[Lace Watkins]

https://laceonrace.com/2021/05/16/redlining-in-the-time-of-the-pandemic/

 

Redlining In The Time Of The Pandemic

Discussion

[Vicki van den Eikhof]

Cross-posted on FB: I live in an area considered “rural” by the government. We have three mass vaccination sites set up by the county. The locations make sense geographically, but not necessarily in terms of population density or disease burden. The closest one is 15 minutes from my house if I drive (56 minutes by bus, according to my app). I was able to get my first shot there, but the second one I had get at a different place that was at least 35 minutes away (one hour and 18 minutes by bus). The clinics will close on June 4. I’m just hoping to have my family finished with their vaccines by then so I don’t have to figure out how to get the second doses through a completely different system. I can’t imagine what anyone will do who doesn’t have access to the internet, or know how to navigate to the correct info about how to get vaccinated. It seems like it’s changed several times and it was frustrating to me-and I’m pretty tech savvy and really trying to follow along…

One thing that really stood out to me was the number of Black women manning these mass vaccination sites. When I went for my first shot, I was wondering if every Black woman who lived in our county worked in public health. There just aren’t a lot of them here in the first place-for many of the reasons you described in your OP. Many of the homes in my town have deeds that restrict ownership to white people. When I talked to the woman who gave me my shot (a Black woman from Florida), she said that most of the people there were travelling nurses-paid to go around the country for a few weeks at a time to do these clinics. She has two teenaged daughters that she left at home with grandparents so she could do this. I thanked her for making such a sacrifice. She said she wanted to teach her daughters the importance of public health.

So much weighed on me from the experience. Does my county have enough local personnel to run clinics like these? How did we manage to get three clinics set up with travelling nurses from all over the country, many of whom are Black, to make sure my county-which is mostly white-can be vaccinated? Have the people in Florida (and elsewhere) been vaccinated already? Are there people who are going unvaccinated because the nurses left where they lived and came to get me vaccinated? Or maybe they came from very populated areas, where they had plenty of nurses, so they weren’t needed like they are here? I do know they get paid well for their work, so that made me feel a little better. What would have happened if we couldn’t pay for travelling nurses to come man these clinics?

I can see how redlining with real estate leads directly to imbalances in health care. Sitting with all of these experiences and questions has been unsettling, but I don’t know that they would have even crossed my mind prior to joining this community.

[Rebecca McClinton]

I, too, live in a predominately white neighborhood. I wonder if in a way the reason white rural areas have had to solicit outside supports is evidence of how far removed those communities are from the labors of people of color. I’ll see if I can explain better what I’m thinking. For example, if white people were purchasing food straight from the laborers (namely of color) who grew, packaged, trucked and distributed their food, rather than buying packaged food off the shelf. The pandemic has shown who those true laborers are, in ways, and at whose expense and cost we benefit.

[Vicki van den Eikhof]

I think you’re on to something. Over time, I think we have become pretty removed in many cases from the labor (and laborers) that provide the abundant lives we live now.

The area I live in is sooo ridiculously expensive that I can’t imagine anyone without two income streams from white collar jobs even being able to rent, much less buy, a house. (I am lucky we bought our house over 20 years ago and could get help from family members for the down payment.)

It has bothered me for a long time that we feel contrained to outsource so much of the “essential” work that needs doing-from cooking and cleaning to caring for the young and old, to growing food. If it is so essential, we don’t treat it as such. Outsourcing this essential work to people we try to pay as little as possible only goes to show that we never valued the work in the first place, and certainly don’t value the people who do it. Cutting out the corporate interference seems like a great place to start. Shopping at farmers markets-if I can get to one, growing my own food-if I can, bartering and trading.

This is also reflected in the fact that rural areas don’t have enough doctors or healthcare facilities-precisely because they won’t be profitable with such a small population. Profits before people.

[Shara Cody]

I’m glad you shared this about nurses travelling to administer vaccines who were mostly Black women which connects to Lace’s original post. When I go for my vaccine I’ll look for who is doing this work to see if it also aligns with your experiences and if it doesn’t, I’ll still be looking for the ways it does or does not align with the North Star.

[Deleted User]

The City of Long Beach created 4 mobile vaccine vans, that went to neighborhoods that were known to be higher risk: i.e. older, disabled, un or under-employed and absolutely yes, much larger populations of POC – the redlining effect lives on.

The vans went to card clubs, senior centers, public parks, churches, and shopping centers in those areas of Long Beach, to offer vaccines to underserved populations. The idea was to bring the vaccine to neighborhoods where those citizens would have a much harder time accessing the shots. Long Beach has the advantage of having their own City Health Department, one of only three in the State of CA. – the other two are in Pasadena, and in Berkeley CA. <font face=”inherit” style=”font-family: inherit; font-size: inherit;”>If one could find a way to get </font>the<font face=”inherit” style=”font-family: inherit; font-size: inherit;”> Long Beach Arena in </font>Downtown<font face=”inherit” style=”font-family: inherit; font-size: inherit;”> LB, (yes, via bus, Blue Line, or a ride from a friend, or family member) walk up appointment were available to the general public, 6 days a week (Saturdays), for both drive up and walk up. Long Beach is a city of just under half a million, but served other close by cities as well, including Lakewood, Bellflower, Cerritos, </font>Hawaiian<font face=”inherit” style=”font-family: inherit; font-size: inherit;”> Gardens, Signal Hill, Compton, Harbor City, Torrance, and North Orange County.</font>

<font face=”inherit”> Another thought would be dial-a-ride, which would only work for those qualified for the service. Ride-sharing apps like Uber require a mobile phone and internet access, both expensive so economic privilege and resource access issues there. The effects of redlining are long lasting and continue to impact Black and Brown folks in every city and town in America. Public Health like so many other </font>entities<font face=”inherit”> meant to serve the American Public – </font>schools, libraries, medical clinics, grocery stores, etc. is under the heel of the same racist, sexist, xenophobic boot as many other agencies, dedicated to serving the public good. The Public Good. There’s a concept. Who is the public? Where are they, and how do we serve the most at risk amongst our public? You are trying pull back the curtain to show us the cracks in the system. It’s heartbreaking to see how far we have to go, to create a just and equitable society.

I saw a meme the other day, that asks, what if we were to fund our education systems with the same zeal as police agencies? I don’t know a teacher who couldn’t use more of everything, including and most of all- time with each of their students, to really give them the full benefit of all they learned in their credential programs. Class size. Paperwork. Meetings. Special needs kids (every kids is special and has needs – but those kids with unique learning challenges). On top of that grading, being available to parents, creating lesson plans…that’s just a short list. <font face=”inherit”>We created the Ca. lottery to better fund our schools. I </font>haven’t<font face=”inherit”> tracked on that…but I </font>don’t<font face=”inherit”> imagine those funds have ended up going to all the schools that truly needed it. More redlining. </font>

[Rebecca McClinton]

your comment reminded me that my spouse was telling me today that uber and lyft are providing free rides to vaccinations. I went to check it out to find out more. One think that comes to mind is that it’s difficult to request an uber or lyft without internet access/wifi, and certainly without a phone. Uber offered this help people get vaccinated, particularly “communities of color that have been disproportionately hurt by the pandemic,” it said in one article I found. This sounds encouraging, but I wonder how they are addressing those other barriers (internet, phone). I also noticed that it says it covers only $15 worth of the trip, so for folks further out that also becomes a barrier.

[Emily Holzknecht]

Also I am thinking in terms of the Uber/Lyft that a lot of people probably don’t want to get into another person’s car with them without being vaccinated first.

[Emily Holzknecht]

And also I’ve read that Black and brown people have had some pretty horrible racist experiences in Ubers/Lyfts.

[Rebecca McClinton]

For a long while in my county the place for COVID testing that had the most appointments accessible was located outside of the main municipality, a good (minimum) 40-50 min bus ride outside of town in a smaller town (that not ironically also was visit by our previous potus on his campaign trails). How they expected anyone to travel out there (while feeling sick and possibly contagious) to get tested was beyond me. It was clearly only suited for those with reliable transportation, and the time to take out of their day for travel. Worse yet, during the pandemic bus services have been cut in half (that means from places in the county where housing is cheaper, there might be two buses a day instead of a steady stream of busses…in other areas, none), with amount of riders limited to 12 for social distancing.

Vaccine locations have been more accessible and a few weeks ago our county started in-home, visiting vaccination services for those who can’t leave their homes or have other barriers to getting to a vaccination clinic. We’ve also locally had vaccination clinics show up on site to our homeless shelters, low income housing sites, and at grocery stores for workers. I’m not sure how that’s being handled down south in the larger metropolitan locations in the greater Seattle area. While those vaccine accessibilities exist now, they didn’t early on in the vaccination processes. It was assumed people had cars, could wait in their cars, could travel long distances, or had the ability to stand in lines to receive them (hmmm…sounds like voter restriction policies as well as the real estate, and health care barriers Lace mentioned).

To personalize, in my day job I work with folks who have insurance from medicaid and medicare, and again and again I see ways they are ‘stuck with’ the often inadequate services offered them. Too often, individuals who are marginalized have to fight to get the bare basic services (eg: getting a med refill on time, being able to see providers in a timely manner rather than months and months of waiting) that those of us with more privilege can do with more ease and much less advocacy. I will continue to advocate and speak out against these disparities and use the influence I have to work to make those changes.

[Shara Cody]

Thank you for reminding me to research COVID testing site accessibility in my area. There is only one in each main township and you can go to the drop in clinic or schedule an appt by phone or online. The clinics can be accessed by bus and there doesn’t seem to be any restrictions on the number of passengers due to COVID. I think time and missing out on paid time specifically seems to be the barrier for Black and brown people in my province but the province implemented a leave fund for those who do not have paid sick leave as part of their job for getting vaccinated, isolating, or illness due to COVID. This leave fund was only put in place March 1, 2021 which is a year later than it should have been and is related to not acting quickly to support those most in need.

[Julia Tayler]

It does seem like after the initial surge there were more places to get the vaccination. It seemed to take a while to get CVS and others in our area on board. We also had the in-home vaccination services but it took a lot of follow up and flexibility in your schedule to take advantage of that service. They didn’t want to give out exact times when they would be there until the day before and as far as I know (in our community) it was a M-F 8a-5p deal.

[Julie Helwege]

I am woefully uneducated on this topic, and I realize quickly reading Lace’s words and research, that’s intentional and part and parcel of the system and white supremacy soup that benefits me.

My healthcare coverage at work provides $5 virtual visits and an on-site health clinic – guess who’s my primary physician? The doctor on staff there.

The on-site clinic covers all my basic healthcare needs; I was even able to be prescribed my anxiety medication and get my annual gyno exam there, if I so choose. I have no co-pay when I visit the clinic and it’s easy to make an appointment and get in quickly. Every employee has access to the free vaccination right now. I rarely have to see a doctor outside of the clinic.

I took public transportation in college to get to work and most of the time I caught a ride with a friend. I have always had a vehicle outside of that, and my bus ride to work was a straight shot requiring no coordination or multiple changes – just had to be at the station a few minutes from my house on time.

I had to go to the ER today and had multiple choices. I could afford the $250 co-pay; I cringe knowing why I only had to wait three minutes to be admitted.

I couldn’t tell you who our top medical providers are in Tulsa, and it’s 7 minutes from my house to my work office, where my primary care physician awaits. Most days, I’m at work and take the elevator down to the floor for my appointment.

The system, by design, fosters and encourages me to be woefully uneducated. To remain unaffected. To bask in comfort and assumption that this experience is similar elsewhere.

While continuing to harm anyone without my privilege and access (I’ve been harmful and unsafe in my silence and my choices).

Because of LoR, I’m involved locally and paying attention to disparity issues all around me, including healthcare. I’m plugged in and contributing financially in a direct way and to those organizations that are pursuing racial equity initiatives in healthcare. I’m listening, believing, following and amplifying Black and brown voices.

I still have a long way to go and there is much work to be done. Leaning into a lot of discomfort and even some shame right now.

I’m re-committing to further education on Tulsa specifically and getting further plugged in. My walking continues.

[Julia Tayler]

I was woefully uneducated too. I did some research just to be able to comment and was very surprised how uneducated I truly was. It turns out my state is/was known as the Mississippi of the West. I’m going to research some more but yelp.

[Christina Sonas]

My county is directly operating two vaccination sites in majority Black/brown areas. There is a walk-up site at a high school in east Oakland, near Fruitvale Station, that is served by three bus lines with a short walk, and two more lines with a longer walk. This is the area where the county’s Black residents are concentrated. There is another set up at the Hayward Adult School, also a short walk from multiple bus lines; this is where working class brown families live, mostly Latinx. The Oakland site is an actual bus stop on one of the lines; the Hayward site is not, so some walking is necessary. Both sites are only open Thu-Sat during the day. The county has also adjusted its paratransit eligibility so that more people can use paratransit to get vaccination sites.

The county’s Black and Latinx populations have the lowest vaccination rates, though: 34% fully vaccinated, another 12% with the first dose. The overall rates are 56% fully, another 18% first dose. The mortality rate is 2x whites for Black people and almost 5x whites for Latinx.

My county is one of the most progressive in the state, but even here, arrangements that look supportive do not result in medical equity. The county had to open these two clinics because there are no private medical sites they could partner with, and what we do after the fact, with vaccinations, does nothing to soothe the families whose loved ones were killed by covid. Redlining of real estate is simply a more overt example of the relentless sidelining of Black and brown people in USAn society.

[Christin Spoolstra]

I’m reminded of a mission trip (that as an adult I understand was super problematic) I went on in Jr High to Nashville. The one day I think was least problematic we were sent out to experience the injustice around access. My group was tasked with going to the office to apply for food stamps. First, we had to walk to the public library to use the computer to look up the location of the office. It was then a 20 block walk only to get there and he told us that service had been moved to a office on the side of town near the library where we had started. Imagine doing that on your one day off with kids in tow and food for your family on the line.

What I learned in Nashville lace is reinforcing for me here. Not only that redlining services is complex and interwoven through multiple sectors and that it is intentional. I’ve been thinking lately on the culture in which I was raised which was all about that Protestant work ethic and how that linked to being “deserving.” What that culture led me to believe for too many years is that poverty is a choice and/or a failing. I allowed it to cover my eyes to all this redlining and how it was designed to make it easier for me and harder for bipoc. These systems need to be broken down and rebuilt in equity. Just as my inner beliefs have had to undergo reconstruction

[Emily Holzknecht]

*crossposted*

My first thought reading this is how I’ve heard several conversations so far with people looking for where their older teen can get the vaccine without having to wait for a text from the state giving them an appointment and the answer in all those conversations has been that vaccines are available at any CVS. I don’t know if that is accurate, but what I want to focus on here is that this information of get vaccinated at CVS is given with what I believe is a strong belief that everyone lives close to a CVS. I realize that I believed that too because these conversations sounded perfectly reasonable to me. Reading this post, I realized that that might not be the case. New Mexico is largely rural, so how many CVSs are there? Additionally where are the CVSs in the city located? CVS doesn’t sound like a business that would care about being located in white areas. Looking at Google Maps I count 10 CVSs that could be considered to be in the greater city area though not all within the city limits. Half of them are pretty close to where I live. I mean, there is one like 2 blocks away from me, but the other four are all clustered together with maybe 4 miles between each one. There is one CVS near one of upscale areas of town and the other 4 are on the outskirts. There are no CVSs in the areas of the city that people talk about as being the poor/Black/brown areas of the city. In most cases one would have to cross a freeway to get to a CVS from the poorer areas or possibly cross a river and a major road (though not quite a freeway) to get to a CVS. This is a city of over 900,000 people. Talking about CVS like it is a convenient place to get the vaccine, convenient for everyone, is misleading. Looking at the store hours for Albuquerque, only one on the outskirts of town is a 24 hour location. The others range from 8-10 or 9-7 open hours.

Looking at the CVS website, it is possible that there are 22 CVSs in the state. I am phrasing it that way because the CVS site lists two additional CVS locations in Albuquerque that have closed. I did not include those in the 22 total, but I don’t know if the other ones around the state are open for business or not. With only 12 locations outside my city for the rest of the state, there’s no way that CVS is an easy way to access the vaccine for everyone in New Mexico.

[Shara Cody]

The province I live in is very small (probably close to the size of the many of the counties others are considering here) and there’s a vaccination site operated by the government in each township as well as at least one pharmacy in each place. I reviewed the locations and generally access is good including the most populated areas having more sites with coverage by bus. The redlining where I live still exists by Black and brown people living mainly in the downtown area where the waits are probably longest to get a vaccine appointment followed by unpaid time or lack of time off to attend a vaccine appointment. I’ve never used the bus system which didn’t even exist until fairly recently to support students. You had to have a car to live here or live downtown and walk everywhere- this is still largely true and is a barrier for Black and brown and other marginalized people.

Beyond the vaccination program, medical redlining exists here despite everyone having universal health care in the form of shortages of doctors. In an almost completely white province, Black and brown people disproportionality are the ones without an assigned doctor forcing them to have to take extra time to go to clinics (check hours, get there early to get on the list, wait forever to be seen) and not affording them the, what I think is better quality care, from seeing the same doctor over time.

*cross posted*

[Vicki van den Eikhof]

Sounds like maybe you are in Canada…

I would love to have a universal healthcare system here in the US, but I can’t let myself think that somehow it would solve underlying causes of health disparities. Thanks for the necessary insight.

[Rhonda Freeman]

On a positive note, I was at the local mall in Tyson’s Corner Virginia, fairly diverse and on the metro and bus line. There was a free walk-up vaccination clinic in one of the anchor store locations. Diverse line of people there when I was there. Encouraging.

Negative note: I am participating in the Johnson and Johnson double dose trial. To participate in my area, you have to go to a clinic in a suburban area with no public transportation. This is, as far as I am concerned, a tragedy and it skews the results of the study.

[Emily Holzknecht]

Thank you for sharing the johnson and johnson trial info. When we talk about medical racism, if the study of the vaccine is done on people who have the time and transport to go to the site, then the results will be skewed, but it will be approved for everyone without knowing how it affects people who don’t have the time and transport who could tend to have different health needs.

[Jen Scaggs]

In the large city near where I live we have very limited public transportation, and with COVID many routes have been closed or reduced, so that makes it even worse. I honestly don’t know a lot of about the vaccination clinics in the city because I live in a small rural area about 40 minutes away and we have our own clinics out here (of course our clinics are all drive through clinics and we have absolutely no public transportation or taxi services in our town, so those without transportation couldn’t go to our clinics anyway). I do know many friends in the city struggled to get vaccination appointments as they were initially rolling out, and you could only get them by making appointments online, checking at exactly the right time and refreshing often. People without internet access, or who don’t have the luxury of working a desk job where they can take care of personal matters when they need to would have a very difficult time making a vaccination appointment.

As far as other medical care, we are sorely lacking hospital facilities in the poorer areas of the city. All of the newer, fancy hospitals are built in the suburbs. There is one hospital facility where a friend works that is in horrible shape, poor ventilation systems have been a problem, especially during COVID, and of course it is in one of the poorest areas of town and there are no plans to improve it.

[Grace Bannerman]

After an initial search, I found little information about redlining in Canada, which would make sense if people who benefited from it are in power. (Though there is a documented history of white settlers taking First Nations and Inuit land and severely restricting where and how they could live). Sources about my city acknowledged that Black or racialized residents and recent immigrants tended to live in certain neighbourhoods at different times, but was silent on why that was the case. Some of these neighbourhoods are no longer home to that concentration of Black or racialized residents, apparently in some cases because the land was taken and buildings demolished to make way for public buildings. The lack of historical and present documentation and research on race and housing access in Canada is disappointing. This is where I have to be aware of the biases of the sources that are available to me, continue to look for more information and think critically about what sources I seek out.

Currently, neighbourhoods with proportionally more Black residents have worse access to transit and fewer hospitals and grocery stores. There have been more COVID cases in those areas. However, some vaccines have been prioritized to hot spot postal codes (though designation as a “hot spot” hasn’t always been transparent) and there have been vaccination clinics and events held in those areas at a range of times, with some areas having relatively high uptake compared to other neighbourhoods. There are some organizations working to provide transportation to vaccination for very small groups of people (elderly or immunocompromised people or people with accessibility needs). Vaccinations relative to the number of cases suggests that areas with lower cases are proportionally more vaccinated, though.

These are just some of the ways discriminatory policy can harm Black residents, and some of the social determinants of health known to be inequitably distributed. I appreciated this prompt to learn more about local history and current issues.

[Julia Tayler]

As time went on the options here got better. In the beginning you had to have internet access to even make an appointment and all of them were between 9am and 5pm. It was problematic for a lot of the population. I did some research, thanks to Lace, about my county. 39% of the COVID cases in our county were people who are Hispanic and 3% were Black. Our population is about 25% Hispanic and 3% Black. The main place to get vaccinated, before CVS, Safeway etc. was a 35-45 bus ride for most people. One way. Which doesn’t include waiting for the bus and how the route system is set up. Our public transportation system is lacking. We really are a automobile driven county.

When I did a further search regarding redlining I found that the CC&R’s that Lace talked about are alive and well here and that the legislature just (2019!!) passed a law making the CC&R’s void. Wow! I need to educate myself and keep walking. Welp.

[Author]

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