Photo by John Rodriguez

Inequality in America during COVID-19

Brunswick recently invited two experts—one on public health, the other on inclusive development—to share their insights.

As part of an ongoing effort to bring colleagues together to foster open conversations, Brunswick’s Inclusion & Diversity Committee organized a webinar on the effects coronavirus is having on vulnerable groups including women and communities of color. Experts speaking on that subject were Dr. April Clark, Senior Epidemiologist for BP, and Ms. Peggy Davis, Vice President of Community Impact from The Chicago Community Trust.

The webinar, held on June 3rd, was led by Brunswick’s Head of New York office, Maria Figueroa Küpçü, and April McFadden, an executive based in Chicago. Brunswick colleagues from around the US listened in and posed questions to Dr. Clark and Ms. Davis.

The conversation has been edited and condensed for clarity.

Maria Figueroa Küpçü: When we envisioned this conversation several weeks ago, we were well aware that the pandemic was exposing inequities and racism. But the death of George Floyd, and the ensuing protests over racial injustice, have added greater urgency to those issues. We’re having this conversation mindful of how they overlap and reinforce one another.

We’re talking to two people who are seeing this play out on the front lines, and who have been focused on this issue for quite some time. We know that the pandemic has been felt hardest in communities of color, among women, among people with lower levels of education. Sixty-one percent of Hispanic Americans say that they or someone in their household has directly experienced the job loss or wage reduction because of COVID-19; that goes for 44 percent of Black Americans and 38 percent of white Americans. A note that I read, actually, from The Chicago Community Trust—Peggy’s organization—was that George Floyd was, himself, out of work because of COVID-19.

We’re only starting to understand the magnitude of the impact of the experience that we have all been going through: how it has affected our health—both physical and mental—our economy; our cultural and democratic institutions. But whatever those are, they have been magnified in low-income communities.

That’s where our conversation today is focused: the community level. Because that’s where it’s happening, and that’s where systemic change will start. I think it’s important to begin that conversation by understanding the facts on the ground. Dr. Clark, from a public-health angle, can you tell us what you’re seeing?

Dr. April Clark: I’m sure everyone has been seeing the disturbing headlines about the experiences that minority communities are having with COVID-19. To cover some of the public-health literature and data that I review for BP, we can see that Black people and Hispanic people are being hospitalized more frequently and have higher mortality rates.

There have been various studies where we see that, even in younger age groups, there are more hospitalizations in those minority communities. If we look at children, Hispanic children are more likely to be hospitalized than white children. When we get into the higher age groups, 18 to 49, we see that Black people are more than twice as likely to be hospitalized. Early data from China suggested that older people were more at risk for contracting COVID-19 and being hospitalized. But here, we see that disparity is happening in a much younger population, which is extremely concerning.

When we look at who’s dying from the disease, we see that Black people are dying at twice the rate as white people. And it’s not just in that older population.

We are still behind in the US with collecting this type of data. From an epidemiological perspective, this is disturbing because we don’t know the full extent of this disease. And collecting that data is necessary to understand how this disease is impacting these communities. One of the risks associated with the disease would be co-morbidities. We know minorities are at greater risk for hypertension and heart disease. But again, that data aren’t being recorded.

Of course, this is a pandemic. All hands were on deck quickly. But now it’s time to gather that data, understand it, and make sure we’re acting on it.

 

Dr. April Clark, senior epidemiologist for BP.

I appreciate you both being on the call and sharing your expertise. My mother lives in an under-served community here in New York City. At first, she was denied care by her primary care doctor. And after she went to a clinic here to get an initial check-up, she received poor care, was misdiagnosed. Two weeks after that visit, she had pneumonia in over 75 percent of her lungs and wound up in hospital when COVID-19 was at its peak. The hospital was overrun with people. She got a test that was faulty. The person administering the test told her—while they were administering the test—that they didn't know how to administer the test. She was sent home after six hours. My mother is 73 years old, with pneumonia in both lungs, and they sent her home. So my siblings I scrambled to figure out how we can help. It was up and down, but she’s better now, after two months. But I wondered if you could speak a bit, Dr. Clark, to underserved communities and medical racism.
Dr. Clark: I'm horrified to hear that, and obviously glad she’s recovered. But sadly, I'm not surprised by your story. It’s one we see in underserved, minority communities across the country. I’m from the Mississippi Delta, and in my hometown there are maybe two or three primary-care physicians for about 20,000 people. My mother, a dean at a community college, still lives there. And she cannot get the help she needs, within a 70-mile radius, for high blood pressure. It’s just crazy.

There's so much data that shows disparities in outcomes in medical care based on race, ethnicity, socioeconomic status. It’s sadly not a new problem. Right now, for instance, Black women are three times more likely to die from pregnancy or childbirth-related causes—and that's across a broad spectrum of socioeconomic statuses. I have a two-year-old. And I was so nervous about giving birth because of the alarming rates of Black women dying in childbirth. And again, it cuts across all income levels. If you’re not familiar with Serena Williams’ story, she almost died after giving birth. She had to really advocate for herself, she was ignored at first by her nurses and doctors when she said something wasn’t right, that she was worried about her history of blood clots. It’s not just about the quality of care you receive, there are cultural, social components. And until we close those gaps that Peggy was discussing, I don't know that we'll get improved outcomes.

I’ve had a number of conversations with colleagues in recent days over the injustice we’re seeing on the streets of Minneapolis, but also about the racial and ethnic disparities that we’re seeing with respect to the COVID-19 outbreak and how it’s affecting different communities around the country. I’d appreciate your take, Ms. Davis, on how a firm like Brunswick could potentially take action—in addition to obviously having these really important conversations about this—to help close some of these gaps.

Ms. Davis: First, let me take a step back and say we, at the Trust, believe that we’re in the unique position to bring parties together to have these kinds of conversations. And to move to action from them. We are at a number of tables with the public- and private-sector that are interested in addressing these issues. So we do take that responsibility. Also, in terms of sharing and generating information, we think that is going to be a critical role going forward.

And we feel like we’re part of the group that should be responsible for making sure that happens. With respect to examples of corporations that are working in communities effectively, I would raise up JPMorgan Chase. And I’m familiar with it because we’re at a lot of the same tables.

So they’ve made a huge commitment to Chicago. And in particular, to inclusive growth in communities in Chicago. They dedicated $40 million to it. But the fact is they are working with organizations on the ground, with other community partners, with key organizations to understand what’s going on and to understand how they might be helpful. And they’ve been a great partner in terms of building up affordable housing, supporting small businesses, all of those things that are aligned with our strategies and that we think will lead to closing the racial and ethnic wealth gap.

I hold them up as a great example. They’ve been a great partner. Obviously it depends how involved you can be. Pre-pandemic, a number of employers were part of Apprentice 2020, which looked to provide opportunities for people who they had typically overlooked—opportunities to get in the organization and to also climb.

Dr. Clark, I’m sure you’re getting calls from colleagues, from friends, asking: “When is it safe for us to get back?” What are you telling them?
Dr. Clark: First and foremost we look at the safety aspect, and then weigh it alongside the business rationale. We’re looking at the data around the world, but I’ll just take the U.S. There were questions recently about opening up our office in San Diego, for example.

And you’ve probably seen the job California has done on containing the virus—making sure that businesses were shut down long enough, having enough hospital beds and ventilators, employing contact tracing. So San Diego’s incidence rates per 1,000 people have been reduced drastically. Now, outbreaks should be largely containable with proper tracing. Still, we obviously can’t be 100 percent certain about what will happen, and we need to follow safety procedures and cleaning protocols, but we know the healthcare system in that city could handle these cases if they happen. And so that is an informed a decision to open up.

But when you add the layer of protests across major cities, that impacts our businesses going back to work. We have a number of conversations—led by senior leadership—recognizing that African Americans are in a different space right now with everything that’s going on, being disproportionately affected by COVID-19, the demonstrations that are happening around the world. There are just so many elements to that question.

Ms. Peggy Davis, Vice President of Community Impact at the Chicago Community Trust

Ms. Davis, this question may be for you. Recovery is now not just about coming back from a global pandemic, but also from the demonstrations. How can we make reopening an accessible and equitable process for everyone—so that not only the downtown sector in Chicago is taken care of, but also the communities that have seen impact from the recent demonstrations? And also, I’d appreciate your thoughts on how we can sustain this momentum and discussions we’re seeing today, rather than allowing them to fade and died down?
Ms. Davis: That’s the million-dollar question. How do we build back in a way that signals real change? I know we’ve heard from community organizers that that’s their concern. That this is just going to be a moment and then once we get past it, people are going to move on to the next thing.

To me, one clear challenge is that we got here because of bad policies. Those need to change in order for things to be different. Business has an important voice in those. As I said, at the beginning: these inequalities, the segregation, it costs our region money. It costs our businesses money.

We should care about that. Businesses should care. To me, it’s taking the time to understand what the issues are, taking the time to understand how these inequities impact the region. And then being outspoken about it. And making sure that we were walking the walk as we ask others to do the same. Making sure our business reflects these values that we’re talking about and asking others to join us in supporting. That’s part of it.

We’re working with the Urban Institute and Brookings right now to gather information and data about what it would take to rebuild equitably. And that will be a phased project. The first one is going to be about what we’re hearing, the top-line messages we can look to in terms of rebuilding. But as time goes on, we’ll be doing a deeper dive in the areas to make sure that what we’re doing and what we’re supporting leads to that equitable recovery.

You’ve heard it before, but we all have a role in making sure that we sustain our focus. Regardless of the reaction that we get, regardless of the disinterest that may set in over time, we can choose to stay focused on it. That’s the only way things are going to change.

It’s been amazing to see the solidarity at the demonstrations, but there are concerns about how they might spread COVID-19. Not just the with crowds of people, but with police using irritants that make you cough or touch your eyes. Knowing that this could inflict under-served communities even harder, what can be done to minimize that?

Dr. Clark: One way to mitigate the effects would be to increase testing and access to testing. The US didn’t have that early on and paid a price for it.

As I research testing sites and centers around Houston, I see that testing is a bit easier now. You don’t have to have symptoms in order to be tested, which is important. And you don’t have to wait five days for results. If you are fortunate enough to have insurance, your insurance covers the testing. People need to have that information. And I’m not sure people in Houston—or in cities around the country—have enough information about testing, how to get it, how it works with insurance, things like that.

As you look ahead, whether that’s six months, a year, what concerns do you have that you’ll be watching closely? And on the flip side, what’s an opportunity we could all engage differently with?

Dr. Clark: For me, it’s around how we speak to communities of color and minorities, those more at risk for severe outcomes from COVID-19. Being able to discuss the risks of this disease in a way that is not offensive and that people in these various communities can understand. I am also watching the space around testing and access to testing for all communities. Those tests need to be made available until we have a vaccine that is widely distributed.

Ms. Davis: The thing I’m concerned about touches on an earlier question. People have started using the phrase, “building back better.” Will we be able to maintain that focus?

What gives me hope is the younger generation. I was on a Zoom call with an African American colleague this morning, and he said so many white people have reached out to him to ask what they can do, what they should read, how they can be part of the solution rather than the problem. And my response to him was to keep that hope, that focus, alive for the next generation. Because that’s what it will take. It will take that long to bring about the kind of change that we’re talking about.

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Dr. April Clark is the senior epidemiologist for BP, where she oversees the company’s epidemiology and global health activities. She began her career at NASA’s Johnson Space Center.

Ms. Peggy Davis is Vice President of Community Impact at the Chicago Community Trust, which connects donors with non-profits to tackle the Chicago-region’s most pressing societal issues. Ms. Davis served as executive director for the Chicago Committee, a membership organization advancing racial and ethnic diversity in the legal profession. Among her prior roles, Ms. Davis served as General Counsel for the Metropolitan Pier and Exposition Authority in Chicago.