ALBANY — University at Albany researchers last week issued a report on the disparate impact the COVID-19 pandemic had on communities of color in New York state.
“Differential Impacts of COVID-19” was the result of a year-long project begun in the spring of 2020 and has two primary purposes: To summarize the results of 14 separate tracks of research and to offer the research ecosystem that was used as a model for similar efforts.
The heart of the matter — that minority communities were infected, hospitalized and killed by the virus in disproportionately high numbers — has been established and repeatedly publicized in New York.
The takeaway from the report is that systemic inequities and racism have caused these disparities and will have to be eliminated if the disparities themselves are to be removed.
Schenectady County’s minority communities are smaller by percentage than New York state as a whole, but many members have seen the same impacts described in the report.
The county’s interim director of public health, Keith Brown, and supervising public health nurse, Claire Proffitt, discussed the UAlbany report with The Daily Gazette on Friday.
“For anyone who’s worked in public health or any kind of related field, this should be no surprise,” Brown said. “I actually can’t name one single health issue that hasn’t disproportionately affected communities of color off the top of my head.”
He said efforts by Schenectady County Public Health Services to reach underserved communities continue. But now doesn’t feel like the right time for a retrospective.
The general public tone, Brown said, seems to be one of a victory lap, that New York has beaten COVID. That attitude worries him because large swaths of entire demographic groups — particularly children, young adults and Black people — are vaccinated at a much lower rate than the rest of the population.
A fast-moving variant of COVID-19 could hit one of these cohorts hard, Brown said, even if it had trouble spreading in the rest of the community.
The larger point of the UAlbany report, the need to address the systemic causes of racial inequities within the health system, is one the county works continually to address, Brown and Proffitt said.
Broken down to their components, problems sometimes are revealed to have multiple causes, Proffitt said.
Breast feeding is recognized as a healthier practice than bottle feeding, but a smaller percentage of Black women breast feed their babies, she said as an example. There can be reasons for this unique to the Black experience in America, and there can be practical reasons, such as the difficulty of nursing while working and waiting for a bus to get to work.
It helps when the message to the community comes from leaders within the community, Brown said, and that’s a priority for the Public Health Services, whether the message is about COVID or lead poisoning or breast-feeding.
The onus, he said, is on the system to fix its problems, not on the people who suffered the effects of the system.
“Health care and public health as institutions both re-created the same harmful designs a lot of other systems have,” Brown said.
It’s not enough to do good, to provide good care, he added. There needs also to be an effort to undo the negative.
“‘Enough’ is literally feeling like you left no stone unturned, no idea on the table,” Brown said. “Our business is public health, not the health of the people who can get to us,” Brown said.
This approach has carried into the local COVID vaccination effort that has given Schenectady County some of the best results of any county in the state.
Schenectady County did not have a regular, or constant mass vaccination site, the way Albany County did. Residents could go to two such sites in nearby Albany County, if they had transportation. Instead, the county ran regular vaccine clinics, and when attendance started to wane, county Public Health switched to smaller popup clinics, then to micro clinics that might administer only three shots a day.
Those small-scale clinics resulted in just 99 vaccinations in June, Proffitt said, but by moving from place to place, they reached people who might otherwise not have gotten a shot.
“It’s labor-intensive,” Brown said. “I don’t know any other way to do it at this point.”
As of Friday morning, Schenectady County and Hamilton County were tied at 80.1% of adults with at least one shot in the arm, highest among the 62 counties.
State data on the racial demographics of vaccination are imprecise because some vaccine recipients don’t report their race.
The data available show Black and Hispanic residents of Schenectady County vaccinated at rates well below white and Asian residents.
Statewide, white and Hispanic New Yorkers are vaccinated roughly in proportion to their percentage of the population while Asian New Yorkers have been vaccinated at a much higher rate and Black New Yorkers at a much lower rate.
COVID mortality rates break down differently:
State statistics published Friday show that as of July 1, the statewide death rates per 100,000 were Asian 93.4, Hispanic 107.7, white 123.1 and Black 183.1.
In Schenectady County, the rates were Asian 215.9, Hispanic 26.2, white 119 and Black 85.2.
As of Thursday, statistics maintained by Schenectady county indicate:
- 6,367 white residents confirmed infected, 382 hospitalized and 126 dead from COVID;
- 1,148 Black residents infected, 67 hospitalized and 13 dead;
- 633 Asian residents infected, 31 hospitalized and nine dead;
- 3,185 residents of other or unknown race infected, 360 hospitalized and 12 dead.
U.S. Census data break down Schenectady County’s estimated 155,299 population in 2019 as 72.5% non-Hispanic white, 12.7% Black, 7.4% Hispanic and 5.0% Asian.
The UAlbany research team looked not just at the disparities of infection but the social, economic and environmental aspects of those disparities, including how the disease progresses across minority groups; how efforts to combat the pandemic affect infection; the importance of community health and expanded telehealth, in languages other than English; the critical role of Black churches in spreading news to their congregants; the secondary social and economic impacts of the pandemic, such as food insecurity; and the results of minority distrust of the medical community.
“Systemic racism has produced, and continues to produce, deeply entrenched differences in health care and the social, economic, and environmental conditions that account for inequities in longevity and the likelihood of disease,” the researchers wrote. “This was true long before the first case of COVID-19 was diagnosed in New York on March 1, 2020, and will remain true unless the resources and will exist to make systemic changes.”