Faulty COVID-19 Data Collection increases risks for Cleveland’s Latino community

Culturally competent awareness, action are critical for control of virus

By Juan Molina Crespo

SPECIAL TO THE REAL DEAL

                          

The Coronavirus pandemic has exacerbated the precarious daily struggle among Latinos for basic necessities. Latinos are at high risk of contracting Coronavirus, yet, they are noticeably absent from testing, hospitalization, ICU treatment, death rate and recovery. Unless we address the realities presently compounding the virus’ effect upon the Latino community, the pandemic will create a destiny of deaths of despair.

According to the Ohio Department of Health, Latinos comprise 8% of Cuyahoga County residents, yet they account for over 15% of the Covid-19 deaths, based on my analysis of the available data. These data do not include City of Cleveland numbers.

Accurate data collection is elusive. Much of what is reported by Ohio Department of Health and the Cuyahoga County Board of Health does not include the number nor the rate per 1000,000 of Latino/Hispanics in the Coronavirus protocols.

The underlying factors contributing to this overrepresentation of Latinos in COVID-19 mortality rates are vast and complicated. The following is a partial list of deeply rooted socio-economic inequities that contribute to the dismal compliance on stay at home and quarantine orders. 

Housing

Affordable housing is in short supply. The gentrification of the Clark/Fulton area where most Latinos live has decreased affordable housing and created a rise in rents of the existing housing stock that is often beyond the financial scope of many Latinos. With limited options, many families find themselves in crowded conditions with three or even four generations of children and adults living together in overcrowded apartments. Lack of adequate air conditioning in most rental units in the Clark/Fulton community will make compliance with stay-at-home and quarantine orders impossible for many. Forced to venture outside for relief from stifling overcrowded quarters, they become likely targets for citations or arrest by overzealous police officers.

Job loss

For most Latinos COVID-19 is not just a public health issue with genocidal implications, it is also an economic catastrophe. Latinos are overrepresented as health care workers. This includes behavioral health providers, home health workers, nursing home facilities and assisted living employees, emergency medical technicians (EMTs), housekeeping and others who work in healthcare and congregate living settings. Latinos are also widely employed as frontline workers in other essential fields, including childcare, public transportation, food industry and landscaping, where they cannot work from home.

Many of these jobs pay low wages [sometimes “under the table], lack sick day benefits and limited if access to preventative primary healthcare and health insurance. Employees must report to work or risk termination. But they are critical both to society and to the breadwinners who must pay rent and utilities, buy groceries, and other basic necessities. Any job loss or income reduction produces immediate and long term financial effects; increasing stress because of pending evictions, utility shutoffs, food insecurity and the erosion of interpersonal relations between parents, spouses/partners and children. Lack of money increases desperation and social isolation, along with negative mental health symptoms and their repercussions. 

Underlying health conditions

Latinos suffer from many existing underlying health conditions identified as high risk factors to contracting COVID-19. Moreover, Latino people are less likely to have access to quality health care, have higher rates of poverty and are concentrated in high risk jobs. We know that those who struggle with high blood pressure, cancer, diabetes, obesity,  and are over 65 years of age are at higher risk of contracting COVID-19. Latinos suffer from higher rates in all of these categories.

According to Covid-Net, CDC’s weekly publication of the characteristics of hospitalization of U.S. Covid-19 patients, for the week ending May 16, 2020, Latinos comprised 42% of U.S. patients ages 0-17, and 37% of ages 18-49. These data illustrate how COVID-19 has the potential to spread among the most vulnerable among marginalized communities. 

Messaging, awareness and education

Very little Spanish language COVID-19 awareness and educational information exists. MetroHealth Systems has a dedicated page on its website.

The Cleveland Department of Public Health [CDPH] has a Spanish flyer on its website and offers a COVID-19 package to those who have tested positive. CDPH reporting of COVID-19 positive cases does not identify any Latino/Hispanic cases, which complicates any efforts to get accurate numbers from the Latino community.

Ward 14 Council representative Jasmin Santana has organized several food and grocery distributions aimed at reducing food insecurity among mostly Spanish language-dominant Latino residents throughout Cleveland. The success of these efforts comes primarily because information is shared through word of mouth. This brings attention to Cleveland’s large digital divide. The lack of reliable internet service, affordability and access to computers will complicate the creation of a local messaging campaign to reach into the heart of Clark/Fulton Latino neighborhoods and surrounding city wards.

Testing

While testing is currently being offered at limited CVS and Rite Aid stores, neither chain provides testing at stores in Clark/Fulton. The chain’s stores closest that offer testing the Clark Fulton community are both in Parma, five to seven miles away.

Getting to Parma would only be a first step. To secure a test, residents must make an advance online appointment; bring the confirmation notice; obtain a physician’s eligibility notice; provide identification; be at least 18 years old; and drive up — no walk ups allowed.

Instructions with the test packages for the self-administered tests are provided in English at the drive up windows, a further challenge for Spanish dominant residents.

MetroHealth Systems on West 25^th Street offers testing according to their website, it does not provide instructions on where to go once on its formidable campus.

Cleveland Clinic Lutheran Hospital on 25^th Street offers COVID-19 testing only to existing patients with a Cleveland Clinic doctor’s order. Testing is typically scheduled within 24 hours. All emergency department walk-ins are evaluated, those experiencing symptoms are isolated and triaged by the COVID nurse.

The testing landscape changes rapidly. Testing sites are added and or deleted regularly. Suffice it to say that the current testing infrastructure is confusing and rife with barriers to adequate access.

           

Seroprevalence

Seroprevalence surveys  are a testing tool to identify people in a population or community that have antibodies against an infectious disease.

Presently, there is a lack of standardized and coordinated COVID-19 testing and protocols. There is an  inability of  government health officials to  obtain accurate data on ethnicity and race of those tested.  These factors, combined with the  failure to create a uniform multi-language messaging campaign, do not allow for the development of a model to obtain accurate and reliable seroprevalence rates among Latinos. As summer approaches and lockdowns are lifted, and self-quarantine and social distancing compliance wanes,  the lack of coordination, will make it increasingly difficult for an accurate count of Latino COVID-19 patients.  Any efforts to measure new occurrences of COVID-19 on individual and community transmissions, and intensity of the virus will be compromised.

Contact tracing

Generations of marginalized communities have had horrific experiences with appointed and elected government officials. Empty promises, discriminatory and racist interactions, and condescending and disrespectful communication have taken a toll.  This will make the creation of a contact tracing model very difficult to achieve. To a large degree, inquiries to obtain private information of everyone an infected person may have had physical contact with can be seen as intrusive. This natural wariness will be magnified in Latino communities where immigration status of individuals is closely guarded. Moreover, residents with outstanding warrants,  heavily in debt, or  family members, friends, or acquaintances with questionable experiences and behavior will most likely not appreciate being called out to authorities.

Contact tracing is in essence an investigation into one’s privacy, viewed by many as government overreach, and interpreted as another means of control and oppression.

Recommendations

This discussion is meant to highlight the developing crisis in the Latino community and to reinforce the understanding that in a pandemic, no group can be left outside.

In light of the challenges and needs of the Latino community, here are some specific recommendations that local governments, health care providers, and civic leaders should implement:

Testing:

• Engage businesses and employers to provide or facilitate testing at work sites. This will allow for health care providers, community service organizations and businesses to gather more accurate data to contribute to the establishment of seroprevalence rates among Latinos.

• Free testing for those with or without Medicaid, Medicare or other insurance.

• Promote comprehensive testing day at or immediately after summer festivals, outings, events to measure spikes in contagion.

Messaging:

• Messaging campaign must have a long-term tagline that is relevant to Latinos.

• Spanish (Spanglish) language materials should be at fourth grade reading levels, and include succinct copy, and visuals and sketches that reflect the community [e.g., faith-based, schools, homes, shopping].

• Messaging campaign must be done in phases that correspond with external social norms, events and holidays.

• Study and replicate the ingredients that have been used in previous successful targeted campaigns. According to the Ohio Department of Health, 69.5% of Latinos in Cuyahoga County, reported receiving the Flu vaccination in 2019 — the only group in Cuyahoga County to achieve the national benchmark of 70%.

• Lobby state health officials to elevate and include racial and ethnic minorities to underlying health conditions to Priority 1.

• Conduct workshops with contact tracing imagery and flow charts to explain the seriousness of communication with friends and family.

Conclusion

It is imperative that public health institutions, hospitals, community health centers, faith-based organizations and all others who service Latinx residents insist on the collection and reporting of accurate data on race, ethnicity, gender and age. Although most public health officials believed that this first wave of COVID-19 would begin to wane in July and August, this is no longer the prevalent thought. The demonstrations across the country in response to the murder of George Floyd by Minneapolis police officers will mostly cause an expansion and extension of the first wave.  The second wave of COVID-19, which was expected to hit in upcoming Fall months, will be felt throughout winter, 2021.

The availability, amount, and process to access government funding and economic resources for our communities will be driven by data. If Latinos are not part of the science, we will find ourselves once again fighting for the leftover crumbs, not an equitable share.

Juan Molina Crespo is a social worker who served as director of The Hispanic Alliance until his retirement last year.

• • •• • •

BULLETIN: BREAKING NEWS

Former President Barack Obama will address the nation this afternoon in a town hall at 5pm EDT. He will be joined by his former Attorney General, Eric Holder, police reform activists and other public figures. 

The town hall will be livestreamed on Obama.org beginning at 5 p.m. ET.

Kent State satellite campus has graduated ZERO black students — for years

Several Ohio campuses have abysmal success rates for black college students

By Delece Smith-Barrow and Aaricka Washington
The Hechinger Report

Kent State University at Ashtabula freshman Alexis Turner chose Ashtabula in part because of its cost. “I didn’t want any debt.”

ASHTABULA, Ohio — Alexis Turner listened carefully as the administrators at the freshman orientation for Kent State University at Ashtabula ticked through the student groups she could join on campus that fall: English Society, Psychology Club, Student Veterans Association. 

She left the auditorium apprehensive. There was no Black Student Union, Latino Student Union or Multicultural Society. 

Once the semester started, it became more apparent why those clubs don’t exist. 

“There’s not a lot of black representation,” said Turner, a black freshman.

Kent State Ashtabula is in a rural county near Cleveland, where black and Latino students make up about a third of the local high school. While Turner is right — black students are underrepresented at the university — hundreds have enrolled in the last decade. 

Very few have succeeded.

The six-year graduation rate for first-time, full-time black students has been zero for five years running, according to federal data. 

University officials said that number fails to capture all its students because Ashtabula is a regional, or satellite, campus. Although Ashtabula offers both associate and bachelor’s degrees, they said, the main campus, Kent State University at Kent, receives credit for Ashtabula’s students who pursue certain bachelor’s degrees. Between fall 2013 and spring 2019, university officials say, 55 black students received an associate or bachelor’s degree from Ashtabula. 

That’s an average of eight a year, at an institution where about 100 black students enroll annually.

At Kent State University at Ashtabula, 55 black students received
an associate or bachelor’s degree between fall 2013 and spring 2019.

When it comes to graduating black students, the university has one of the worst records in Ohio among public colleges and universities, in a state that stands out nationally for how poorly it serves students of color. In Ohio, “black students are half as likely to complete a degree at a public four-year institution compared to white students,” said Marshall Anthony Jr., a research analyst for higher education at Ed Trust. The six-year grad rate for black students in Ohio is about 30 percent, compared to 40 percent for black students nationally.

Related: With white students becoming a minority, public universities push harder to diversify

Ohio has a desperate need for more college graduates, but its problems serving black students contrast with universities across the U.S. that are actively working to attract more diverse students and make sure they succeed. Many college systems in other states are adding more support services, like centers for students of color, data tracking to keep tabs on students’ progress and even cash grants for those facing financial difficulties. 

Though Ashtabula has limited support services targeted for black students, officials at the university said the abysmal graduation rates aren’t their fault. 

School leaders say that their students, many of whom are low-income, must juggle jobs along with their coursework, lengthening the time it takes them to graduate. They also said local public schools don’t prepare young people for the rigor required for university classes. “Before they can enroll in, I’m going to say college-level, courses, they're in developmental math or developmental English,” said Susan J. Stocker, the dean and chief administrative officer. “They're taking at least a year to complete prerequisites.”

Across the state, Kent State’s campuses of comparable size are also struggling to serve these students. Among full-time, first-time students at Kent State University Salem, which is 4 percent black, two black students received an associate degree and one received a bachelor’s degree in 2017. At the Tuscarawas campus, also 4 percent black, one black student received an associate degree and zero received a bachelor’s in 2017. Student enrollment hovers between 1,400 and 1,800 students at each institution.

Part of Ohio’s challenge is cost. “Ohio is 45th out of 50 states in college affordability. Like we are one of the worst — the worst places — cost wise,” said Maggie McGrath, director of the Higher Education Compact of Greater Cleveland. 

Cost of attendance is now at $8,101, and 62 percent of students receive federal aid, though it’s often not enough. Between 2004 and 2014, Ohio cut funding for a college grant program for low-income students by 33 percent. The state also consistently decreased spending on colleges and universities for 10 years. In 2018, it spent 16.5 percent less per full-time equivalent student, after adjusting for inflation, than it did in 2008.

“Public institutions in Ohio most certainly have to do more to serve black students.” Marshall Anthony Jr., senior policy analyst at Ed Trust.

Yet money doesn’t completely explain why Ohio’s public universities are failing to graduate students of color. Campus culture is a major factor in student success, research has found. And black college students at Ashtabula rarely see a faculty member who’s a person of color. This school year, only four of 99 instructional faculty members were people of color. Scholars have long argued that minority faculty provide mentorship for minority students and enrich the classroom in other ways. Nonetheless, at Ashtabula, no programs are underway to increase that number, and no campus administrator is specifically charged with running diversity initiatives.

Turner wishes the university had additional resources for black college students like her, though their numbers are relatively small. Black students at Ashtabula comprise 6 percent of the student body; students of color overall, about 15 percent. “I honestly don’t even really see people my color at school,” she said. 

“I wish there were more,” she said. “It gives me an unsettling feeling.”

The state should be more proactive with helping black students succeed, said Anthony from Ed Trust. “Public institutions in Ohio most certainly have to do more to serve black students.” 

Kent State University at Ashtabula is small, just four buildings for nearly 2,000 students. The campus is located in Ohio’s northeast corner, bordering Lake Erie, 53 miles from Cleveland. About 17 percent of households in Ashtabula County earn incomes under the federal poverty line, and there are few options for postsecondary education. “We’re the only college in our county,” said Amanda Dolan, director of enrollment management and student services. “We’re our own competition.”

The journey to graduation for most Ashtabula students takes longer than six years because they juggle several responsibilities outside of school. At Ashtabula, 43 percent of students are part-time, which naturally slows their pace for degree attainment. “Eight years for a bachelor's degree, four years for an associate degree, maybe three and a half for an associate degree,” said Dolan. “Most of our students are working and have families.”

Turner chose Ashtabula largely for its location, 10 minutes from her home, and its price: “I didn’t want any debt,” said Turner. Her federal Pell Grant, reserved for college students with the highest financial need, covers much of her costs. 

If she graduates, she’ll be the first in her family with a college degree. Making sure she succeeds is an urgent problem for this state, and the region.

In Ohio, 44 percent of working-age adults have a certificate or degree, but to keep up with workforce demand that number needs to reach 65 percent. To make Ohio an attractive option for businesses and jobs, the state is pushing for 1 million more adults to get a certificate or degree by 2025.

Manufacturing dominates here, meaning that, for decades, some of the best jobs haven’t required a college degree. Most residents have a high school diploma, yet only 28 percent have a bachelor’s degree or higher, according to Census data. But in Ohio the high-wage jobs that are growing the fastest now require more education.

Jobs in health care are expanding, which is a plus for Turner, who is studying nursing, a career that could propel her into the middle class.

Turner attended Ashtabula’s high school, Lakeside High, where almost every student is economically disadvantaged. The Ohio Department of Education gave Lakeside an F for its ability to prepare students for life after high school. Turner says Lakeside required her class to take the ACT college-entrance exam her junior year but didn’t actively help students study. For the Lakeside class of 2016, just 37 percent entered college within two years. 

“I wasn’t prepared for it,” said Turner, who scored less than 20.3, the average score for Ohio test takers.

Students of all backgrounds struggle at Ashtabula. Its eight-year grad rate is 26 percent.

Related: Many state flagship universities leave black and Latino students behind

University officials say they offer plenty of help outside of class for students to get up to speed. Ashtabula regularly has more than a dozen tutors available, and can increase the number depending on need, said Carol Jones, coordinator of academic services. Students receive academic advising and can visit the writing center, sign up for tutoring or attend supplemental instruction.

Supplemental instruction “targets our historically difficult classes,” said Jones. These are classes in which students often get a grade of D or F, such as anatomy and physiology. Supplemental instruction, just like the campus’ tutoring program and writing center offerings, is optional. The instructors for the supplemental learning option spend three hours a week going over lectures, preparing students for exams and offering other guidance.

As a nursing major, Turner has taken classes in anatomy and physiology, chemistry and English, a rigorous course load that has had her in class until 7 p.m. some evenings. The irregularity of the college course schedule places more responsibility on her to keep up with class material. 

Now, “it’s harder for me to remember everything and stay fresh on all of the content,” she said.

Many students are unable to persist through the tough classes and, as a result, leave the university. Ashtabula had the lowest retention rate of full-time students in 2017 — 44 percent — out of all the public colleges and universities in Ohio.

With so many institutions with low retention and graduation rates, the state has taken a few recent steps to make college more enticing and affordable. In July, Gov. Mike DeWine signed legislation to increase funding for Ohio’s college grant program by $50 million over two years. And even with a significant depletion of the state’s budget because of the covid-19 pandemic, “everything possible will be done to ensure that these higher-level per-student award amounts are maintained in the next academic year,” said Ohio Department of Higher Education Chancellor Randy Gardner in a statement. 

DeWine has also said that public institutions will be required to guarantee that students will pay the same tuition their freshman, sophomore, junior and senior years. The covid-19 crisis, however, may hurt these efforts to improve student outcomes. The state’s revenue is down by almost $777 million, and in May the governor reduced the state’s higher education budget by $110 million.

Changing the culture of the institutions, however, while challenging, could reap more benefits, education experts say. Diverse college classrooms can help students sharpen their critical-thinking and problem-solving skills. Students of color in such classrooms are also at a lower risk of experiencing discrimination, which can affect how and if they excel. 

When a student doesn’t see others like them, it can affect their performance and persistence in school, says McGrath. “They don’t feel comfortable,” she said.

At orientation this summer, Deahrah Williams, a black student, was already considering transferring to another university after she finishes a year at Ashtabula. 

“I feel like, as African Americans, when we get a chance to leave or do something better, we take the chance,” Williams said. 

She grew up in Ashtabula, and says her father wants her to go south for college because he thinks there will be more opportunities.

Nate Ritchey, vice president for Kent State System Integration, which requires him to be a bridge between the Kent campus and the regional institutions and keep track of enrollment at all of the universities, agrees that the university system should be doing more to recruit and support students of color. “There’s a need across the regional campuses to increase diversity. That’s absolutely true,” he said.

“In the last couple of years, we’ve invested in a lot of recruiters,” Ritchey said. “Before that, students kind of just showed up on a regional campus.” 

Other changes, though slow, may be on the way. The retention rate for all freshmen is going up, Ritchey says, rising from 50 percent to 56 percent between the most recent school years, though he couldn’t verify that black freshmen are included in this uptick. 

"We want people to come here and know
that they’re accepted no matter what,”
said Valerie Gonzalez, an Ashtabula
alum and admissions counselor.

Some students of color have felt more at home at Ashtabula. Valerie Gonzalez, a 2018 Ashtabula graduate, wanted to attend Ohio University but couldn’t afford it. At Ashtabula, she picked up a work-study job in the admissions office and fell in love with the university, so much so that she wanted to continue working there after graduation. 

And Ashtabula wanted her to stay, too. Gonzalez, whose parents are Mexican immigrants, speaks Spanish. As an admissions counselor, she supports Spanish speaking students. And she helped launch the school’s first Hispanic Heritage Month celebrations this school year.

“We want this to be a campus where people feel safe,” said Gonzalez, “We want people to come here and know that they’re accepted no matter what.” 

School administrators say they’re following their students’ lead on which cultural activities to introduce. They said there’s been little excitement for a club or student group for black students, but that could be a reflection of the university’s low black student population rather than a real lack of interest.

Turner considered starting a group for black students like herself early in the school year, but once classes started and she saw how few other black students there were, she paused. She was also too busy. She works 28 to 35 hours a week at a gas station — ringing up items, making food and meeting other customer needs — on top of taking a full course load.

“Of course you have those moments where you get very overwhelmed, and you’re like, man, like is this even for me?” Turner said. “But you have to keep going. That’s the only thing you can do is keep going. So that’s what I’m doing now.”

This story about Kent State Ashtabula was produced by The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education.

• • •• • •

White Privilege is a threat to national security

By R. T. Andrews

Several thousand citizens assembled in downtown Cleveland Saturday afternoon, to protest the lynching of
George Floyd by police officers in Minneapolis MN and to demand an end to systemic police misconduct
across the United States. • Photograph by Vince Robinson 

                                                                                                                            
The unforgettable video image of a Minneapolis police officer casually using his knee to take the life of the helpless black man pressed to the asphalt pavement beneath him, blithely indifferent to the pleas of both his victim and the helpless onlookers pleading vainly for him to stop, is perhaps the starkest distillation of white privilege imaginable.

Like the image of the naked Vietnamese girl running in unspeakable despair from the horrible destruction behind her, the image of Derek Chauvin officer executing George Floyd next to a squad car with eponymous license plate declaring the state’s power, will come — in its cold indifference to black life – to symbolize how America treats its citizens of color.

This was no faded black and white tableau of a Ku Klux Klan lynching carried out by hooded terrorists in the dead of night in the back woods of the Deep South a century ago.

This was no fit of rage by a squad of enraged cops with an expected sense of privacy and immunity as they brutally stomped Rodney King for his aggravating behavior.

This wasn’t an untrained, unstable rookie cop rolling up precipitously on Tamir Rice, a 12 year old boy playing with a toy pistol, and shooting him dead within two seconds.

This wasn’t the South Carolina cop expecting to get away with killing middle aged Walter Scott after shooting him in the back by planting a phantom gun by the corpse and telling official lies about what happened.

This wasn’t vigilantes killing Skittles-eating teenager Trayvon Martin on a rainy night in a gated community. It wasn’t self-appointed auxiliary cops pursuing and confronting an unarmed black jogger before killing him.

It wasn’t Louisville Kentucky police officers breaking into Breonna Taylor’s apartment under color of a wrongly executed “no knock” warrant and killing her as she slept.

This wasn’t the FBI bursting in on Fred Hampton and assassinating him in a hail of bullets in furtherance of a rogue government COINTELPRO operation.

This was worse in its unapologetic and unequivocal callousness. In broad daylight, in a showplace middle American city of Protestant prosperity, with a chorus of accomplices, and before a horrified audience, Officer Devon Chauvin conducted a public lynching.

It’s a mistake to call Chauvin, who along with three other policemen was fired from the force the next day, a bad apple. That is the system’s way of protecting itself, providing an illusion of self-discipline: cast aside a replaceable part and keep rolling.

If Chauvin were a bad apple, we’d have to look not at the branch or the tree or the grove that produced him. We’d have to recognize that the American orchard of justice sits on toxic ground, its soil poisoned by underground waters that a racist society that glorifies violence.

In killing George Floyd so publicly, so slowly, and so inexorably, Chauvin and his colleagues catalyzed an immediate and undeniable recognition among millions of white Americans that this systemic violence is being done in their names. He showed what policing in the black community truly is: the random brutality that reflects this society’s appraisals of black life as cheap.

As heinous, horrible and in-your-face as it was, if these were normal times the lynching of George Floyd might still have outlasted the normal news cycle such atrocities typically receive.

But these are not normal times. We have not enjoyed normal times since 2008, the year Barack Obama won the presidency.

Election of the nation’s first black president did not signal the dawn of a post racial America. Instead, it unleashed in America a reaction that is spiritual heir to the Redemption of the 1870s and the Massive Resistance of the 1950s and Sixties. Those movements put craters in the nation’s path towards a fairer and more open and just society that still impede our progress.

Redemption and Massive Resistance [to the mandate and logic of the Supreme Court’s unanimous 1954 decision in Brown vs. Board of Education] were largely centered in the South. The North acquiesced in the Redemption and was indifferent to the Resistance.

The nation is now rapidly moving to a choice point where acquiescence or indifference may prove fatal to our experiment in democracy. The death of that experiment clearly does not matter to our  current President. It seems to matter less every day to his party.

The rest of us will have to decide soon where we stand. November will be here soon. A wrong choice may bring our experiment to a permanent December.