Thread by @ia4phs

1/n Before I begin today, I’d like to invite us all to mourn the #COVID19 Deaths. 233,792 Globally. 63,019 in the U.S. There are names and faces attached to these unsettling statistics and our shared humanity calls on us to grieve the loss of life. Please add a candle below.🕯

2/n During the #COVID19 pandemic, it's important to be grounded in this notion of shared humanity. It will help us as we ask the questions, Who's dying and why? Hopefully, this will lead us to more nuanced responses that critically examine these deaths 'in context'.

3/n In the U.S., we must contend with the fact, that the #COVID19 pandemic is unfolding within the context of a society steeped in interlocking systems of racism leading to the disproportionate impact among Blacks and other marginalized racial groups. #RacismNotRace

4/n This is why colleagues and I co-wrote an IAPHS blog, to lay out with extreme clarity, how racism would operate during the #COVID19 pandemic. S/O to @zinzinator, @DrChandraFord, @Dr_S_Jefferson, and others for putting collective scholarship in practice. iaphs.org/racism-in-the-…

We wrote, "While #COVID19 is indiscriminate in its transmission, its propagation within a society steeped in structural racism will undoubtedly, as we are already beginning to see, lead to disproportionate impacts among marginalized racial groups in this country." #RacismNotRace

5/n I have found the website below extremely thorough in documenting racial inequities in #COVID19 deaths. #RacismNotRace

COVID-19 deaths analyzed by race and ethnicity — APM Research Lab apmresearchlab.org/covid/deaths-b…

6/n In the blog, we outline several ways #Racism is operating:
1) Access to Testing & Treatment
2) Structural Constraints to Prevention
3) Discrimination in Healthcare
4) Residential Segregation
5) Mass Incarceration

These all intersect and lead to the disproportionate impact.

7/n Framing the disproportionate impact of #COVID19 using a structural racism lens is so critical because it dictates the actions we take. Without the proper diagnosis, we won't develop the proper solutions. More on this later... #RacismNotRace

8/n Now a word on disaggregated #COVID19 data by race (and other factors). It's critical that we collect this data uniformly because we can't address what we can't 'see'. Krieger et al. have an excellent piece on this in @Health_Affairs healthaffairs.org/do/10.1377/hbl…

9/n "Grounded in concerns both for population health overall and health equity... we assert the time is now for the #COVID19 public health surveillance system to record and publicly share the critical data needed to protect the people’s health and prevent health inequities."

10/n It's important to note that there are issues related to data collection on race:
1) Data are not Complete
2) Data are not Collected Uniformly
3) Not All Localities (states, cities) are Collecting Data on Race

11/n And not all marginalized groups are being captured in the #COVID19 data by race. For example, Native Americans are often included in the 'other' category, rendering this group invisible during the pandemic. Again, we can't address what we don't 'see'. Data is critical.

12/n But not only data by race, other factors like gender, income, geography (e.g. zip code). This allows us to examine intersections of marginalization. Data linked to zip codes is particularly relevant because we can examine structural drivers like residential segregation.

13/n In a @nytimes article from early April, I noted that the history of redlining and residential segregation is critical to our understanding of the impact of #COVID19 in Blacks echoing the sentiments of many colleagues in the field. #RacismNotRace
google.com/amp/s/www.nyti…

14/n And to reiterate, we don't need this disaggregated data on #COVID19 simply for our own intellectual curiosity or just just for research. We need to be able to mobilize data for ACTION, both in the short term and the long term. More on this later today.

15/n In the meantime, drop any helpful resources on #Racism and #COVID19 in the comments below 👇🏽

16/n Wrapping up today with a call to action. @uche_blackstock and colleagues have an insightful blog in @healthaffairs about 'The Harm of A Colorblind Allocation of Scarce Resources'. bit.ly/2VK76g7

17/n @UREssein and colleagues also have great insights to share in @JAMAHealthForum about expanding Medicaid and other safety net programs during this time.

18/n My colleagues and I also shared insights in our blog: "Efforts to mitigate the effects of the #COVID19 pandemic must work in tandem with our ongoing commitment to dismantling the structural and institutional drivers of health inequity that existed before this crisis..."

19/n "We have an ethical and moral responsibility to harness our collective strength, speak truth to power, and demand that racial equity and social justice be central to our response to this pandemic and beyond..."

End/n "...The stakes are too high to sit on the sidelines. This is a matter of life and death and we must all act accordingly." 

I hope we all rise to the call. The times in which we live demand it and our very lives depend on it. ✊🏾🔥 #RacismNotRace #BlackEpiMatters