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The disproportionate impact of the COVID-19 pandemic on African Americans has highlighted economic and health disparities across the United States created by centuries of systemic racism, an annual report from the National Urban League finds.

Produced in partnership with the Johns Hopkins Center for Health Equity, the report, 2020 State of Black America: Unmasked, found that African Americans, who are more likely than white Americans to live in crowded housing and work in essential jobs, are nearly three times as likely to contract the virus. Black Americans also are more likely to be uninsured than white Americans, to suffer from pre-existing conditions that increase risk of severe illness, and to receive less aggressive treatment, and as a result are nearly five times as likely to be hospitalized for and more than twice as likely to die from COVID-19.

This year’s report includes a 2020 Equality Index, which gauges how well African-American and Latinx people are doing relative to white Americans based on indicators in five areas: economics, health, education, social justice, and civic engagement. The composite index score for 2020 is 73.8 percent, up 1.6 percentage points from the revised 2018 score of 72.2 percent. Based on pre-COVID data, the index for Black Americans showed improvements in health (79.3 percent to 83.8 percent), social justice (55.9 percent to 57.5 percent), economics (58.2 percent to 59.2 percent), and civic engagement (99.7 percent to 100 percent), and no change in education (77.4 percent and 77.3 percent). Compared with the 2005 index, however, the 2020 composite score shows only slight improvement (72.9 percent to 73.8 percent), while the sub-index score for social justice has declined significantly, from 67.5 percent to 57.5 percent. 

In the report, National Urban League president Marc H. Morial shares “19 Lessons of COVID-19,” including “racism is the pandemic within the pandemic”; “bias in health care is both explicit and implicit,” as seen, for example, in how African Americans with COVID-19 symptoms are less likely than white Americans with the same symptoms to be tested; “Black communities never fully recovered from the Great Recession,” with African-American homeownership rates still well below pre-recession levels; “essential workers, disproportionately people of color, are undervalued”; and “too many African Americans still lack health insurance.”

“Like an earthquake exposes the fault lines in the earth, the COVID-19 pandemic exposed the fault lines in America’s social and economic institutions,” the report’s authors write. “The expansion of healthcare coverage under the Affordable Care Act, which coincided with a decade-long economic expansion, partially masked the healthcare and economic disparities festering just beneath the surface. Now, they are unmasked.”

Read more at PhilanthropyNewsDigest.org.

On a morning he should have been in middle school, 12-year-old Isaac Durham collapsed on the sidewalk after drinking a fifth of vodka stolen from a Circle K in Flagstaff, Arizona. After the paramedics pumped his stomach, he was charged with underaged consumption of alcohol and became a juvenile offender for the first time.

In the seven years that followed, Durham, a member of the Hopi Tribe, spent five years, on and off, in juvenile detention. Before he was locked up, he strategically bounced between the reservation and non-Indian land to avoid punishment—exploiting the divide between tribal and county jurisdictions.

“By the age of 19, I was a full-blown meth and heroin addict, injecting meth and heroin and homeless on the streets,” Durham said. “That’s when I was at my rock bottom.”

Generations of historical trauma and increased exposure to violence make young Native Americans more vulnerable to the complicated, often contradictory clutches of the juvenile justice system, legal experts say. Once in the justice system, Native children become lost in a jurisdictional web, a dysfunctional state system and a federal system that has no proper place for them.

Isaac Palone, a member of the Fort Yuma Quechan Indian Tribe, whose desert reservation straddles the Colorado River in southern Arizona and California, shares a similar story.

Palone was born on his grandmother’s living room floor to an alcoholic mother who had taken laxatives to conceal her pregnancy. After years of abuse in both his family home and in state care, he turned to drugs and alcohol.

“By 12, I was already involved with the cops,” Palone said.

He spent his last four months as a minor on probation for burglary. Soon after he turned 18, he broke the law again and, according to the Yuma Sun, was one of the city’s most wanted criminals. Tried for three burglaries and aggravated assault with a deadly weapon, he was convicted and imprisoned for seven months.

Durham and Palone live nearly 200 miles from each other, but they share strikingly similar stories, and their experience is common to Native American youths, who are three times more likely to be imprisoned than their white peers, according to the Sentencing Project.

Native young people are “almost twice as likely to be petitioned to state court for skipping school, violating liquor laws, and engaging in other behaviors that are only illegal because of their age, (often known as status offenses),” according to a 2015 brief by the Tribal Law and Policy Institute. In 2017, 752 Native American youths lived in residential placement, which includes detention centers, group homes, and boot camps, according to the National Center for Juvenile Justice.

Unlike other children, Native American children can be tried and sentenced in tribal, state, or federal justice systems. Once they make contact with the justice system, Native youths face unique complications that many don’t understand, said Addie Rolnick, associate professor of law at the University of Nevada, Las Vegas.

“It kind of makes many people throw up their hands and not want to touch the issue of Native youth,” Rolnick said.

These policies mean that the federal justice system affects Native children in unique ways, according to the Indian Law and Order Commission, created in 2010 to investigate what it called the broken justice system in Indian Country.

“Today’s American Indian and Alaska Native youth have inherited the legacy of centuries of eradication and assimilation-based policies directed at Indian people in the United States,” the commission reported.

Read more at Slate.com.

People are living in unprecedented times amid COVID-19. A report from the U.S. Centers for Disease Control and Prevention finds 40% of adults struggle with mental health and substance use during this pandemic.

Over a dozen times a day, Benjamin Champion, a Retreat Behavioral Health outpatient coordinator, receives calls from people who have either relapsed or they’re looking for other recovery programming and support.

”Sometimes the calls are an hour long,” Champion said.

At one point, Champion was on the other line himself. In May 2016, he entered Retreat Behavioral Health for alcohol abuse.

”In the Hispanic culture it’s not cool to be the one who can’t drink because that’s what you do on a Friday night,” Champion said.

Champion said cultural norms almost prevented him from seeking help. Today, half his calls are for alcohol abuse and he’s not the only one concerned the isolation and uncertainly surrounding the pandemic has only compounded the problem.

”There’s definitely an increase in overdoses and relapses since COVID-19 started,” said Caroline Franklin, primary therapist at Retreat Behavioral Health.

Franklin is also concerned with the people choosing to seek help.

”I think it’s a cultural thing,” Franklin said.

The National Alliance on Mental Health reports almost 50% of White adults seek help verses only 25% of Asian adults, 31% of Black adults, 32% of mixed/multicultural adults, and 33% of Latinx adults.

A report from the CDC also found 54% of essential workers and 66% of unpaid caregivers had at least one adverse mental or behavioral health symptom.

Joi Honer, Retreat Behavioral Health senior director of alumni and community engagement, has grown tired of the headlines and the numbers. She’s behind Retreat’s first seminar of its kind to present solution focused gifts this winter.

”Empowerment is a strong message in wellness,” Honer said. ”You might be in a situation that you can’t control but you can control your attitude. The people that I feel for the most is the person who doesn’t know that help is out there.”

Read more on WPTV.com.

The Sacramento County Board of Supervisors declared racism as a public health issue Tuesday but not without controversy.

The resolution “pledges to promote racial equity while shaping policies, appropriating resources, implementing programs, and issuing directives,” the county said in a press release. 

District 1 Supervisor and Board Chair Phil Serna, who presented the resolution, said Sacramentans should have the opportunity to live their lives free from systemic racism.

“Research has demonstrated that racism adversely impacts the physical and mental health of people of color. The resolution we passed today acknowledges Sacramento County’s commitment to face this crisis head-on through fair and just governance and service delivery,” Serna said.

During the same meeting where the resolution was passed, Sacramento County Health DirectorDr. Peter Beilenson referred to Asian Americans as “yellow folks.”

Speaking in favor of the resolution, Beilenson said, “this is a major area of interest from public health in general, and it’s it’s a crucial thing that we need to be doing to address the issues of African American and brown and yellow folks in our country as well as the white folks.”

Timothy Fong, a professor of Ethnic Studies at Sacramento State, explained to ABC10 why it is problematic to refer to Asian Americans as “yellow.”   

“The terms has been used very negatively against Asian people, historically,” Fong said.

Asian American advocates say referring to Asians and Asian Americans as “yellow” is considered both outdated and tied to anti-Asian sentiments and racist laws in the early 1900s. Plus, Fong said, it ties in to a more modern problem.

“I think what was particularly difficult about the comment today, is the fact of the whole context of racial antagonism, particularly with the COVID-19 pandemic, and the uses of these slurs,” Fong said, citing anti-Asian sentiments stoked by coronavirus fears.

Beilenson told ABC10 his comment during the board of supervisors meeting was wrong. 

“I’m really sorry for that,”  Beilenson said. “I will obviously make sure in the future to talk about Asian Americans and Asian Pacific Islanders, which is what I normally do.” 

Fong said the important thing is Beilenson apologized for his comment.

Supervisors passed the resolution on a 4-1 vote, with Supervisor Sue Frost casting the lone ‘no.’

The resolution will:

• ensure the consistent collection, analysis, and reporting of demographic, socioeconomic, and public health data to measure progress toward eliminating racial inequities
• design, develop and deploy community-based alternatives to prevent trauma and eliminate harm associated with racial inequity
• advocate for local, state, and federal policies that improve health and wellness in communities of color and support legislation that advances racial equity

The resolution will also give the board the chance to create a Sacramento County Racial Equity Policy Cabinet. The cabinet would issue reports to the board of supervisors and be responsible for promoting coordination, cooperation, and collaboration across county departments and the community to promote racial equity. 

Read more on ABC10.com.

Jessica Ross, a 23-year-old Black woman in Atlanta, said she – and many other Black women in her circle – are nervous about getting the COVID-19 vaccine.

She’s a graduate student in public health at Emory University and has been closely following news of the vaccine’s development. But that doesn’t shake off the fear history has imprinted on her community.

Medical testing such as the Tuskegee Syphilis Study on Black men, which did not provide them with treatment to cure the disease, and the case of Henrietta Lacks, a Black woman whose cancer cells were used for research without her or her family’s permission, many have cultivated distrust in public health systems.

Many in her circle of family and friends “are nervous about, ‘Is this going to be … tested out on minority groups?'” she said. “They fear something similar happening again with the COVID-19 vaccine.”

Several polls have shown the ambivalence surrounding the vaccine among people of color. Half of surveyed Black adults aren’t planning to take the vaccine, even if it’s available free and scientists assure it’s safe, according to a study by the Kaiser Family Foundation and The Undefeated, ESPN’s race, sports and culture website.

But a recent survey has found Black women like Ross and Latinx women, more than men, are most reluctant to get the vaccine.

Only 19% of Black women and about one-fifth of Latinx women opted to take the vaccine as soon as possible, according to the poll by MassINC Polling Group in Massachusetts, which surveyed 1,100 residents across the state.

In contrast, 36% of Black men and just shy of a quarter of Latinx men responded they’d take the vaccine as soon as possible.

That rate was about a third of white women and 44% of white men.

Historically, public health campaigns are usually developed to help educate and inform communities about the safety, effectiveness and importance of vaccinations – but the COVID-19 vaccine was developed so quickly that proper dissemination of information to specific populations hasn’t really been done yet, Rodriguez said.

“It shows we have a lot of work to do,” she said. “What we need to do is have trusted community ambassadors and messengers just relaying that this is a safe vaccine, that it’s efficacious.”

Part of that, Rodriguez said, is ensuring that Black, Latinx and Native American women and men understand the alternative of not getting vaccinated.

“People that are not minorities, white Americans, white men and white women who have high privilege … have access to higher quality resources or extremely beneficial or high-quality health care,” Ross said. “Those are the people that I would like to see going forth and taking this vaccine first.”

Read more on USAToday.com.

Hip-hop is one of the world’s most popular music genres, with its global prominence transcending language and geography. More than ever before, hip-hop artists are publicly acknowledging their mental health struggles, promoting anti-stigma campaigns around mental health, and normalizing seeking treatment for mental health issues.

 Hip-hop can be a vehicle for tackling stigma around mental health and addressing cultural imbalances. Hip-hop connects with groups that healthcare has historically struggled to reach, particularly men within the Black community. Underrepresented communities are at higher risk of developing mental health problems, and they are more likely to experience worse mental health outcomes. This is, in part, due to socioeconomic disparities. They are also less likely to use mental health services. Stigma around mental health issues is common in underserved communities, and it is a substantial barrier to accessing health services. Discrimination, bias, and a lack of cultural competence from healthcare professionals can also lead to unmet needs, late presentation of symptoms, and poorer quality of care.

For those who embrace hip-hop music and culture, we believe this medium could facilitate engagement, help normalize mental health, and promote seeking access to treatment. In addition, there is hope that the awareness gained from engaging with resources related to mental health and hip-hop can provide new ways for opening up conversations between health professionals and patients (such as asking if the patient likes music, and whether any particular genre, artist, and/or song resonates with how they are feeling at the moment). Health professionals do not need to have any knowledge of hip-hop. Culturally sensitive and context relevant approaches might open up more patient centered ways of building trust and deepening discussions about mental health, which can otherwise feel very stigmatizing. Likewise, understanding how mental health is portrayed in hip-hop can offer a different perspective for healthcare professionals, helping them to build empathy with someone whose experiences may be completely different to their own. This knowledge might also help health professionals to be more aware of any potential trends that link the contagion effects of suicide, self harm, and self medication from hip-hop icons to some of their patients, and to be prepared for this.

Hip-hop is an art form filled with passionate expression, and its lyrics resonate with people all over the world. Art and culture are powerful mediums for self expression and for translating experiences. It can also help shape perceptions, challenge opinions, bridge communication, and help to understand other people’s points of views. Since the genre’s conception almost five decades ago, hip-hop’s progressive narratives have increasingly addressed stigma around mental health problems. Hip-hop artists are speaking candidly through their art form, and they may be helping people around the world to acknowledge their own inner struggles.

Read more on BMJ.com.