The number of black and African-American Mainers who have tested positive for COVID-19 nearly doubled for the second consecutive week, increasing the urgency for state officials to confront deep-rooted health care disparities being exposed nationwide during the coronavirus pandemic.
But at the same time, leaders in Maine worry about focusing too much on the disparity. In one of the nation’s whitest states, officials and immigrant community leaders say providing too many details about infections could lead to harassment and further stigmatization of the state’s small immigrant and minority communities.
“These concerns weigh heavily on me,” Dr. Nirav Shah, director of the Maine Center for Disease Control and Prevention, said in a phone interview.
Maine became the last state in New England to post statewide COVID-19 case data by race and ethnicity on April 29 and updates it weekly. However, it remains the only state in the region not reporting deaths by race and ethnicity and one of the few not disclosing hospitalizations that way. Officials here don’t release race and ethnicity data of positive tests by county, either.
“We have been trying to walk a very difficult tightrope,” Shah said. “Given the small numbers overall of the members of the minority, new Mainer and immigrant populations, we have been trying to balance putting out data of that nature with inadvertently revealing who they are or alternatively revealing or implicating their minority subgroup.”
Shah and advocates such as the American Civil Liberties Union of Maine and Maine Equal Justice, a nonprofit that advocates for solutions to poverty, health care, inequality and other issues, say the disparity stems from less access to health care and paid sick time for minority groups, coupled with the fact that people in these groups often work in jobs that require face-to-face contact, such as convenience store clerks and direct care workers, or higher-risk environments like manufacturing or food processing plants.
“In light of this growing disparity, our leaders at every level have a responsibility to ensure access to life-saving measures like testing, personal protective equipment and adequate health care for those who need it most,” ACLU of Maine Executive Director Alison Beyea said in a written statement. “Officials must do more to craft a response to the coronavirus that protects all people.”
Nationally, blacks/African Americans and whites each account for nearly 39 percent of hospitalizations, according to U.S. Centers for Disease Control data. However, blacks and African Americans account for only 13.4 percent of the population, whereas whites account for 76.5 percent of the population.
As of Wednesday, 140 black and African-American Mainers had tested positive for the virus, an increase of 67 cases from the previous week. They now account for 9.2 percent of Maine’s cases, despite being only 1.6 percent of the state’s population. That rate increases to 11.8 percent of the cases in which race is known, since 331 people (nearly 22 percent) declined to provide that information.
The disparity is greater in Maine than in other New England states. Blacks and African Americans account for 1.4 percent of the population in New Hampshire and Vermont, but account for 5.4 percent and 2.3 percent of those states’ respective caseloads. In Massachusetts, blacks and African Americans account for 8.6 percent of the total caseload and 8.9 percent of the population.
Most of Maine’s COVID-19 cases – 980 as of Wednesday – are among whites, who make up 94.6 percent of the state’s population.
Despite there being far more cases among white Mainers than black and African Americans, Shah and immigrant leaders are worried that stigma and harassment will grow if case counts continue to rise.
Shah said an epidemiologist investigating the outbreak at the Tyson Foods poultry processing plant in Portland relayed concerns from some of the workers Thursday. The plant has a history of employing immigrants, but Shah would not say how many of the 51 employees infected at the plant were blacks and African Americans.
“One person was denied entry into a store, because he was wearing something that identified them as a member of this (immigrant) community,” Shah said. “Another report was from an African individual who was ostracized.”
Mufalo Chitam, director of the Portland nonprofit Maine Immigrant Rights Coalition, said other immigrants who are being called back to work feel like they’re being singled out. One individual was told that if they they had COVID-19 not to come to work, she said, suggesting that some employers are more fearful of immigrants spreading the disease.
“In a small state like this, if it starts becoming clear there are more people of color getting infected, that’s creating some fear when they see people of color,” Chitam said. “That’s is our long-term concern. We don’t want to see these numbers go up. When they go up they begin creating this stigma of one group.”
Shah said the state has moved aggressively to confront the disparity, including expanding access to testing at facilities known to care for people of color, such as Greater Portland Community Health, which received the state’s first rapid testing machine. More testing would help officials contain transmission by identifying and isolating people with the disease.
Shah said health officials remain in close contact with immigrant community leaders, so they can advise community members about the importance of seeking health care when they’re not feeling well.
Because many refugees and asylum seekers escaped violence and persecution in their homelands, many are inherently distrustful of government. Shah said officials are working with community leaders to allay those concerns, so they will share information with officials and get the help they need.
Shah said other agencies within the Department of Health and Human Services are working to meet other socioeconomic needs, including ensuring that those who are sick have safe housing and access to food while they quarantine or isolate themselves. But Shah concedes it’s not enough, saying he plans to continue meeting with immigrant leaders and health care providers.
Maine Equal Justice Partners is advocating for the expansion of MaineCare, the state’s Medicaid program, to include everyone regardless of immigration status, as a way to increase health care access for minority groups.
Spokespeople for Gov. Janet Mills did not respond to an email Thursday or Friday about whether the governor supported this proposal, or if she was working on any other plans to address this disparity.
Kathy Kilrain del Rio, Maine Equal Justice’s director of campaigns and health care advocacy, called on state leaders to work more closely with minority communities to address the disparities. She said it’s important that these groups have a strong social safety net and better protections for low-wage workers who don’t have access to paid sick time or health care.
Some immigrant leaders want the state to expand its definition of congregate housing — which includes nursing homes, homeless shelters, assisted living facilities and group homes — to cover public housing complexes, so more aggressive testing can take place in those settings, Chitam said.
She’d also like to see the state hire immigrant contact tracers, because they are familiar with their communities, speak the languages and are familiar with customs.
Chitam said immigrant leaders are ready to help – as they did last summer when she and others helped feed, house and care for hundreds of asylum seekers who had arrived unexpectedly in Maine and were temporarily housed at the Portland Expo.
“We know our community better – we serve them,” she said. “We want to be part of the solution. We did it during the Expo and we can do it now.”
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