color Hit Hardest

Cross and Taylor: Lies, Damned Lies, And Race-Based Statistics

Reading this commentary reminded me of an anecdote that I can’t unfortunately locate: former PM Harper’s decision to replace the mandatory census with the voluntary, and less accurate, National Household Survey in 20ll was driven in part by the data being used by academics, advocates and activists as a basis for more progressive policies.

The alternative, as Cross and Taylor appear to advocate, is not to have visible minority breakdowns in the labour force survey to avoid this use of data. To my mind, it is a head in the sand approach as such data is needed to understand how well Canadian society is working in terms of economic integration.

COVID-19 has demonstrated the various inequalities between different groups. The regular censuses have also captured these inequalities as well so expanding this to the labour force survey (and public service employment equity reports) is consistent with long-standing practice.

To my mind, issues lie more with respect to how the disparities are interpreted, whether narrowly or looking at the range of factors that influence these disparities.

For example, when I look at public service employment equity data, groups that have lower levels of educational attainment (e.g., Blacks, Latin Americans) are less represented among occupations requiring university degrees. This disparity, of course, likely reflects in part earlier barriers and discrimination encountered by those groups (e.g., streaming of Blacks into non-academic streams, recently addressed by the Ford government).

Disaggregated date is need to be aware of disparities and point towards questions regarding the reasons for these disparities, and assess the degree to which policy interventions, and which kinds, may be warranted.

To their credit, Cross and Taylor do some analysis, looking at occupations and visible minorities, highlighting that Koreans, Filipinos and Southeast Asians are more concentrated in the accommodation and food service industry than not visible minorities as an explanation of why these groups were more affected by COVID-19 lockdowns.

But it is ingenuous, at best, to present socioeconomic circumstances as completely unrelated to barriers faced by some groups.

And of course, the data will be used and sometimes misused by advocates and activists, and one could argue that Cross and Taylor are equally and legitimately using data to support their position.

But curious for a former statistician to be arguing for less data and thus less needed information for evidence-based policy. And using France as a model?:

Since July, Statistics Canada has been publishing labour-market data divided into 12 ethnocultural categories including Chinese, South Asian, Southeast Asian, West Asian, Korean, Japanese, Arab, Black, Filipino, Latin American, White, and Others. Sliced this way, Statcan’s figures reveal the unsurprising fact that unemployment is unevenly distributed across Canada’s racial populations, just as it varies by region, gender and age. The adult Canadian unemployment rate in January was 9.4 percent, but 20.1 percent for Southeast Asians, 16.4 percent for Blacks and 16.6 percent for Latin American Canadians. “Others” had a slightly-better-than-average unemployment rate of 8.9 percent.

This move to produce racially-specific labour-market data may well have been inevitable, given the intersectional enthusiasms of Prime Minister Justin Trudeau, who recently declared his next budget will be an explicitly “feminist”document. It also follows logically from his government’s creation of Statcan’s Centre for Gender, Diversity and Inclusion Statistics in 2018. Equally predictable is the effect this new information has had on public discourse.

The release of race-based labour-market data has provided further fuel to the ascendent view that Canada is an inherently unfair and racist country. Lobby groups and organizations representing the various racial groupsidentified by Statcan have latched onto the new data to back up claims regarding the “negative labour market impact of racism on Black youth” and other collective sins aimed at Canadian society. The figures are also frequently held as proof that employment equity programs and other government market interventions must be scaled to industrial proportions to eliminate the discrimination baked into Canada’s labour market.

But when it comes to fomenting outrage, Statcan is just getting started. In a recent commentary in The Globe and Mail, Anil Arora, Chief Statistician at Statistics Canada, explained his organization’s intention to double down on the collection and dissemination of race-based data. Because the initial effort last July revealed such glaring “racial disparities”, he wrote, Statcan will now be using “data from varying lenses…to measure those inequalities and track the progress being made to address them.”

French law specifically forbids INSEE from processing or analyzing data regarding “ethno-racial classifications” because it could violate constitutional requirements that all citizens must be treated equally.Tweet

As exciting and progressive as all this may seem, however, Statcan should tread carefully. Collecting race data is inherently contentious and divisive, something all national statistical agencies must recognize. While the United States has a long history of collecting very detailed race-based data, others such as France’s Institut national de la statistique et des études économiques (INSEE) do not disseminate any race statistics. In fact, French law specifically forbids INSEE from processing or analyzing data regarding “ethno-racial classifications” because it could violate constitutional requirements that all citizens must be treated equally “without distinction of origin, race or religion.”

As we shall see, unequal racial outcomes revealed by national statistics do not necessarily prove racism, and often lead to intractable debates. This is especially so in a country like Canada, where there’s a large overlap between visible minorities and immigrants who historically take years to match the outcomes for Canadians born in the country. Feeding a culture of grievance that denies any role for cultural differences in generating observed inequality can, paradoxically, perpetuate unequal racial outcomes. And as the state of affairs in the U.S. suggests, a surfeit of race-based statistics is no guarantee of racial harmony.

Neither is Statcan exempt from the principle of opportunity cost. Collecting one set of data inevitably means foregoing others – some of which may be of greater value. For years, researchers from social policy groups such as Cardus have asked for better data on how marital status affects employment and income. This would provide more detail on the important role played by family in the labour market. Yet these requests have long been ignored for cost reasons. Statcan presumably has better things to do with its limited resources. Now, however, in the middle of a pandemic, the agency has suddenly discovered the means to produce divisive race-based unemployment data.

Pandemic and Race

There are many pitfalls and risks associated with attributing different outcomes experienced by different racial groups exclusively to race, especially when these accusations are based on superficial statistics. In its July 2020 labour market report that, for the first time, segmented unemployment by race, Statcan itself noted that the top line figures showing poorer outcomes for most visible minorities categories reflected, in large part, the tendency of certain racial groups to work in industries deeply affected by the pandemic.

For example, 19.1 percent of Koreans, 14.2 percent of Filipinos and 14.0 percent of Southeast Asians were employed in the accommodation and food industry, according to the 2016 Census, compared with only 5.9 percent of Whites. Given the dramatic effect the pandemic-related lockdowns and other measures have had on the hospitality sector, it seems reasonable to conclude that race played little or no role in these unequal outcomes. Rather, it was the circumstances of the industries they were working in.

It has also been widely reported that different racial groups contract Covid-19 at different rates. Some concluded that this was because these groups are particularly disadvantaged by a racist society, while others wondered whether particular racial groups might have a different genetic susceptibility to the virus. As a recent U.S. National Bureau of Economic Research study warns, merely noting differences among racial groups without knowing their source means “the political discourse can gravitate toward ‘biologic explanations’ or explanations based on racial stereotypes which are harmful in themselves and get in the way of policy solutions.” The same study made plain that it was the socio-economic circumstances of particular groups that affected their exposure to the virus. This was due to working in particular industries and using public transit, which increased their contact with other people and, in turn, led to a higher rate of infection. Once the data was corrected for these variables, visible minorities in the U.S. were found to be no more susceptible to the virus than whites.

Given how easily some data can be misinterpreted or misrepresented, it would seem that Statcan has a clear responsibility to caution users about its proper use. Figures regarding the distribution of federal government revenues and spending by province, for example, are regularly twisted by politically-motivated analysts and governments. As a result, Statcan published an article in 2007 offering a detailed explanation for why these statistics should not be considered a scorecard for which provinces are gaining or losing from their dealings with the federal government.

Much of the current debate over racism in Canada arises from the presumption that all aspects of life should be perfectly evenly distributed, and that any deviation from pure equality must be considered prima facie evidence of systemic racism. Tweet

It is, accordingly, curious that these new race-based labour-market figures do not come with a similar warning; race data is far more emotionally and politically incendiary than provincial fiscal data. It is also surprising that Statcan did not directly address the issues raised by France’s refusal to collect race-based data.

Racism of the Gaps

Much of the current debate over racism in Canada arises from the relatively recent presumption that all aspects of life should be perfectly evenly distributed, and that any deviation from pure equality (a term also recently redefined from equality of opportunity to sameness of outcomes) must be considered prima facie evidence of systemic racism. With dizzying speed, this eminently contestable claim has been elevated nearly to conventional wisdom.

In an insightful commentary published earlier this month by the Macdonald-Laurier Institute, Vancouver-based writer Sonia Orlu tackled head-on the notion that “any disparity in outcomes between blacks and whites is the direct result of racism, as opposed to class differences, culture, personal ‘(ir)responsibility,’ or any other myriad of situational factors.” As Orlu, who is black, points out, this “racism of the gaps” generally relies on surface-level observations lacking in context or detail.

Nowhere is this assumption more explosive than regarding claims that members of visible minorities are disproportionately targeted, arrested or killed by police. As Orlu points out, a case for systemic racism in policing can only be proven with detailed race-based data showing police interactions as a share of the overall criminal population, rather than the population at large. While racism may create the conditions in which visible minorities commit more crime, simply arresting more visible minorities is not, in and of itself, proof police are acting with racist intent.

Orlu notes, however, that Canada does not collect the sophisticated race-based data necessary to come to an informed observation on this heated topic. With only the most basic statistics available regarding race, arrests and incarcerations, it is easy to conclude that police actions are driven by racism rather than other factors. And even when detailed race and crime evidence is available, as it is in the U.S., Orlu points out it is generally ignored by the media and public because it does not align with popular “anti-racism ideology” narratives. More information, in this case, does not produce a better debate or better decisions.

This problem is further illuminated by economist Tim Harford in his fascinating new book The Data Detective. Harford offers the example of an algorithm called COMPAS (Correctional Offender Management Profiling for Alternative Sanctions) used in the U.S. to predict the probability of a criminal being re-arrested. Because the algorithm produced racially disparate results – giving higher probabilities for blacks to be re-arrested than whites under similar circumstances – it was accused of perpetuating systemic racism. And yet the algorithm itself was colour-blind; race was not an input factor.

A detailed investigation by a team of statisticians revealed that the differing results were the product of members of different races behaving differently and/or living in different neighborhoods. As Harford concluded, “The only way in which an algorithm could be constructed to produce equal results for different groups…would be if the groups otherwise behaved and were treated identically.” Such an outcome adds evidence to the proposition that unequal results between races do not prove racism if behaviour and circumstances differ.

Examples of the racism gap fallacy are in ample supply elsewhere. Last month, for example, Akim Aliu, a former NHL player and founding member of the lobby group Hockey Diversity Alliance, claimed that an observed lack of racial diversity in the National Hockey League could only have one possible source. “There are still owners in the league who don’t even believe [racism] is a problem,” Aliu complained to Reuters in a Black History Month article. “To me that is just unfathomable, 95 per cent of your league is white and you don’t see there is an issue of race.”

Yet visible minorities make up a vast majority of the lineups in many other sports. The National Basketball Association is 74 percent black, and the National Football League 68 percent. While the Canadian Football League does not provide readily-accessible race-based statistics, the number of black players in this league also appears to far exceed representation in the general population. Should all this be taken as self-evident proof that football and basketball are equally prejudiced, but in favour of visible minorities? Of course not.

In another fixation on gaps, Statcan’s Arora in his Globe and Mail commentary emphasizes the importance of moving “toward levelling the uneven economic playing field”, citing the unequal unemployment and poverty rates among immigrant women as a key example. It must be noted, however, that there is a large overlap in Canada between visible minorities and immigrants. The lagging labour market outcomes for visible minorities and other Canadians reflect the long-standing challenges of immigrants establishing themselves in Canada.

In 2016, for example, Canada admitted thousands of Syrian refugees, many with limited education and little or no knowledge of either of Canada’s official languages. Do inferior incomes and more joblessness among the women of this group in the short time since they arrived prove the “playing field” in Canada is uneven? Inferior outcomes for some players don’t necessarily indicate a tilted field, it may merely demonstrate that they were sent out onto the field without the skills and training needed to compete. It is also worth remembering that the prevalence of poverty and inequality of income is much greater in the countries most immigrants come from, than is their inequality compared with native-born Canadians.

 The Inconvenient Truth that some Minority Groups Outperform the Majority

Racism – defined as the presence of deep-seated prejudices that affect individual and collective behaviour – certainly exists in Canada, as it does in all countries. And wherever present, it should be challenged and overcome. That said, collecting race-based data may not contribute to that worthy goal at all. It could instead cultivate a mentality of grievance and entitlement that undermines the impetus for individuals to strive to achieve more for themselves and their children. Look how easy it was for Aliu, for example, to take a simple statistic regarding the race of NHL players and turn it into a bitter accusation.

Arora’s recent Globe commentary, meanwhile, laments the “many economic challenges facing racialized populations, Indigenous people, persons with disabilities and other marginalized groups” as proof of the need for Statcan’s big move into race data. But might it not be more useful to study how certain minority groups have overcome even-greater challenges in the past? Few groups have suffered more persecution and discrimination than Jews, yet their internal culture enabled Jewish people to achieve superior results in multiple fields of endeavour in country after country. Japanese Canadians are another example, overcoming their forcible removal from their homes to be quarantined in remote camps during the Second World War, and going on to achieve one of the highest income levels of any racial group.

It is too easy to dismiss the achievements of certain races or ethnic groups as the result of advantages and privileges. While the lagging performance of some visible minorities is automatically assumed to be evidence of Canada’s innate racism, the opposite conclusion is never drawn from the superior results displayed by other minority groups (such as Chinese, to use Statcan’s terminology) in terms of employment, scholastic achievement or avoidance of crime. Looking south of the border, pre-Covid U.S. Census Bureau data revealed that the real median household income of Asian-Americans is nearly 30 percent higher than that of whites.

Thomas Sowell, the renowned black economist at the prestigious Hoover Institution at Stanford University, has written extensively on the use and misuse of race-based data. His insights on the importance of the culture internalized within racial groups provides a good lesson on the pitfalls of superficial interpretations of race data. As Sowell observed in his 2013 book Intellectuals and Race: “Different races, after all, developed in different parts of the world, in very different geographical settings, which presented very different opportunities and restrictions on their economic and cultural evolution over a period of centuries.” Further, people tend to blame racial differences on bias, which ignores “internal explanations of intergroup differences in favor of external explanations.”

As Sowell noted wryly in his 1996 book Black Rednecks and White Liberals, “all things are the same except for the differences, and different except for the similarities.” Given current demands for diversity in all things, he was observing, why should anyone expect identical outcomes as a result? Perhaps that comment should be attached to every Statcan press release on racial differences in the labour force survey.

The Politics of Distribution Versus the Economics of Growth

There is a growing sense of malaise in Canada, including worry that we are falling well short of our economic potential. Our political and economic leaders ought to be focusing on creating the macroeconomic and cultural conditions wherein all groups can thrive. Instead, our country’s growing fixation on racial issues – including the collection of race data – invites policymakers to think in terms of improving Canada one micro-group at a time.

We have already seen its nefarious impact. The most salient fact of the Covid-19 pandemic has been its devastating impact on all of Canada, with 5.5 million people losing their jobs or having their work severely curtailed in the spring of 2020. Rather than proposing general solutions to support growth and allow the reopening of the economy, numerous special interest groups have used the pandemic as an excuse to advance their particular pet policy projects, re-packaging old proposals that have circulated for years or decades to “solve” a once-in-a-lifetime crisis. The ideas include greater provision of day care, universal basic income, universal Pharmacare, extended employer-paid sick leave and so on, almost ad infinitum, as if budget constraints no longer existed.

The greater influence of broad economic conditions than specific social policies is revealed by Arora’s own reference to the “significant progress” visible minorities were making towards equality before the pandemic set them back. He cited a sharp drop in poverty and “rapidly rising employment rates among working-age immigrant women” as evidence of this happy situation. Such pre-pandemic levels of achievement – closing numerous gaps with the rest of society – was not the product of programs targeting specific aggrieved minority groups, but the result of an improving and robust economy-at-large. As Canada as a whole grows, its gaps shrink.

The best way to resuscitate the fortunes of visible minorities is the same as for all other Canadians: reopen the economy as quickly as possible and adopt policies and attitudes aimed at supporting long-term economic growth. Tweet

The same phenomenon was in even greater evidence in the U.S., where wage gains in 2019 were led by the lowest wage-earners, especially visible minorities. In recognition of this, more Latino and black voters cast ballots for Donald Trump last November than in 2016, despite his obvious negative attributes. The clear lesson is that better macroeconomic policy and economic growth always outweigh the impact of targeted government programs.

It is important to remember that the reversal of fortunes for minorities during the pandemic was because our economy was struck by the economic equivalent of a thermonuclear device, not because Canada overnight became more racist. The best way to resuscitate the fortunes of visible minorities, therefore, is the same way as for all other Canadians: reopen the economy as quickly as possible and adopt policies and attitudes aimed at supporting long-term economic growth.

Statcan’s new race-based data invites the facile conclusion that one group’s success explains another group’s relative failure and justifies its grievance. And our faltering economic growth reinforces the sterile view that the size of the economic pie is fixed and any gain by one group comes at the expense of others. The result is a focus on the politics of distribution instead of the economics of growth.

To be fair, Statcan did a lot of good work in response to the pandemic. This includes flash estimates of GDP, adjustments to how it measures labour under-utilization, more timely data on firm turnover, and innovative ways to track population mobility during a lockdown. The agency’s recent move into race-based data does not, however, rank among these useful innovations. And its effects may outlast all the others due to the appeal it holds for groups dedicated to fanning the flames of internal complaint.

With race-based data now being widely disseminated, this process may be unstoppable. Any move to cut off funding for this project will be widely condemned by the many vocal advocates of the “race industry”. Canadians should thus prepare themselves for a steady stream of studies in the coming years declaring the presence of gaps that allegedly prove the existence of systemic racism, but which tell us nothing about their origin or the best way to reduce them. All this is an unfortunate but costly distraction from the bigger and more important issues of innovation, investment and entrepreneurship that will be necessary to restore an economy that will benefit all Canadians – of every race and colour.

Philip Cross is a senior fellow of the Macdonald-Laurier Institute and the former chief economic analyst at Statistics Canada. Peter Shawn Taylor is senior features editor of C2C Journal.


Ottawa should require banks to share race-related data on services: business groups

Of note (expect banks are doing some of this already internally as part of understanding their client and potential client base):

Canadian banks should have to disclose data related to race, gender, income and neighbourhoods to ensure more equitable access to credit and loans, say organizations representing racialized and Indigenous business owners who want Ottawa to step in.

Nadine Spencer, president of Black Business and Professional Association, says Black business owners grapple with microaggressions, unconscious bias and discrimination in banking, and both tracking and releasing this data would help hold banks accountable.

“In order for us to move along, we have to look at the data, look at the gaps and address the issues,” she said.

Banks in the United States have had to keep track of applicants for business loans by race, gender, income and neighbourhood for more than 40 years through their obligations under the Community Reinvestment Act. Designed as a way to encourage banks to better serve lower-income neighbourhoods and racialized communities, it involves the U.S. Federal Reserve and other banking regulators evaluating their performance on this front, with ratings published in an online database.

Duff Conacher, co-founder of Democracy Watch, said the federal government should require something similar of banks in Canada as a way to fight systemic racism.

“Four of our six big Canadian banks own U.S. banks and have, for decades, followed the U.S. law in the U.S. but they have not done anything up here to track and disclose discrimination,” said Conacher.

He was referring to Bank of Montreal, Canadian Imperial Bank of Commerce the Royal Bank, and Toronto-Dominion Bank, which all own U.S.-based operations.

Herbert Schuetze, an economics professor at the University of Victoria, said disclosing such data would encourage more researchers to look at whether businesses owned by racialized people are getting the same access to credit and other services. He said U.S. studies have shown a discrepancy, but that research cannot easily be done in Canada.

“I wouldn’t be surprised to see that (here) but it’s something that, without data, we can’t identify how big of an issue it is in Canada,” he said.

The government announced up to $221 million for Black entrepreneurs in partnership with several Canadian financial institutions in September, but Conacher said this program is not enough to address the gap in funding for Black-owned businesses.

A spokeswoman for Finance Minister Chrystia Freeland said the Liberal government is open to adopting other measures, although did not commit to this one.

“The federal government is currently undertaking pre-budget consultations. We invite all Canadians to share their ideas and priorities,” said press secretary Katherine Cuplinskas.

“We absolutely know there is much more work to be done.”

RBC spokesman André Roberts said the bank does not collect information on race or gender when clients access services, noting the bank is participating in the Black entrepreneurship program.

Bank of Montreal spokesperson Jeff Roma did not say whether BMO would support the disclosure of data but said it is also participating in the federal Black entrepreneurship program. TD Bank and did not say whether it would back sharing data and CIBC did not respond to a request for comment.

“The banks are already collecting this data on all their borrowers, and can easily add one box on the form saying: do you want to identify as a visible minority?” Conacher said.

Vivian Kaye, who owns an online business selling hair extensions to Black women, said she has faced discrimination from her bank since she started eight years ago.

She said her bank’s agents repeatedly questioned money transfers she made and never offered her a line of credit, even though they could see her business had been growing.

Caroline Shenaz Hossein, a professor of business and society at York University, said disaggregating the data would show who gets access to banking services in Canada — and who does not.

She said many Black people, including herself, have turned to online banking, even before the COVID-19 pandemic, to avoid dealing with racism at bank branches.

“I hated the humiliation of going in to a bank, and them watching me up and down like I am some sort of like terrorist’s drug mule, because I’m of Black-Caribbean descent,” she said.

“We already know about systemic racism and it does exist. We do not need data to tell us that part. We want to know who actually gets the loans.”

She said also said minority communities often create alternative sources of funding.

“Chinatown and (Gerrard India Bazaar, in Toronto) have all been built on these informal collectives or co-operative groups that are really rooted in mutual aid,” she said.

Shannin Metatawabin, the CEO of the National Aboriginal Capital Corporations Association, which provides alternative funding for Indigenous businesses, said publishing data from the banks would allow organizations like his to create new products or advocate for better services.

“Historically, Black, Indigenous, people of colour have always been an afterthought,” he said. “The response to the needs of our community has always been after the mainstream population.”

He said policy-makers should change that, noting that banks are federally regulated.

“It’s integral for them to get involved to make sure that everybody receives equitable service,” he said.

Jason Rasevych, president of the Anishnawbe Business Professional Association, which supports Indigenous businesses in northern Ontario, said accessing race-based data would guarantee transparency and could prompt banks to make changes.

“It also puts the financial institutions in a position to explore a potential refresh (of their policies) and strategies related to Indigenous relations, or Black or people of colour relations.”

Schuetze, the University of Victoria professor, said creating a ratings system for financial institutions to encourage them to provide loans to minority-owned businesses, like the one in the U.S., would have a positive impact.

He said other policies could also help, including tackling discrimination in the labour market, reducing barriers to operating businesses and getting experience and providing startup grants for minority-owned businesses.

“If you can reduce those barriers then, obviously, access to capital from financial institutions will increase,” Schuetze said.

Spencer said governments and financial institutions should talk to business owners and ask them what they need.

“The No. 1 thing that the financial institutions can do is to look at each customer and client as a contributor to their revenue base and respect them in a way that they should,” she said.

Source: Ottawa should require banks to share race-related data on services: business groups

Before COVID-19, inequity in healthcare was, in effect, a pandemic for Black communities. Here are five issues that need to be addressed

Of note. Good list of issues:

Toronto has a new, $6.8-million plan to fight the disproportionate impact of COVID-19 on the Black community. But the roots of health inequity were taking hold long before the pandemic started.

“These are conversations we have been having. We’ve been advocating, we’ve been speaking about it,” said Lydia-Joi Marshall, president of the Black Health Alliance. “This is not a new crisis for the Black community …. This is just highlighting the inequities that have been happening all along.”

Marshall, who has worked in healthcare research for more than 15 years and was a speaker at this month’s TEDxToronto: Uncharted, spoke with the Star to explain five long-standing issues that have made the healthcare system unequal for the Black community. Many of these still need to be addressed.

It’s not biology, it’s racism: As a geneticist, Marshall said she does not believe in race as a biological construct. “Race is not the determinant of health. Racism is,” she said.

“We often hear all these higher rates of illness in Black people — Black people have higher hypertension and diabetes,” and we can see that and think there must be a “very specific biological reason,” Marshall said. But, really, it’s more to do with systemic barriers that make these illnesses more likely, such as disproportionate stress and lack of access to nutritious food. “What are the other social determinants?” she said.

For instance, a 2019 study by FoodShare and the University of Toronto showed that Black Canadians are twice as likely as white Canadians to be food insecure. Without access to affordable, healthy food, health problems can fester.

“This idea that it is biological, we have to come away from that, because it allows people to dismiss the systemic and institutionalized racism of why we’re seeing such different rates.”

Microaggressions take a toll on physical health: Dealing with small, daily instances of racism can overtime lead to poorer health outcomes. “It takes a toll on our health,” Marshall said.

A study conducted by Harvard University and NPR in 2017 found that people who reported high numbers of daily indignities, such as receiving poor service in a restaurant or being treated with less courtesy than others, also ranked high in developing heart disease, or, in the case of pregnant women, ranked high in giving birth to babies of a lower weight.

“This stress, whether it is daily stress or overt … can result in illness,” Marshall said.

Mental health and wellness has a ripple effect: Marshall notes that mental health can affect other branches of health, and yet have so far not received as much attention.

Much of Marshall’s research relates to other clinical and chronic illnesses, but rates of under-diagnosed or misdiagnosed mental illness in the Black community, have “shocked” her, when she has looked at them.

Black respondents ranked the lowest in a December 2020 mental health surveyconducted by Morneau Shepell.

Barriers to mental healthcare for the Black community must be reduced, and a better understanding at the point of diagnosis developed, so the rates of under- and misdiagnosis are addressed.

Bias affects quality of care: Marshall recalls a time when her aunt called Telehealth to assess her symptoms when she was feeling ill. The questions went: “Are you healthy? Does your skin look pink?” Marshall said.

“I had to explain to her that this is just the ingrained bias — that here in Canada, the normal is not us.”

Apart from small instances such as this, the phenomenon also manifests in textbooks that are used in medical schools, hospital visits and is a hardship shared by Indigenous communities.

Mistrust of the system lingers: As concerns about hesitancy around taking the vaccine get more attention in public policy, it’s worth really considering the questions Black communities have and the source of their concerns, Marshall says.

Mistreatment has been both on a large scale historically — as with the Tuskegee study in the U.S. and nutrition experiments in the Indigenous community in Canada — but also on a smaller scale in the form of personal trips to the hospital.

Many are “asking valid questions, because of a historical pattern of the system not catering to our needs,” she said.

“Why would we trust a system that has not been built for us?”

This approach can inform the way Canada addresses vaccine concerns in the Black community.

Source: Before COVID-19, inequity in healthcare was, in effect, a pandemic for Black communities. Here are five issues that need to be addressed

Mortality Risk After Ischemic Stroke According to Immigration Status and Ethnicity

Ontario study, showing lower risks of transient ischemic attacks or strokes for immigrants:

Immigrants may be at a lower risk for mortality after ischemic stroke compared with long-term residents, although the risk for vascular event recurrence was similar in both groups, according to study results published in Neurology.

The objective of the current study was to determine the association between immigration status, ethnicity, and the risk for mortality or vascular event recurrence in patients with a history of ischemic stroke in Ontario, Canada.

This retrospective cohort study was based on data from the Ontario Stroke Registry, a province-wide registry with data on a random sample of patients with stroke treated in one of the medical institutions in the province. Study researchers identified patients with ischemic stroke between April 1, 2002 and March 31, 2013. Patients born in Canada and those who moved to Canada before 1985 were classified as long-term residents, while those who were born outside of Canada and arrived after 1985 were classified as immigrants.  In addition, patients were categorized into 3 different ethnic groups: Chinese, South-Asian, or other.

The study sample included 31,918 adults with ischemic stroke, including 2740 (median age, 70 years; women, 48%) immigrants, and 29,178 long-term residents (median age, 76 years; women, 49.2%).

During a median follow-up of 5 years, the mortality risk was lower for immigrants, compared with long-term residents (46.1% vs 64.5%, respectively). The mortality risk decreased after adjustment for baseline characteristics and comorbid conditions (hazard ratio [HR], 0.94; 95% CI, 0.88-1.00), but persisted in those who were younger than 75 years old (HR, 0.82; 95% CI, 0.74-0.91).

The mortality risk was higher among South-Asian immigrants than among South-Asian long-term residents (HR, 1.30; 95% CI, 1.05-1.61), similar in Chinese immigrants and Chinese long-term residents (HR, 0.96; 95% CI, 0.79-1.15), and lower in immigrants of other ethnic origin than their long-term resident counterparts (HR, 0.89; 95% CI, 0.83-0.95) (P =.003 for all-cause mortality).

Compared to long-term residents, the risk for mortality among immigrants was lower in immigrants from all regions, except for immigrants from South Asia. Study researchers observed the greatest survival advantage in immigrants from East Asia (HR, 0.75; 95% CI, 0.65-0.86).

The risk for vascular event recurrence was similar in immigrants and long-term residents (adjusted HR, 1.01; 95% CI, 0.92-1.11). Within ethnic groups, there was no difference in the risk for vascular event recurrence between immigrants and long-term residents.

The study had several limitations, including determining ethnicity using surname algorithms with potential misclassification, a heterogeneous study sample, and missing data on additional risk factors or secondary preventative measures.

“Long-term mortality following ischemic stroke is lower in immigrants and long-term residents, but is similar after adjustment of baseline characteristics, and it is modified by age at the time of stroke and by ethnicity,” concluded the study researchers.

Source: Mortality Risk After Ischemic Stroke According to Immigration Status and Ethnicity

Across The South, COVID-19 Vaccine Sites Missing From Black And Hispanic Neighborhoods

Not surprising. Hope someone will do a similar analysis for Canada (once we have a full supply of vaccines):

Georgia Washington, 79, can’t drive. Whenever she needs to go somewhere, she asks her daughter or her friends to pick her up.

She has lived in the northern part of Baton Rouge, a predominantly Black area of Louisiana’s capital, since 1973. There aren’t many resources there, including medical facilities. So when Washington fell ill with COVID-19 last March, she had to get a ride 20 minutes south to get medical attention.

Washington doesn’t want to fall sick again, so she was eager to get vaccinated, which is in line with federal health recommendations. But she faced the same challenge she did last year: finding a local provider, this time for a vaccine. She tried for weeks, checking at pharmacies in the area. And she was put on a waiting list.

Georgia Washington has lived in Southern Heights, a predominantly Black neighborhood in the northern part of Baton Rouge, La., since 1973. After falling ill with COVID-19 last year, Washington was eager to get vaccinated, which is in line with federal health recommendations. But Washington again had difficulty finding a local provider, this time to get a vaccine.

“I’ve got lots of patience,” Washington said. “I just want to get it over with.”

Communities of color have been disproportionately harmed by the COVID-19 pandemic. Now they’re at risk of being left behind in the vaccine rollout.

Using data from several states that have published their own maps and lists of where vaccination sites are located, NPR identified disparities in the locations of vaccination sites in major cities across the Southern U.S. — with most sites placed in whiter neighborhoods.

NPR found this disparity by looking at Census Bureau statistics of non-Hispanic white residents and mapping where the vaccine sites were. NPR identified counties where vaccine sites tended to be in census tracts — roughly equivalent to neighborhoods — that had a higher percentage of white residents, compared with the census-tract average in that county. Reporters attempted to confirm the findings with health officials in nine counties across six states where the differences were most dramatic: Travis and Bastrop counties, Texas; East Baton Rouge Parish, La.; Hinds County, Miss.; Mobile County, Ala.; Chatham County, Ga.; DeKalb County, Ga.; Fulton County, Ga.; and Richland County, South Carolina.

The reasons are both unique to each place and common across the region: The health care locations that are logical places to distribute a vaccine tend to be located in the more affluent and whiter parts of town where medical infrastructure already exists. That presents a challenge for public health officials who are relying on what’s already in place to mount a quick vaccination campaign.

It’s a problem that exists not just in the South but across the country. A team of researchers at the West Health Policy Center and the University of Pittsburgh found nearly two dozen urban counties where Black residents would need to travel farther than white residents to a potential vaccination site — unless health officials act to narrow the disparities.

“We’re hopeful there will be new facilities that are stood up,” says Dr. Utibe Essien, an assistant professor of medicine at the University of Pittsburgh who studies health disparities and worked on the research team. “But what we saw play out with COVID testing was there were new facilities that came up, but they relied on existing infrastructure.”

“This is structural and foundational to the racial disparities in our country.”

Troubles getting vaccinated in Black neighborhoods

In the part of Baton Rouge where Georgia Washington lives, there is just one Walgreens where COVID-19 vaccines can be found.

Ever since an interstate was built through Baton Rouge in the 1960s, the population in the northern part of the city has struggled with housing, food insecurity, poverty and crime. These inequities have always fueled disparities in health care in Baton Rouge. The vaccine rollout is just the latest example.

“When you go to north Baton Rouge, there are very few [health care] choices. And then how many of those are participating in the vaccine program?” said Tasha Clark-Amar, CEO of the East Baton Rouge Council on Aging.

Clark-Amar runs about two dozen senior centers around the city, and her organization stepped up to fill the pharmacy gap by obtaining and providing vaccines. Clark-Amar’s group organized a pop-up clinic in mid-January, giving out around 1,000 doses that it secured from the grocery chain Albertsons. But another time, a community health clinic planned to give Clark-Amar around 150 doses for seniors — except the clinic couldn’t deliver on that promise and she had to cancel the pop-up event at the last minute.

“I was livid. I was so angry and frustrated,” she said. “Thirty-five of the people we had registered are between the ages of 80 and 99. Now you tell me, how am I supposed to pick?”

Clark-Amar has been able to schedule other pop-up events. In fact, that’s how Washington was finally able to get a vaccine. She went to one of the council’s pop-up events at a local community center in late January.

Clark-Amar says this patchwork of resources is part of life in many underresourced Black communities.

In the next state over, people are facing similar challenges. In Hinds County, Miss., where the state capital of Jackson sits, there’s only one major drive-through site, which is where the state is sending the vast majority of doses. The state added the site in late January, weeks after it had already put two drive-throughs in the wealthier, whiter suburbs just outside the city.

“It took us a little bit of time to get it logistically set up to make sure we had a Hinds County site,” Mississippi’s state epidemiologist, Dr. Paul Byers, acknowledged at a recent news conference. “But we were always planning to do that. And we are glad that we have that now.”

There’s still a problem for the residents of Hinds County, nearly three-quarters of whom are Black: The vaccination site is north of downtown Jackson in a neighborhood that is 89% white and already has more medical facilities. It’s close to a 30-minute drive from the more rural parts of the county, where many Black residents live.

In Alabama, the state has consistently ranked near the bottom in vaccine distribution since the rollout began.

But in terms of where the vaccine is available, NPR’s analysis found a disparity in one of the state’s largest counties. In Mobile County, 18 vaccination sites are listed on the Alabama Department of Public Health webpage. Fourteen are located in the whiter half of neighborhoods in the county.

Rendi Murphree, director of the Bureau of Disease Surveillance and Environmental Services at the Mobile County Health Department, said it has been hard for the county to get any vaccines at all. She also said distribution is based on which sites have the capacity to store vaccines at very low temperatures.

Joe Womack, a native of a historically Black neighborhood known locally as Africatown, said Black communities in the northern part of Mobile have always dealt with poverty, pollution and health disparities.

“It’s been a struggle ever since the ’70s,” said Womack, president of the Africatown community group C.H.E.S.S.

Beyond the South

Because of the need for a quick rollout, vaccination sites are largely dependent on the health care infrastructure already in place. Places such as pharmacies, clinics and hospitals make convenient sites for vaccines to be administered.

But the locations of those facilities can be inconvenient for millions of Americans. Those are the findings from a team of researchers at the nonpartisan West Health Policy Center and the University of Pittsburgh who analyzed the distance that Americans live from these types of places.

In 23 of the nation’s urban counties, the researchers found, Black residents were less likely than white residents to be within a mile of a site that could potentially distribute vaccines. In just these counties, they estimated 2.4 million Black residents were farther than a mile.

“We worry this is going to exacerbate disparities in outcomes even more now,” says Inmaculada Hernandez, an assistant professor of pharmacy and therapeutics at the University of Pittsburgh who analyzed the data. “The limitations of existing infrastructure in counties are very different.”

And it’s not just in urban areas. In more than 250 other U.S. counties, the researchers found, Black residents were less likely than white residents to live within 10 miles driving distance of a site. Hernandez estimates the true number of places with this disparity to be higher, since the researchers only estimated based on a sample of county residents. Georgia and Virginia top the list of states with the most counties that have this disparity.

The Georgia Department of Public Health declined to comment on the University of Pittsburgh study. The Virginia Department of Health pointed to plans to deploy the National Guard to assist with vaccinations, as well as mass vaccination sites it set up at places like a convention center, a raceway complex and a vacated department store.

“A long history of racism”

The effects of this gap, coupled with historical trust issues between Black Americans and health care providers, are already reflected in the nationwide data showing who’s getting vaccinated. According to a Centers for Disease Control and Prevention analysis published this week — which included race data on half of those who were vaccinated in the first month of the vaccination campaign — Blacks are lagging behind in vaccination rates, even when accounting for the demographics of health care workers and others who were in top priority groups.

Thomas LaVeist, a dean and health care equity researcher at Tulane University in New Orleans, says medical deserts go back into the early evolution of health care.

“But I do think that the South is perhaps more of a problem than some other parts of the country,” says LaVeist, who is also co-chair of the Louisiana COVID-19 Health Equity Task Force. “Part of that is a long history of racism, Jim Crow and, in some cases, intentional actions that were taken to ensure that some communities did not have access to health care and other resources, while others did.”

And it’s not just Black neighborhoods having trouble getting access. In Texas, with its large population of recent immigrants, the problem of location and convenience is interwoven with a lack of trust.

Texas health officials recently designated several vaccination “hubs” around the state after advocates and local officials raised concerns about the state’s initial plan to rely heavily on chain grocery stores and pharmacies to distribute the vaccine. The hubs will make their own decisions about where to distribute the vaccines they are allocated.

But as the Texas Tribune reported, when Dallas County tried to take it a step further by prioritizing ZIP codes where mostly Blacks and Hispanics live, state officials threatened to withhold doses.

The way that hubs allocate their vaccines is an especially important issue in smaller counties like Bastrop County, east of Austin.

The state’s list of providers in the county shows they are almost all clustered around State Highway 71 — mostly in the city of Bastrop — which is far from the rural county’s outskirts, where many Latinos live.

Edie Clark, a leader with a local faith-based nonprofit, said her group is worried for neighborhoods like Stony Point, which is a small immigrant community in the county.

Clark said members of the Stony Point community are still reeling from events a few years ago when the Sheriff’s Department turned over roughly a dozen residents to Immigration and Customs Enforcement for deportation. Many of those arrested were pulled over for minor traffic violations, like a broken taillight.

“They have a lot of distrust and fear of giving their information out without knowing it’s not going to be used against them,” she said.

Clark said it’s tough to imagine that a lot of people in Stony Point will drive to get vaccinated in the city of Bastrop when they won’t even drive there to get groceries. The U.S. Department of Homeland Security announced this week that immigration agencies will not make immigration enforcement arrests at vaccination sites.

Fast or fair

Reaching long-neglected communities takes time — and in the race to get vaccines to as many people as possible, time is in short supply.

Still, when the CDC outlined four ethical principles for the allocation of vaccines, two of them included equitable and fair distribution. CDC spokesperson Kristen Nordlund said, “Vaccine allocation strategies should aim to both reduce existing disparities and to not create new disparities.”

But the pressure to get the vaccine out quickly means not everyone follows those principles. In South Carolina, the board of the state’s Department of Health and Environmental Control shunned a proposal last week that would have factored age and “social vulnerability” metrics into its vaccine allocations. It opted instead to distribute solely by county population, citing a need for speed.

“I think when you look at speed, certainly, it’s probably a lot easier and faster and quicker to do those calculations when it’s just based on per capita,” said Nick Davidson, the South Carolina health department’s senior deputy for public health.

In Georgia, the high demand for COVID-19 vaccinations has left little opportunity for providers to build up new infrastructure to supplement what already exists or to work with members of historically marginalized communities on any hesitations they might have about getting vaccinated.

That’s why the Good Samaritan Health Center in Atlanta has been saving a handful of its vaccination appointments for people who might want to meet with a health care provider at the clinic to ask questions before rolling up their sleeves.

“And at the end of most of those conversations, the person says, ‘You know what? That was what I really needed. And now I’m ready to be vaccinated,’ ” said Breanna Lathrop, the clinic’s chief operating officer.

Even for those eager to get the vaccine, it’s hard to find in certain parts of the city. Only one of Atlanta’s five large-scale county vaccination sites falls in the Black neighborhoods south of Interstate 20 — and that outlier sits in a shopping mall directly adjacent to the interstate on the outskirts of the city. Many of the smaller vaccination sites that are in those Black neighborhoods are grocery store pharmacies, which receive a much lower number of doses than what can be found at hospitals and the county sites.

A few hours away in Savannah, Ga., NPR’s analysis shows just one of Chatham County’s half-dozen vaccination sites is located in a majority-Black neighborhood. That didn’t surprise Nichele Hoskins. She’s assistant director of a local YMCA-led coalition called Healthy Savannah and works to flatten out health disparities among people of color.

“In order to get people vaccinated, you’re going to have to have that kind of trust,” Hoskins said, noting it can seem a tedious process. “If you’ve ever done retail, it’s going to take a little bit of hand-selling.”

The Coastal Health District in Savannah, of course, can’t take each patient by the hand. The health director, Dr. Lawton Davis, says it’s tough to formalize a plan targeting Black residents, who make up about 42% of Chatham County’s population. So far, the Coastal Health District has reached out to two Black churches and a community health center in a predominantly Black neighborhood to arrange mobile vaccination clinics. It’s also using an existing hurricane evacuation registry of people with disabilities and health issues to help identify neglected neighborhoods around Savannah.

“There simply is not enough vaccine to go around,” Davis says. “I don’t have a formal document that says this is, you know, step A, B, C and D, but we have had reasonably in-depth discussions and we have, shall we say, a game plan on how we think this will go.”

There are other options in a public health game plan.

“Alternative facilities come to mind,” Jeni Hebert-Beirne, who leads the Collaboratory for Health Justice at the University of Illinois at Chicago’s School of Public Health, wrote in an email to NPR. “Public libraries (an important source of free wifi), community centers/park districts, faith-based organizations, barber/beauty shops. These are places that people regularly convene/gather and places where people are more likely to feel they belong.”

Shivani Patel, a researcher tracking COVID-19 health equity issues at Emory University in Atlanta, is quick to acknowledge that the problem is too large for a state’s public health system to solve on its own. Like many across the country, Georgia’s public health system has seen funding cuts in recent years that have reduced its capacity to respond to the pandemic.

Washington is also promising new support for states: A million more doses weekly are on their way to pharmacies, and the White House’s COVID-19 czar said, “[Pharmacy] sites are selected based on their ability to reach some of the populations most at risk.” The new sites are expected to start receiving the doses next week.

“Every day is potentially more lives lost,” Patel said. “This is extremely urgent.”

WWNO’s Shalina Chatlani is a health care reporter for NPR’s Gulf States Newsroom; she reported from Baton Rouge, Louisiana. KUT reporter Ashley Lopez reported from Bastrop, Texas. WABE reporter Sam Whitehead reported from Atlanta.

Methodology: NPR gathered addresses of permanent vaccination sites from state websites. NPR verified these sites by contacting county and state health officials in the nine counties mentioned in this report. Officials were offered the opportunity to review the findings and point to additional testing sites. What counts as a vaccination site varies by state. NPR geocoded vaccination site locations using the Google Geocoding API joined with Census Bureau shapefiles to determine what census tracts they were within. For each county, the analysis included only census tracts within the county’s official boundaries. The Census Bureau provided demographic data per census tract. The main demographic measure referenced in this story was the percentage of the population that identifies as “white alone,” not Hispanic or Latino. For percent white, NPR calculated the number of sites for tracts above and below the median county’s percentage of white residents. Medians referenced are medians of census tracts and are not population totals, and may therefore differ slightly from population totals.

Source: Across The South, COVID-19 Vaccine Sites Missing From Black And Hispanic Neighborhoods

Study: Structural racism has material impact on health of ethnic minorities, immigrants

Medical study:

Structural racism can lead to discrimination in many aspects of life including criminal justice, employment, housing, health care, political power, and education. A new study published in the American Journal of Preventive Medicine examines the impact of structural racism on health and confirms that chronic exposure to stressors leads to a marked erosion of health that is particularly severe among foreign-born Blacks and Latinx. Investigators say largescale structural policies that address structural racism are needed.

Structural racism is defined as laws, rules, or official policies in a society that result in a continued unfair advantage to some people and unfair or harmful treatment of others based on race.

There is evidence that structural racism has a material impact on the health of racial/ethnic minorities and immigrants. Comparing allostatic load–a multidimensional measure of the body’s response to stressors experienced throughout the life course–between immigrants and non-immigrants of different racial/ethnic backgrounds can help shed light on the magnitude of health differences between groups.”

Brent A. Langellier, PhD, Lead Investigator, Department of Health Management and Policy, Dornsife School of Public Health, Drexel University

Investigators examined patterns in allostatic load among US- and foreign-born Whites, Blacks, and Latinx. Using data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES), they collected data on a 10-item measure of cardiovascular, metabolic, and immunologic risk.

Measures of cardiovascular risk included systolic blood pressure, diastolic blood pressure, total cholesterol, and high-density lipoprotein cholesterol. Metabolic risk indicators included body mass index (BMI), blood sugar (HbA1c), urinary albumin, and creatinine clearance. Immunologic measures were white blood cell count and current or previous asthma diagnosis.

Based on the literature suggesting that, for many outcomes, immigrants have paradoxically good health that declines with time in the US, investigators examined aging gradients in allostatic load for each group. They also assessed whether allostatic load in each group changed across NHANES survey cycles. Their analyses were conducted in March 2020.

Results showed that allostatic load increased with age among all groups, but the increases were much steeper among foreign-born Blacks of both genders and foreign-born Latina women. The difference between the first and last survey cycle was most pronounced among US-born Black women (from 2.74 in 2005-2006 to 3.02 in 2017-2018), US-born Latino men (from 2.69 to 3.09), and foreign-born Latino men (from 2.58 to 2.87).

Aging gradients in allostatic load were steepest among foreign-born Blacks of both genders and foreign-born Latina women, and flattest among US-born and foreign-born Whites. Notably, foreign-born Latina women had among the lowest allostatic load at the youngest ages but among the highest at the upper end of the age distribution.

“Our findings add to the evidence that structural racism has a material impact on the health of racial/ethnic minorities and immigrants – and that this effect accumulates throughout the life course,” noted Dr. Langellier. “They further suggest that the disadvantage experienced by racial/ethnic minorities is compounded among minorities who are also immigrants, which erodes the health advantage that many immigrants have at early ages.”

These findings highlight the magnitude of the disparities in health that are produced by inequities in exposure to these risk and protective factors. “Collectively, our findings and evidence in the broader literature suggest that reducing these disparities will require big, structural policies that address structural racism, including inequities in upstream social determinants of health,” concluded Dr. Langellier.

Source: Study: Structural racism has material impact on health of ethnic minorities, immigrants