Addressing racial disparity: Virus outreach to black communities is underway

DOVER — It’s been said that when America gets a cold, the black community gets the flu, noted Eugene Young, president and CEO of Metropolitan Wilmington Urban League.

The remark was part of a panel put together by the Delaware Division of Health and Social Services to focus on COVID-19 and its impact on the state’s black community.

In Delaware, as of early Tuesday, 43 individuals had died due to COVID-19; 70% of those deaths have been white individuals, 23% black and 7% Hispanic, said Kara Odom Walker, secretary of DHSS. (The number of deaths increased to 46 Wednesday, but data for race was not available.)

At large, however, data is incomplete when it comes to race, she said.

For positive cases in the state, race was unknown for 45% of individuals. In the cases where race is known (55%), 44% of those who tested positive are black, 43% are white and 13% are listed as other, Dr. Walker said.

“The race and ethnicity data is submitted by a health care provider on the lab requisition form when someone is tested,” she said. “The problem is, about half the time, the provider did not submit that data or check it off when testing the patient.”

In an emergency order signed last week, Dr. Karyl Rattay, director of Division of Public Health, is requiring health providers to submit this information going forward, said Dr. Walker. DPH is additionally working with the Delaware Health Information Network to help record the missing data.

Dr. Kara Odom Walker, secretary for the Delaware Department of Health and Social Services. center, and Gov. John Carney listen as Dr. Karyl Rattay, director of the Delaware Division of Public Health, speaks about the coronavirus last month at the Carvel State Office Building. Special to the Delaware State News/Butch Comegys

“The DHIN will then search its existing medical records for these patients and give us back records with complete race and ethnicity information,” she said. “We will then add the missing records back to give us a more complete picture of the impact by race. But we have a lot more work to do to connect the dots.”

She added the caveat that, with the way race is being recorded, someone checking a box on a lab form is not the same as asking someone what their race and ethnicity is.

“Sometimes people miscategorize, they just assume, ‘Oh, check the box white, or check the box Latino,’” she said. “For the black community, we know that that’s a critical thing, is making sure that people are able to self identify. So we won’t have perfect data because of that challenge, we will have better data in the coming weeks.”

Beyond the full data of breakdowns for current positive cases, Dr. Walker said those at the highest risk for contracting COVID-19 are seniors, especially those 65 years and older, and those with chronic health conditions such as hypertension, heart disease, diabetes, obesity, asthma and other lung diseases.

“As a practicing physician, Dr. [Richard] Henderson and I know that African Americans have a disproportionate rate for many of those chronic diseases and coupled with a lack of access to health insurance and health care, the risk for exposure to COVID-19 can increase dramatically,” Dr. Walker said.

Dr. Henderson, an OB/GYN and past president of the Medical Society of Delaware who was part of the panel, noted that while everyone is at risk for COVID-19, risk is heightened for those with conditions that affect the black community at a higher rate.

“When we look at the African-American, black community we see a large number of individuals in this age group are either leading the family, or larger numbers are present in that family, and who have one, two, or three of these major chronic conditions, which expose them to increased risk for this infection and dying,” he said.

“That’s why it’s so very, very important that we in a black community do two things: One is recognize what our risk factors are and who’s at risk from having them and dying from it. And then, two, take the steps necessary to limit the spread of this infection,” he said.

Recommendations like refraining from touching one’s face, washing hands and practicing social distancing remain important. Dr. Henderson also suggested opening dialogue in the family to see who has those health conditions.

Dr. Walker said there are increased health risks due to economic and social circumstances, as well as implicit racial bias in health care.

“We also know that they’re more likely to work in the service industry or be low-wage workers than white people, which increases their exposure and puts them at a higher risk for contracting,” she said.

People of color are also more likely to live in locations and housing situations that put them “in increased risk of infection because we know that the virus spreads more quickly in densely populated urban settings and high occupant living arrangements.”

She acknowledged that access to testing has come up several times, and whether federally qualified health centers, such as Westside Family Healthcare and Henrietta Johnson Medical Center, will partake.

“They are part of our testing collaborative. They are integrated into the conversations about testing access,” she said. “We will continue to evolve and see where there are opportunities to increase locations. But right now, as we’ve experienced, it’s really important to make sure that if we have testing, we also have the capability to run the test, to have the supplies.”

To increase outreach to low-income minority communities, Mr. Young said during the panel discussion, his organization is reaching out through social media, television and door knockers.

“One of the things that we’re really focusing on is this idea that we need to meet people where they are,” he said.

There is no physical contact, but there is the passing of information on resources and supplies hung on doorknobs in the community.
“I think the beauty about the black community is that we’re very close, especially being in a state like Delaware where there are less than a million people, are very close anyway. But this allows for us to connect with one another,” he said.

Efforts like that are underway downstate.

At the First State Community Action Agency, a nonprofit working to lessen the effects of poverty, work hasn’t stopped during the pandemic. Executive Director Bernice Edwards said her agency has always been a “boots on the ground agency.”

“What we are doing now is working closely with other nonprofits and other agencies to make sure that we are able to meet the needs of families that we have with our community-based program, with our after-school program,” she said.

The organization is using different methods to connect with the families it serves — from social media to word of mouth to making calls to families.

“Our governor has done an excellent job keeping us updated with the COVID updates that we’ve been sharing with our social media platforms, on the website … as well as our staff. We’re in constant communication on a daily basis,” said Sade’ Truiett, public relations specialist.

Ms. Truiett said First State has acted as a bridge to help get people to testing if they need transportation. She added that health care workers have been responsive about the various testing sites.

“First State has graciously been able to help support the cost of transportation for people that need to get testing or medical supplies or prescriptions during this time,” she said.

Leandra Marshall, vice president for external relations, development and outreach for Delaware Multicultural and Civic Organization, Inc., said DEMCO is collaborating with other groups — like the NAACP, faith-based organizations and school districts — to make an impact.

They’ve also used Facebook and their website to put out information, from helping parents support their children’s remote learning, to helping figure out how to file for unemployment.

“We’re actually working more collaboratively, trying to figure out ways we can partner to have the greatest impact in this timeline,” she said. “One thing we’ve learned from COVID is that you can’t do things in isolation right now. We all have got to work together.”

Concerns regarding minority safety during the public health crisis were raised in a letter to Gov. John Carney from Delaware NAACP President Richard Smith Wednesday.

“As the number of COVID-19 cases in Delaware continue to grow exponentially, so do disparities that inhibit equal access to health, education, and economic stability,” he wrote. “We urge you to review the areas of concentration outlined within this letter and make a concerted effort to work with the proper agencies, stakeholders, and constituents to address them.”

Richard Smith

In the letter, Mr. Smith calls for attention to equitable testing, care and treatment; additional safety measures for those incarcerated; protection for essential business workers; the status of K-12 education; and economic stability for small, minority-owned businesses.

Freeman Williams, vice president of NAACP and chairman of the Delaware NAACP COVID19 Strategic Planning Committee, said in a separate interview that the NAACP is cognizant of, and works closely with, the community.

“Some of our leaders received some feedback about some of these situations and we felt that we needed to address them and a very, very cohesive and focused manner,” he said. “We really believe that the NAACP’s role is to make sure that, for our constituents, that’s someone’s a spokesperson and an advocate for them to make sure that in all the efforts that are being discussed and put forward, that the citizens that we represent will have access and the opportunity to participate in the recovery opportunities that are being discussed.”

During the panel discussion, Dr. Walker said that Lt. Gov. Bethany Hall Long was tapped by Gov. Carney to lead outreach to black communities, which includes working with DHSS, the Department of Labor and other state agencies.

She also pointed to organizations that reached out regarding data, testing availability, unemployment compensation and remote learning.
“As state government, we will continue to work to address those issues,” she said. “We will listen and act.”

Helpful Coronavirus links

Delaware Division of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage
Reopening Delaware: Resources for Businesses
Delaware Phase 2 guidance

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