Who was Biddy Mason? After her portrait was found in a group of Works Project Administration (WPA)-era murals slated for destruction, a flurry of media reports has fostered a growing curiosity about Mason’s place in the pages of Black history and the history of nursing.
Biddy Mason is among the figures depicted in the “History of Medicine in California,” a 10-mural series completed by Bernard Zakheim in 1938. The murals, which have long been on display at the University of California, San Francisco, are housed in a building that is going to be demolished in 2022 to make way for a new medical center. The family of the artist was told that they would need to furnish the funds required for the preservation of the murals. As UCSF and the Zakheim family battled over the cost of preserving the murals, the conflict gathered a varied group of interested parties, including Mason’s descendants Cheryl and Robynn Cox. In June, the General Services Administration entered the fray. The GSA countered UCSF’s ownership claim, insisted that the paintings be preserved and stated that “ownership of the murals resides with G.S.A., on behalf of the United States.”
The debate over the fate of the murals continues, but one happy result is that Biddy Mason’s story has emerged from obscurity. And her story is a classic American journey. Mason began life as a slave in the Deep South. She toiled in slavery on the pioneer trail before gaining her freedom. Finally, after working as a free nurse and midwife, she became a wealthy (and charitable) community leader who improved the lives of her contemporaries and later generations as well.
Born enslaved in Mississippi, Mason ultimately became the property of a Mormon convert. As she traveled west in a caravan with her owner, his family, and their enslaved laborers, she performed midwife duties, herded cattle, and cooked. The caravan ultimately made its way to California. In 1856, five years after her arrival, Nelson successfully petitioned for freedom for herself and 13 members of her family. She then moved to Los Angeles, where she worked for $2.50 a day as a midwife and nurse for Dr. John Strother Griffin, one of the first formally trained doctors in Southern California. Eventually, she set up her own business.
She never learned to read, but Mason was canny with money. She invested her earnings in property in various locations around Los Angeles and became a wealthy woman. By the time she died in 1891, Mason was a prominent philanthropist, and left her heirs an estate worth 3 million dollars. In addition to donating time and money to relieve prisoners and the impoverished, Nelson founded LA’s oldest Black church, the First African Methodist Episcopal Church, a daycare for the children of poor working mothers, and a Traveler’s Aid center. She lived until 1891.
Visit here to see a more detailed history of Biddy Mason and her place in history. For an account of the debate over the UCSF WPA murals, see this article in the New York Times.
Data from National Nurses United (NNU) suggests that while only 4% of US nurses are Filipinos, some 30% of the nearly 200 RNs who have died from COVID-19 are Filipino Americans. NNU believes that overall, nurses are primarily endangered by PPE shortages and restrictive guidelines limiting access to tests, but Filipino nurses tend to face additional risks.
The odds of being exposed to the virus tend to be higher for Filipino nurses and healthcare workers. One reason for their vulnerability is based on sheer numbers, particularly in California and New York. One fifth of California nurses are Filipino, and according to a ProPublica analysis of 2017 US Census data, 25% of the Filipinos living in New York work in the health care industry. The types of jobs they take also increase the likelihood of exposure. A 2018 Philippine Nurses Association of America survey (cited by ProPublica) found a large proportion of respondents working in bedside and critical care, and a StatNews report noted that “because they are most likely to work in acute care, medical/surgical, and ICU nursing, many ‘FilAms’ are on the front lines of care for Covid-19 patients.” The StatNews story added that Filipino frontliners often “work extra shifts to support their families and send money back to relatives in the Philippines. Those extra hours, and extra exposure to patients, mean higher risk.”
Roy Taggueg, of the Bulosan Center for Filipino Studies at University of California, Davis recently told NBC News that in addition to the low rates of testing in their communities, Filipino nurses are also more likely to reside in multi-generational households, which makes them and their families more vulnerable to the virus. He explained, “One person might be going out, but they definitely are bringing everything back with them when they come home from work, because they’re forced to work out there on the front line. We’re talking about their parents, their kids, all of that. It’s a very particular position to be in, and it’s one that I think is unique to the Filipino and Filipino American community.”
While many nurses have been speaking out about the lack of tests and inadequate PPE, Filipino nurses usually find it more comfortable to remain silent. Cris Escarrilla at the San Diego chapter of the Philippine Nurses Association of America remarked, “We don’t really complain that much. We are able to adapt and we just want to get things done.” Zenei Cortez, president of National Nurses United and the California Nurses Association acknowledged this, saying “Culturally, we don’t complain. We do not question authority. We are so passionate about our profession and what we do, sometimes to the point of forgetting about our own welfare.” However, Cortez thinks that the younger generation of Filipino nurses seem to be finding their voices: “What I am seeing now is that my colleagues who are of Filipino descent are starting to speak out. We love our jobs, but we love our families too.”
Immigrant women receive dubious hysterectomies and staffers openly neglect even basic COVID precautions at Georgia’s Irwin County Detention Center, says LPN Dawn Wooten in a complaint filed by four non-governmental organizations.
According to Wooten, the private immigrant detention facility has refused to test symptomatic inmates, has not been isolating those suspected of having the virus, and is disregarding mandatory CDC social distancing practices. Wooten’s complaint also notes that she and other nurses have been alarmed by the inordinate number of hysterectomy operations performed at the Center. In reference to the frequent and questionable hysterectomies one detainee described the detention center as “an experimental concentration camp.”
COVID-19 safety and treatment are given short shrift at the center, and Wooten says that even before the pandemic the facility was often dilatory in providing medical care for detained immigrants. Since the pandemic, the complaint alleges, the center has made almost no use of its two rapid-response COVID testing machines, and has instead sent swabs to be tested at a local hospital. Wooten was told she should not be “wasting tests” on people she suspected of being infected, and when she inquired about testing one detainee, a co-worker responded, “He ain’t got no damn corona, Wooten.”
In addition to failing to provide PPE for staff working directly with confirmed cases of COVID-19, Wooten’s complaint states that the facility forced symptomatic staff to continue to work in the facility and threatened them with discipline if they refused to work in dangerous conditions. Because she spoke out against such practices, Wooten says that she was transferred from her full-time position to a part-time job in which her shifts consisted of a few hours a month.
On Tuesday, September 15, House Speaker Nancy Pelosi called for an investigation. Regarding the alleged misuse of hysterectomies on immigrant women detainees, Pelosi said “The DHS Inspector General must immediately investigate the allegations detailed in this complaint. Congress and the American people need to know why and under what conditions so many women, reportedly without their informed consent, were pushed to undergo this extremely invasive and life-altering procedure.” She also called attention to the neglect of COVID safety measures and proper treatment, and referred to “ICE’s egregious handling of the coronavirus pandemic, in light of reports of their refusal to test detainees including those who are symptomatic, the destruction of medical requests submitted by immigrants and the fabrication of medical records.”
Project South, one of the organizations filing the complaint, states that “ICDC (Irwin County Detention Center) has a long track record of human rights violations.”
For more details on this story and quotes from Dawn Wooten, see the article in The Intecept.
As ICU nurse Alex Duron learned, evangelical schools do not welcome gay students with open arms. After Union University accepted Duron into their graduate program for nurse anesthetists, he thought his next three years were mapped out. Unfortunately, his plans were thrown into disarray when the Jackson, Tennessee evangelical school found evidence that their new student was gay. University officials quickly rescinded Durin’s acceptance on the grounds that he was engaged in “sexually impure relationships.”
While there is some debate about whether a Title IX religious exemption allows schools to deny admission to homosexual students, Union University officials maintain that they have the right to deny admission to gay students. Union cited the school’s Community Values Statements on the “worth of an individual,” which asserts that “sexual relationships are designed by God to be expressed solely within a marriage between a man and a woman” (the statements also declare that “identifying oneself as a gender other than the gender assigned by God at birth is in opposition to the University’s community values”). Duron took issue with the decision, noting on Facebook, “Did you know that Union University is not a fully private school and accepts federal funding? Did you know that your taxes are allowing them to discriminate against LGBTQ+ and their allies?”
Duron signed the university Values statement when he applied, but he paid little heed to the fine print. He did not expect his fiancé to accompany him to Jackson, and in his view, being gay and in a committed relationship would have no bearing on his campus life. He had not been questioned about his sexual preference during the admissions process, but apparently school officials discovered Duron’s fiancé in his LinkedIn profile. Although he had not mentioned his fiancé, the school expressed concern about possible cohabitation when they emailed him about their decision: “Your request for graduate housing and your social media profile, including your intent to live with your partner, indicates your unwillingness to abide by the commitment you made in signing this statement.”
Duron’s prospects have improved since he went public. In an interview with Buzzfeed News, he said he had “dodged a bullet” by not attending Union;s grad program, and after hearing about his story, nursing schools around the country have been contacting him to see if they can find a way to grant him admission this fall.
While the disproportionate impact of COVID-19 on Black and Hispanic Americans is no secret, the National Institutes of Health (NIH) “All of Us” project has launched a study of the disparity that they hope will better prepare the country for the next great epidemic.
The NIH began the ambitious “All of Us” research project in 2018 with the goal of enrolling at least a million people in the world’s most diverse health database. Officials saw it as an antidote to medical research that traditionally has skewed heavily white, well-off and male.
Amid a wavering federal response that has allowed staggering levels of disease to sweep the country, the NIH program is a potential bright spot. About 350,000 people have consented to be part of the project, and more than 270,000 of them have shared their electronic health records and submitted blood or DNA samples. Of the latter, more than half are members of minority groups, and 81% are from traditionally underrepresented groups in terms of socioeconomic background, sexual identity or other categories, according to NIH.
NIH researchers are trying to get a better sense of how socioeconomic factors like income, family structure, diet and access to health care affect COVID infections and outcomes. The hope is to come up with insights that will better prepare the country, especially its Black and Hispanic communities, for the next pandemic.
The participants’ blood and DNA samples, and access to their electronic health records, offer researchers a trove of data about the pandemic’s effect on minorities. As part of the program, NIH has promised to return research results to all participants in plain language.
In a sense, “All of Us was designed for COVID-19,” said Hugo Campos, a program participant and ambassador who lives in Oakland, California. “If we can’t deliver value to participants now, we might as well just forget it.”
The NIH constructed All of Us with the expectation “that something like COVID-19 could come,” said Josh Denny, the project’s chief executive officer.
All of Us, started by NIH Director Francis Collins under President Barack Obama, aims to answer questions that will allow health care to be tailored to individuals based on their unique genetics, environmental exposures, socioeconomics and other determinants of health. Now, scientists are tapping into its database to ask how factors like isolation, mental health, insurance coverage and work status affect COVID-19 infections and outcomes.
The first NIH study employing the database, already underway, will conduct antibody testing on the blood of at least 10,000 program volunteers, starting with those who joined most recently and going back in time to determine when COVID-19 entered the U.S.
Beginning in early May, All of Us has distributed monthly surveys to participants, via email or text, inquiring about stress levels associated with social distancing, work habits and environments, mask-wearing and hand-washing. It’s also asking whether participants have had COVID-19 symptoms or have been tested, and includes queries about insurance coverage, drug use and mental health status.
Another study will provide researchers with de-identified data, including antibody test results and digital health information, to study whether symptoms vary among people who have tested positive for COVID-19 depending on their ethnicity, socioeconomic status and other categories.
Federal data shows that Black seniors have been four times as likely, and Latino seniors twice as likely, to be hospitalized with COVID-19 as white seniors. It’s understood that structural racism and socioeconomic differences contribute to this gap, but All of Us hopes to help pinpoint reasons and potential solutions.
The minorities who’ve experienced the poorest COVID-19 outcomes are well represented in the All of Us research cohort, said Denny. “We will really be able to layer a number of kinds of information on what’s happening to different populations and try to drive at some of that ‘Why?’ Are there genetic differences, differences in prior medical history, timing of testing?”
One of the precepts of All of Us is to share the results of its studies with participants as well as involve them in study designs. NIH hired leaders of churches, community organizations and other grassroots groups to spread the word on the program.
The largely Spanish-speaking clientele at San Ysidro Health, a federally qualified health center based in San Diego, has been eager to participate in the COVID-19 research, said Fatima Muñoz, the health system’s director of research and health promotion. Most of the All of Us participants she helped recruit prefer in-person interactions, but they are adapting to the pandemic’s online requirements, she said.
“There is historically a well-founded mistrust amongst some diverse populations and communities of color in biomedical research,” said Denny. “We can’t control history but can try to engage authentically going forward.”
The Black Lives Matter protest movement has pushed the program’s leaders to do more for its diverse participants, Denny said.
“It’s caused us to think more of how we can promote diversity in researchers, which had not been as much of a focus,” he said. “It has heightened some of the urgency and importance of what we’re doing. It’s a great call to action.”
The All of Us program is funded with $1.5 billion over 10 years through the 21st Century Cures Act of 2016. Denny said he expects results from the antibody testing, an $850,000 project that was contracted out to Quest Diagnostics, to be published this year, with insights from the surveys published after that.
The All of Us database provides unparalleled access to information on research groups whose level of harm by the virus would have been hard to predict, said Dr. Elizabeth Cohn, a professor of nursing at Hunter College in New York. Cohn is a community engagement lead for All of Us and chairs its publications committee.
“This is the demonstration of why we built this platform,” said Cohn. “This is a big moment for All of Us because this is what it was built to do.”
The pandemic has made it even clearer why it’s necessary to have a multicultural base for health research, said Dr. Randall Morgan, executive director of the W. Montague Cobb/National Medical Association Health Institute, an All of Us partner.
“When we get to 1 million, we hope to still have that level of representation,” he said.
Published courtesy ofKHN (Kaiser Health News), a nonprofit news service covering health issues. KHN is an editorially independent program of KFF (Kaiser Family Foundation), which is not affiliated with Kaiser Permanente.
From Boston to San Bernardino, California, communities across the U.S. are declaring racism a public health crisis.
Fueled by the COVID-19 pandemic’s disproportionate impact on communities of color, as well as the killing of George Floyd in the custody of Minneapolis police, cities and counties are calling for more funding for health care and other public services, sometimes at the expense of the police budget.
It’s unclear whether the public health crisis declarations, which are mostly symbolic, will result in more money for programs that address health disparities rooted in racism. But officials in a few communities that made the declaration last year say it helped them anticipate the COVID-19 pandemic. Some say the new perspective could expand the role of public health officials in local government, especially when it comes to reducing police brutality against Black and Latino residents.
The declarations provide officials a chance to decide “whether they are or are not going to be the chief health strategists in their community,” said Dr. Georges Benjamin, executive director of the American Public Health Association.
“I’ve had a firm view [that] what hurts people or kills people is mine,” said Benjamin, a former state health officer in Maryland. “I may not have the authority to change it all by myself, but by being proactive, I can do something about that.”
While public health officials have long recognized the impact of racial disparities on health, the surge of public support for the Black Lives Matter movement is spurring calls to move from talk to financial action.
In Boston, Mayor Martin J. Walsh declared racism a public health crisis on June 12 and a few days later submitted a budget that transferred 20% of the Boston Police Department’s overtime budget — $12 million — to services like public and mental health, housing and homelessness programs. The budget must be approved by the City Council.
In California, the San Bernardino County board on Tuesday unanimously adopted a resolution declaring racism a public health crisis. The board was spurred by a community coalition that is pushing mental health and substance abuse treatment as alternatives to incarceration. The coalition wants to remove police from schools and reduce the use of a gang database they say is flawed and unfairly affects the Black community.
Those localities follow in the footsteps of Milwaukee County, Wisconsin, which last year became the first jurisdiction in the country to declare racism a public health crisis, citing infant and maternal mortality rates among Blacks. The county’s focus on the issue primed officials to look for racial disparities in COVID-19, said Nicole Brookshire, executive director of the county’s Office on African American Affairs.
Milwaukee County was training employees in racial equity and had launched a long-term plan to reduce disparities in health when the pandemic hit. “It was right on our radar to know that having critical pieces of data would help shape what the story was,” said Brookshire.
She credits this focus for the county’s speedy publication of information showing that Black residents were becoming infected with and dying of COVID-19 at disproportionate rates.
Using data to tell the story of racial disparities “was ingrained” in staff, she said.
On March 27, the county launched an online dashboard containing race and ethnicity data for COVID-19 cases and began to reach out to minority communities with culturally relevant messaging about stay-at-home and social distancing measures. Los Angeles County and New York City did not publish their first racial disparity data until nearly two weeks later.
Declaring racism a public health crisis could motivate health officials to demand a seat at the table when municipalities make policing decisions, and eventually lead to greater spending on services for minorities, some public health experts say.
The public is pressuring officials to acknowledge that racism shortens lives, said Natalia Linos, executive director of Harvard’s Center for Health and Human Rights. Police are 2½ times as likely to kill a Black man as a white man, and research has shown that such deaths have ripple effects on mental health in the wider Black community, she said.
“Police brutality is racism and it kills immediately,” Linos said. “But racism also kills quietly and insidiously in terms of the higher rates of infant mortality, maternal mortality and higher rates of chronic diseases.”
The public health declarations, while symbolic, could help governments see policing in a new light, Linos said. If they treated police-involved killings the way they did COVID-19, health departments would get an automatic notification every time someone died in custody, she said. Currently, no official database tracks these deaths, although news outlets like The Washington Post and The Guardian do.
Reliable data would allow local governments to examine how many homeless or mentally ill people would be better served by social or public health workers than armed police, said Linos.
“Even symbolic declarations are important, especially if they’re accurately capturing public opinion,” said Linos, who is running to represent the 4th Congressional District of Massachusetts on a platform of health and equity. “They’re important for communities to feel like they’re being listened to, and they’re important as a way to begin conversations around budgeting and concrete steps.”
Derrell Slaughter, a district commissioner in Ingham County, Michigan, said he hopes his county’s declaration will lead to more funding for social and mental health as opposed to additional policing. Slaughter and his colleagues are attempting to create an advisory committee, with community participation, to make budget and policy recommendations to that end, he said.
Columbus City Council members coincidentally declared racism a public health crisis on May 25, the day Floyd died in Minneapolis. Four months earlier, the mayor had asked health commissioner Dr. Mysheika Roberts for recommendations to address health issues that stem from racism.
The recent protests against police brutality have made Roberts realize that public health officials need to take part in discussions about crowd control tactics like tear gas, pepper spray and wooden bullets, she said. However, she has reservations about giving the appearance that her office sanctions their use.
“That definitely is one of the cons,” she said, “but I think it’s better than not being there at all.”
Published courtesy ofKHN (Kaiser Health News) is a nonprofit news service covering health issues. It is an editorially independent program of KFF (Kaiser Family Foundation), which is not affiliated with Kaiser Permanente.