Rafiah Maxie has been a licensed clinical social worker in the Chicago area for a decade. Throughout that time, she’d viewed suicide as a problem most prevalent among middle-aged white men.
Until May 27, 2020.
That day, Maxie’s 19-year-old son, Jamal Clay — who loved playing the trumpet and participating in theater, who would help her unload groceries from the car and raise funds for the March of the Dimes — killed himself in their garage.
“Now I cannot blink without seeing my son hanging,” said Maxie, who is Black.
Clay’s death, along with the suicides of more than 100 other Black residents in Illinois last year, has led locals to call for new prevention efforts focused on Black communities. In 2020, during the pandemic’s first year, suicides among white residents decreased compared with previous years, while they increased among Black residents, according to state data.
But this is not a local problem. Nor is it limited to the pandemic.
Interviews with a dozen suicide researchers, data collected from states across the country and a review of decades of research revealed that suicide is a growing crisis for communities of color — one that plagued them well before the pandemic and has only been exacerbated since.
Overall suicide rates in the U.S. decreased in 2019 and 2020. National and local studies attribute the trend to a drop among white Americans, who make up the majority of suicide deaths. Meanwhile, rates for Black, Hispanic and Asian Americans — though lower than their white peers — continued to climb in many states. (Suicide rates have been consistently high for Native Americans.)
“Covid created more transparency regarding what we already knew was happening,” said Sonyia Richardson, a licensed clinical social worker who focuses on serving people of color and an assistant professor at the University of North Carolina-Charlotte, where she researches suicide. When you put the suicide rates of all communities in one bucket, “that bucket says it’s getting better and what we’re doing is working,” she said. “But that’s not the case for communities of color.”
Research shows Black kids younger than 13 die by suicide at nearly twice the rate of white kids and, over time, their suicide rates have grown even as rates have decreased for white children. Among teenagers and young adults, suicide deaths have increased more than 45% for Black Americans and about 40% for Asian Americans in the seven years ending in 2019. Other concerning trends in suicide attempts date to the ’90s.
“We’re losing generations,” said Sean Joe, a national expert on Black suicide and a professor at Washington University in St. Louis. “We have to pay attention now because if you’re out of the first decade of life and think life is not worth pursuing, that’s a signal to say something is going really wrong.”
Rafiah Maxie pages through a scrapbook on July 9, 2021, in Olympia Fields, Illinois. She and her son, Jamal Clay, made the book together. Clay died by suicide at age 19 in 2020. (Taylor Glascock for KHN)
These statistics also refute traditional ideas that suicide doesn’t happen in certain ethnic or minority populations because they’re “protected” and “resilient” or the “model minority,” said Kiara Alvarez, a researcher and psychologist at Massachusetts General Hospital who focuses on suicide among Hispanic and immigrant populations.
Although these groups may have had low suicide rates historically, that’s changing, she said.
Paul Chin lost his 17-year-old brother, Chris, to suicide in 2009. A poem Chris wrote in high school about his heritage has left Chin, eight years his senior, wondering if his brother struggled to feel accepted in the U.S., despite being born and raised in New York.
Growing up, Asian Americans weren’t represented in lessons at school or in pop culture, said Chin, now 37. Even in clinical research on suicide as well as other health topics, kids like Chris are underrepresented, with less than 1% of federal research funding focused on Asian Americans.
Suicide is the leading cause of death for Asian Americans ages 15 to 24, yet “that doesn’t get enough attention,” Chin said. “It’s important to continue to share these stories.”
Kathy Williams, who is Black, has been on a similar mission since her 15-year-old son, Torian Graves, died by suicide in 1996. People didn’t talk about suicide in the Black community then, she said. So she started raising the topic at her church in Durham, North Carolina, and in local schools. She wanted Black families to know the warning signs and society at large to recognize the seriousness of the problem.
The pandemic may have highlighted this, Williams said, but “it has always happened. Always.”
Pandemic Sheds Light on the Triggers
Pinpointing the root causes of rising suicide within communities of color has proven difficult. How much stems from mental illness? How much from socioeconomic changes like job losses or social isolation? Now, covid may offer some clues.
Recent decades have been marked by growing economic instability, a widening racial wealth gap and more public attention on police killings of unarmed Black and brown people, said Michael Lindsey, executive director of the New York University McSilver Institute for Poverty Policy and Research.
With social media, youths face racism on more fronts than their parents did, said Leslie Adams, an assistant professor in the department of mental health at Johns Hopkins Bloomberg School of Public Health.
Each of these factors has been shown to affect suicide risk. For example, experiencing racism and sexism together is linked to a threefold increase in suicidal thoughts for Asian American women, said Brian Keum, an assistant professor at UCLA, based on preliminary research findings.
Covid intensified these hardships among communities of color, with disproportionate numbers of lost loved ones, lost jobs and lost housing. The murder of George Floyd prompted widespread racial unrest, and Asian Americans saw an increase in hate crimes.
At the same time, studies in Connecticut and Maryland found that suicide rates rose within these populations and dropped for their white counterparts.
“It’s not just a problem within the person, but societal issues that need to be addressed,” said Shari Jager-Hyman, an assistant professor of psychiatry at the University of Pennsylvania’s school of medicine.
During this time, suicide deaths among Hispanic Texans climbed from 847 deaths in 2019 to 962 deaths in 2020, according to preliminary state data. Suicide deaths rose for Black Texans and residents classified as “other” races or ethnicities, but decreased for white Texans.
Marc Mendiola often heard his classmates at South San High School say they were suicidal. In 2017, Mendiola and his classmates began advocating for mental health services at the school. (Photo: Marc Mendiola)
The numbers didn’t surprise Marc Mendiola. The 20-year-old grew up in a majority-Hispanic community on the south side of San Antonio. Even before the pandemic, he often heard classmates say they were suicidal. Many faced dire finances at home, sometimes living without electricity, food or water. Those who sought mental health treatment often found services prohibitively expensive or inaccessible because they weren’t offered in Spanish.
“These are conditions the community has always been in,” Mendiola said. “But with the pandemic, it’s even worse.”
Four years ago, Mendiola and his classmates at South San High School began advocating for mental health services. In late 2019, just months before covid struck, their vision became reality. Six community agencies partnered to offer free services to students and their families across three school districts.
Richard Davidson, chief operating officer of Family Service, one of the groups in the collaborative, said the number of students discussing economic stressors has been on the rise since April 2020. More than 90% of the students who received services in the first half of 2021 were Hispanic, and nearly 10% reported thoughts of suicide or self-harm, program data shows. None died by suicide.
Many students are so worried about what’s for dinner the next day that they’re not able to see a future beyond that, Davidson said. That’s when suicide can feel like a viable option.
“One of the things we do is help them see … that despite this situation now, you can create a vision for your future,” Davidson said.
A Good Future
Researchers say the promise of a good future is often overlooked in suicide prevention, perhaps because achieving it is so challenging. It requires economic and social growth and breaking systemic barriers.
Tevis Simon works to address all those fronts. As a child in West Baltimore, Simon, who is Black, faced poverty and trauma. As an adult, she attempted suicide three times. But now she shares her story with youths across the city to inspire them to overcome challenges. She also talks to politicians, law enforcement agencies and public policy officials about their responsibilities.
Growing up in West Baltimore, Maryland, Tevis Simon dealt with poverty and trauma. She attempted suicide three times as an adult — but now uses her story to teach and inspire others. (Photo: Tevis Simon)
“We can’t not talk about race,” said Simon, 43. “We can’t not talk about systematic oppression. We cannot not talk about these conditions that affect our mental well-being and our feeling and desire to live.”
For Jamal Clay in Illinois, the systemic barriers started early. Before his suicide last year, he had tried to harm himself when he was 12 and the victim of bullies. At that time, he was hospitalized for a few days and told to follow up with outpatient therapy, said his mother, Maxie.
But it was difficult to find therapists who accepted Medicaid, she said. When Maxie finally found one, there was a 60-day wait. Other therapists canceled appointments, she said.
“So we worked on our own,” Maxie said, relying on church and community. Her son seemed to improve. “We thought we closed that chapter in our lives.”
But when the pandemic hit, everything got worse, she said. Clay came home from college and worked at an Amazon warehouse. On drives to and from work, he was frequently pulled over by police. He stopped wearing hats so officers would consider him less intimidating, Maxie said.
“He felt uncomfortable being out in the street,” she said.
Maxie is still trying to make sense of what happened the day Clay died. But she’s found meaning in starting a nonprofit called Soul Survivors of Chicago. Through the organization, she provides education, scholarships and shoes — including Jamal’s old ones — to those impacted by violence, suicide and trauma.
“My son won’t be able to have a first interview in [those] shoes. He won’t be able to have a nice jump shot or go to church or even meet his wife,” Maxie said.
But she hopes his shoes will carry someone else to a good future.
Young nurses all over are battling despair as their dream careers seem to be mired in a grim, unrelenting cycle of needless mortalities. Fortunately, the caring sciences attract a lot of natural fighters (not to mention pro boxers and MMA contestants), and some are drawing on their frustration and war-weariness in the hope that their stories will make a difference. After all, people trust nurses even more than doctors; maybe these nurses will reach some of the people who refuse to heed Dr. Fauci.
Nurse of the Week Bailey Baker has been working in the University of Tennessee Medical Center Covid-19 unit for a year and a half now. Baker is doing all she can to stop the pointless deaths of this summer’s Delta surge,l whether on or off duty. A few days ago, the Tennessee ICU nurse shared her experience dealing with the consequences of the state’s abysmal Covid vaccination figures. Patients now in her care at UT Medical Center are “not only young but healthy with no underlying conditions—I’m talking 20s and 30s,” the 26-year-old stresses. “Mothers who have just had babies, mothers with 4 and 5 years olds…. This isn’t like anything I’ve ever experienced in my career.”
Baker spoke to her local news station to try to spread the message to her community and raise awareness of the gravity of the current situation. Surviving Covid, she argues, does not necessarily lead to a full return to blooming health. Even when it does not kill, this virus can bring about life-altering changes and entail a lengthy and painful recovery period. Baker told CBS 8, “You have them on their bellies, you’re encouraging them to do everything that you know of to keep them off that ventilator because you know in the back of your mind that the likelihood of their coming off [the ECMO] isn’t great… And if they do, you know their quality of life is likely to be severely compromised.”
At the outset of summer, UTMC staff were enjoying the deceptive eye of the Covid hurricane. The worst seemed to have passed, vaccines had become readily available, and during breaks, the conversation was even light-hearted at times. They were on the way back to “normal,” surely, after some 14 hellish months? “It was really nice, you know. We kind of got that glimpse of what the old reality was,” she recalls.
But now, “there are more patients—and sicker—than I’ve seen since we started this whole global pandemic.” The most painful aspect of the new surge is that so many of the new patients are Baker’s own age. Mustering her best glass-half-full tone, she says, “hopefully, if they make it, they will recuperate from this illness that is destroying their bodies and their lungs.”
What does she want to say to the people of Tennessee? Bailey Baker, BSN speaks of evidence, of course: “Politics aside, opinions aside, the statistics are that our severely critical patients on ventilators suffering from this virus—are unvaccinated.” Full stop. Back on the glass-half-full side, Tennesseans—like many others—do seem to be responding to the urgency of the Delta invasion. Somewhat, at least. The vaccination rate has nearly doubled in the state since July… after a 200% spike in Covid cases. About 48% of Tennesseeans have now received at least one dose of a Covid vaccine (which is ironic, as Tennessee’s percentage of fully vaccinated adults ranks them at #48 among US states). So, indeed, there is still a great deal of room for improvement, especially among those in Baker’s age group.
Now that Covid is again ending more than 1,000 American lives a day, all we can do is keep stating the facts, again and again, if need be. We hope that people will listen, and pray they recognize that nurses—from those sobbing with pain and frustration as they plead to the carefully composed stoics citing harsh, undeniable data—are not trying to run their lives; they are trying to save them.
But there is a knowledge gap in how COVID-19 has affected a public health crisis that existed before the pandemic: the opioid epidemic. Prior to 2020, an average of 128 Americans died every day from an opioid overdose. That trend accelerated during the COVID-19 pandemic, according to the Centers for Disease Control and Prevention.
We are a team of health and environment geography researchers. When social distancing began in March 2020, addiction treatment experts were concerned that shutdowns might result in a spike in opioid overdose and deaths. In our latest research in the Journal of Drug Issues, we take a closer look at these trends by examining opioid overdoses in Pennsylvania prior to and following the statewide stay-at-home order.
Our findings suggest that this public health response to COVID-19 has had unintended consequences for opioid use and misuse.
History of the Opioid Epidemic
Opioid misuse has been a major U.S. health threat for over two decades, largely affecting rural areas and white populations. However, a recent shift in the drugs involved, from prescription opioids to illegally manufactured drugs such as fentanyl, has resulted in an expansion of the epidemic in urban areas and among other racial and ethnic groups.
From 1999 to 2013, increasing death rates from drug abuse, primarily for those from 45 to 54 years of age, contributed to the first decline in life expectancy for white non-Hispanic Americans in decades.
The state’s stay-at-home order, implemented on April 1, 2020, mandated that residents stay within their homes whenever possible, practice social distancing and wear masks when outside the home. All schools shifted to remote learning, and most businesses were required to operate remotely or close. Only essential services were allowed to continue operating in person.
In the following months, the public’s overall cooperation with these mandates contributed to measurable declines in coronavirus infection rates. To learn how these mandates also affected people’s use of opioids, we assessed data from the Pennsylvania Overdose Information Network for changes in monthly incidents of opioid-related overdose before and after April 1, 2020. We also examined the change by gender, age, race, drug class and doses of naloxone administered. (Naloxone is a drug widely used to reverse the effects of overdose.)
Our analysis of both fatal and nonfatal cases of opioid-related overdose from January 2019 through July 2020 revealed statistically significant increases in overdose incidents for both men and women, among whites and Blacks, and across several age groups, most notably the 30-39 and 40-49 groups, following April 1. This means there was an acceleration of overdoses within some of the populations most affected by opioids prior to the COVID-19 pandemic. But there were also uneven increases among other groups, such as Black people.
We found statistically significant increases in overdoses involving heroin, fentanyl, fentanyl analogs or other synthetic opioids, pharmaceutical opioids and carfentanil. This is consistent with previous research on the main opioid classes contributing to increases in drug overdose and death. The results also affirm that heroin and synthetic opioids such as fentanyl are now the major threats in the epidemic.
When a Pandemic and an Epidemic Collide
While we found significant change in opioid overdoses during the COVID-19 pandemic, the findings say less about some of the driving factors. To better understand these, we have been interviewing public health providers since December 2020.
Among the important factors they highlight as contributing to increased opioid use are pandemic-driven economic hardship, social isolation and the disruption of in-person treatment and support services.
From March to April 2020, unemployment rates in Pennsylvania shot up from 5% to approximately 16%, resulting in a peak of more than 725,000 unemployment claims filed in April. As workplace shutdowns made it harder to pay for housing, food and other needs, and the opportunities for in-person support disappeared, some people turned to drugs, including opioids.
People in the early stages of treatment or recovery from opioid addiction may be particularly vulnerable to relapse, suggested one of our public health partners. “They might be working in industries that are closed down, so they have financial problems … [and] they have their addiction issues on top of that, and now they can’t like go to meetings, and they can’t make those connections.” (Under our clearance with Penn State for doing research with human subjects, our public health informants are kept anonymous.)
An addiction treatment counselor told us that especially for those with past or present opioid use problems, or histories of mental health issues, “It’s not a good thing to be alone in your own thoughts. And so, once everybody was kind of locked down … the depression and anxiety hit.”
Another counselor also pointed to depression, anxiety and isolation as driving increased opioid misuse. The pandemic “just spun everything out of control,” they said. “Overdoses up, everything up, everything.”
One question is whether states like Pennsylvania will continue to support telehealth in the future. While the transition from in-person to telehealth services has increased access to treatmentfor some, it has raised challenges for populations like the rural and elderly. As one provider explained, “it’s really hard for that [rural] population out there” to utilize telehealth services due to limited internet and broadband connection. In other words, flexible modes of addiction treatment might work for some but not others.
The goal of our research is not to criticize efforts to mitigate the spread of COVID-19. Without the mandatory stay-at-home order in Pennsylvania, both infection and death rates would have been worse. However, our research shows that such measures have had unintended consequences for those struggling with addiction and emphasizes the importance of taking a holistic approach to public health as policymakers work to confront both COVID-19 and the addiction crisis in America.
Nurse of the Week, Carla Brown, RN, accompanied by a colleague clutching a clipboard to her chest, is standing outside a house in her North Baton Rouge, LA neighborhood. “You seem kind of impatient when you get to these doors to talk to these people…” a CBS reporter remarks. “Yes,” Brown replies, “Because I feel the urgency… Today I could see you, and tomorrow, you may not be here.”
Carla Brown does not have time for nonsense. These days, in addition to her work as an RN in a hospice, Brown has also donned the mantle of a community nurse. After experiencing her own tragic Covid loss, she’s managing her grief by doubling down on what nurses do best: helping people. Now, when not on duty at the hospice, Carla is on duty in her majority-Black North Baton Rouge area, pounding the pavement (nurses are also expert walkers!) and signing up neighbors for Covid-19 vaccination appointments. And when her elderly or disabled “patients” cannot reach a vaccination site, Brown swings by in her car and drives them there.
Her own loss was the nightmare of every frontline nurse. After Brown unknowingly contracted an asymptomatic case of Sars-CoV-2 at work, she came home and infected her family with the virus. The consequences were devastating. Carla’s husband, “the love of my life, David,” fell ill, as did her 90-year-old father, and 67-year-old brother. All three—husband, father, and brother—had to be hospitalized. Her spouse, David Brown, died in the hospital at age 67.
The grim statistics in the Baton Rouge vaccination efforts against Covid-19—that 64% of the white population has had at least one shot, while just 26% of the city’s Black community have had jabs—gave the bereaved Carla a new purpose: “All I can do now,” she says, “Is save somebody else.”
The vast discrepancy between white Baton Rouge and Black Baton Rouge has less to do with vaccine hesitancy than it does with our old familiar frenemy, structural racism. North Baton Rouge (NBR) has long been underserved by the local healthcare system, and the Covid vaccines have been strangely scarce in the area. Aside from a few ephemeral pop-up vaccination sites that have been hosted by Black churches, vaccines have been available at only four sites in the district.
To attack the vaccine scarcity problem, Carla employed some special artillery. Clad in her hospice uniform, the undaunted RN stepped into a popular neighborhood pharmacy—with a CBS reporter and camera crew in tow—and asked to speak with the owner. She told the proprietor that she could provide the completed registrations, insurance paperwork, and ID confirmations for NBR locals who have been won over by her urgent campaign. “We just need,” she said, “Somebody to supply us with the vaccine.”
The result? Well, it is hard to dismiss nurse Brown even when she is not accompanied by a news team from a major national broadcasting network. In fact, after agreeing to order vaccine ASAP, the pharmacist implied he had little choice: “She’s an angel!” he said of Carla. “An angel in disguise.”
A tough angel, though. As Brown told a local station in Baton Rouge, “You want to go to your grave early, or you want to live? That’s been my sales pitch.” And when walking the streets and knocking on doors doesn’t get results, “Some [neighbors] I just physically took in my car and brought.”
In the hospital with covid-19 in December, Lavina Wafer tired of the tubes in her nose and wondered impatiently why she couldn’t be discharged. A phone call with her pastor helped her understand that the tube was piping in lifesaving oxygen, which had to be slowly tapered to protect her.
Now that Wafer, 70, is well and back home in Richmond, California, she’s looking to her pastor for advice about the covid vaccines. Though she doubts they’re as wonderful as the government claims, she plans to get vaccinated anyway — because of his example.
“He said he’s not going to push us to take it. It’s our choice,” Wafer said, referring to a recent online sermon that praised the vaccines as God-given science with the power to save. “But he wanted us to know he’s going to take it as soon as he can.”
Helping people accept the covid vaccines is a public health goal, but it’s also a spiritual one, said Henry Washington, the 53-year-old pastor of The Garden of Peace Ministries, which Wafer attends.
Clergy must ensure that people “understand they have an active part in their own salvation, and the salvation of others,” said Washington. “I have tried to suggest that taking the vaccine, social distancing and protecting themselves in their household is something that God requires us to do as good stewards.”
Many Black Americans look to their religious leaders for guidance on a wide range of issues — not just spiritual ones. Their credibility is especially crucial on matters of health, as the medical establishment works to overcome a legacy of experimentation and bias that makes some Black people distrustful of public health messages.
Now that the vaccines are being distributed, public health advocates say churches are key to reaching Black citizens, especially older generations more vulnerable to severe covid disease. They have been hospitalized for covid and died at a disproportionate rate throughout the pandemic, and initial data on who is getting covid shots shows that Black people lag far behind other racial groups.
Black churches have also suffered during the pandemic. African American pastors were most likely to say they had had to delete positions or cut staff pay or benefits to survive, and 60% said their congregations hadn’t gathered in person the previous month, as opposed to 9% of white pastors, according to a survey published in October by Lifeway Research, which specializes in data on Christian groups.
Washington’s 75-member church is in Richmond, which has the highest number of covid deaths in Contra Costa County, outside of deaths in long-term care facilities. The very diverse city, across the bay from San Francisco, also has one of the lowest rates of vaccination.
Offerings to Washington’s church plunged 50% in 2020 due to job loss among congregants, but he’s weathered the pandemic with a small-business loan and a second job as a general contractor remodeling bathrooms and kitchens.
To combat misinformation, he’s been meeting virtually with about 30 other Black pastors once a month in calls organized by the One Accord Project, a nonprofit that organizes Black churches in the San Francisco Bay Area around nonpartisan issues like voter registration and low-income housing. Throughout the pandemic, the calls have focused on connecting pastors with public health officials and epidemiologists to make sure they have the most up-to-date information to pass on to their members, said founder Sabrina Saunders.
The African American church is an anchor for the community, Saunders said. “People get a lot of emotional support, people get resources, and their pastor isn’t just looked upon as a spiritual leader, but something more.”
And guidance is needed.
The share of Black people who say they have been vaccinated or want to be vaccinated as soon as possible is 35%, while 43% say they want to “wait and see” the shots’ effects on others, according to a KFF survey. Eight percent say they’ll get the shot only if required, while 14% say they definitely won’t be vaccinated. Among whites, the first two figures are 53% and 26%, respectively; for Hispanics, 42% and 37%. (KHN is an editorially independent program of KFF.)
Among the “wait and see” group, 35% say they would seek information about the shots from a religious leader, compared with 28% of Hispanics and 14% of white people.
Grassroots outreach to Black churches happens in every public health emergency, but the pandemic has hastened the pace of collaboration with public health officials, said Dr. Leon McDougle, assistant dean for diversity and cultural affairs at the Ohio State University College of Medicine. The last time he saw such a broad coalition across Black churches, medical associations, schools and political groups was during the HIV/AIDS epidemic in the 1980s.
“This is at an entirely different level, though, because we’ve had almost half a million die in a year,” McDougle said of the covid pandemic.
Historically, no other institution in African American communities has rivaled the church in terms of its reach and the trust it enjoys, said Dr. Paris Butler, a plastic and reconstructive surgeon at the University of Pennsylvania Health System. Last month, he and a colleague spoke to leaders from 21 churches in Philadelphia to answer basic questions about how the vaccine was produced and tested.
“Being an African American myself, and growing up in a Baptist church, I understand the value of that trusted voice,” Butler said. “If we don’t reach out to them, we’re making a mistake.”
Leaders with massive social media followings, like Bishop T.D. Jakes, are also weighing in, publishing video conversations with experts including Dr. Anthony Fauci to inform followers about the vaccines.
Church attendance is waning among young Black adults, as it is for other races. But elders can set examples for younger people undecided about the vaccine, said Dr. Judith Green McKenzie, chief of the division of occupational medicine at the University of Pennsylvania’s Perelman School of Medicine.
“When they see their grandma go, they may say, ‘I’m going,’” she said. “Grandma got this two months ago and she’s fine.”
Encouraging vaccine trust is delicate work. The Black community has reason to be skeptical of the health system, said Eddie Anderson, the 31-year-old leader of McCarty Memorial Christian Church in Los Angeles. In one-on-one conversations, congregants tell him they fear being guinea pigs. The low vaccine supply also makes Anderson hesitate to recommend, from the pulpit, that members get the shot as soon as they’re able. He fears frustration with difficult online sign-ups would further sap motivation.
“I want to do that when it’s readily available,” he said. “I want to preach it, and then within a weekend a family can actually go get the vaccine.”
Despite the doubts and fears, Anderson said the majority of his 125-member congregation, about half of whom are senior citizens, want the vaccine, in order to be with loved ones again. One older member is desperately seeking a vaccine appointment so he can help his daughter, who is going through cancer treatments. But the online sign-up process is confusing and nearly impossible for his followers, Anderson said.
For now, he’s focused on asking several vaccinated members to write down everything about their experience and share it on social media. He also plans to record them talking about their shots — and to show that many people of different races were in the same vaccine line — and will broadcast the videos during church announcements.
While he can’t tell people what to do, Anderson hopes he can remove any potential spiritual barriers to the vaccine.
“My biggest fear is for someone to say, ‘I didn’t get vaccinated’ or ‘I didn’t get a test’ because it’s against [their] faith, or because I don’t see that in the Bible,’” he said. “Any of those arguments, I want to get those off the table.”
Article republished courtesy of KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
As the numbers in Covid-19 rise and healthcare workers struggle to keep patients safe, indigenous communities still struggle to be recognized. The current pandemic, along with many other diseases, has disproportionately impacted tribal communities, who at times lack basic essential needs or access to adequate medical care. Covid-19 is just the tip of a very big iceburg that has systematically crushed indigenous people for generations which has woven itself into the fabric, or the very essence, of a nation, causing economic loss, environmental instability, religious and political oppression and more.
The current health crisis has had a ripple effect on indigenous people who already suffer from chronic illnesses like heart disease, diabetes, PTSD, depression, and suicide. Tribal Health Programs and Urban Indian Organizations provide limited resources, health options, and timely information. As we know, Covid-19 is a virus that has been difficult to contain and misinformation along with fear have devastated many communities. We, as healthcare workers must educate the public in order to contain it. If part of our community distrust the information given, it puts everyone at risk.
According to the Urban Indian Health Institute (a division of the Seattle Indian Health Board) 35% of Native People who get Covid-19 die compared to 6.3% of white people. Furthermore, the CDC is lacking the available data to quantify the disparity in covid-19 incidence among indigenous people. The lack of data, exclusion in research, and misrepresentation in medical and academic publications can continually harm native people by delaying assistance and affect evidence based practice models.
The lack of information can increase risk factors, prevent proper education regarding disease process, and continue to have an insurmountable effect on the social and economic growth of a tribe. Not having the adequate information to treat our patients affects how we do our job. Generalized equation models of data, does not adequately include covid-19 symptoms, current underline health issues, ICU admissions, indigenous survival rate and deaths.
So how do we as healthcare providers, help break this cycle? First, we must recognize tribal communities as sovereign entities. Our interventions must be tailored to a very unique group of people who need to be respected and who historically, distrust the medical community. We need to educate in a way that encompasses and includes the tribal traditions in order for the information to be received properly. Healthcare workers must ask questions that are unique to indigenous people. For instance, does the patient prefer the information in his/her language which is pivotal in curtailing this virus or would the patient prefer to have his/her family involved in medical decisions. Furthermore, health services for indigenous people need rich resources that extend throughout their community and include important elders and those that have a political, economic, and religious impact. We must learn to think outside the box and realize not every community sees health and disease process the same way.
Hospitals must also implement a better system of documentation that includes native people. Exclusion of data and research will not help any healthcare system who is servicing an indigenous community. Documentation should include not just basic statistics and medications, but availability of testing, results, side -effects, availability for research or vaccines, and understanding of current disease process.
Lastly, we must not only educate but advocate for the health of the community where elders are pivotal to the survival of a tribe. They are the guardians of tribal culture and language and the most at risk during this pandemic. As healthcare workers, we have a responsibility to all communities and seek preventative mechanisms that are appropriate for all.