Inmates, Covid, Healthcare and The African American

African American Prisoners/Healthcare for COVID-19

I am invisible, understand, simply because people refuse to see me. Like the bodiless heads you see sometimes in circus sideshows, it is as though I have been surrounded by mirrors of hard, distorting glass. When they approach me they see only my surroundings, themselves or figments of their imagination, indeed, everything and anything except me. Ralph Ellison, Invisible Man (1952)

A Personal Story

I think there are great deal of folk that have had the experience of have a male family member incarcerated only to find out that they were not the same young man they knew before the incarceration.  I don’t know that we all can identify when trying to reconnect that not only are they different, but we too have evolved this makes for strange bedfellows.  Personally, I have interacted with a family member only to find myself more frustrated at the behavior of said individual than realizing he is different.  I don’t know what it is like to be incarcerate (in jail) albeit I have my own struggles where I voluntarily opted for incarceration metaphorically.  Non-the-less, I don’t know what it’s like to wake up in the same cage day after day, week after week, month after month, year after year and/or decade after decade.  I haven’t got a clue what it must be like to be controlled i.e. told what to wear, when to get up when to lay down, when I can shower, when I can a make a phone call.  I don’t know what  it’s like to be locked up with nothing but men/women without any freedoms that you and I take for granted on any given day.  I don’t know why the history of Black men has positioned a person to fall into the category of inmate, jail bird, or felon.  I’ve heard the idea that the construction of prisons were/are constructed based on 3rd grade scores – Experts often cite third grade as a decisive year for students and schools. In fact, there is common folklore that asserts that public officials will forecast prison construction based on a state’s third-grade literacy rates.   An article in The Atlantic called this phenomenon “An Urban Myth That Should Be True.” The article goes on to say, “U.S. prison planners don’t use local third-grade reading scores to predict future inmate populations. But maybe they should.” This is a two topic writing on the healthcare of the inmate and that of the Black American and Covid-19.

The persistent and pervasive notion of African American male criminality which was injected into the American consciousness during the post Reconstruction period persists steadfastly today in the United States. It is a driving force behind the nation ’ s post-1970 mass incarceration binge for which economically disadvantaged Black males are the primary victims. It also serves as fuel for insensitive comments, unwarranted surveillance, and other microaggressions such as those now in the media glare. Few African American males, regardless of their achievement, social standing or economic status, are immune to the stress associated with these subtle forms of hostility

Healthcare and the Inmate

Imprisonment, homicide, non-lethal assault and other crime, chronic and infectious disease, substance abuse, suicide, and accidents all contribute to the much wider gap in the community-level sex ratios found among African Americans compared to those observed found among other ethnic and racial groups in the United States. This wide array of causes and correlates of African American male mortality, disability, and confinement suggests that one area in need of interdisciplinary inquiry that examines the intersection between public health and public safety. These lines of inquiry must situate and contextualize the lived experiences of the African American male. Health analysts and social scientists across many disciplines have all studied African Americans and their communities extensively over the past decades because this population has disproportionately high levels of disease, disability, premature death, and exposure to the criminal justice system.

A large body of research has documented black, white disparities in health and mortality in the United States ( Adler & Rehkopf, 2008 ; Frisbie, Song, Powers, & Street, 2004 ; Geruso, 2012 ; Pampel, Krueger, & Denney, 2010 ; Williams & Jackson, 2005 ; Williams & Mohammed, 2009 ). Racial differences in socioeconomic status (e.g., income, education) largely account for these gaps with individual and institutional discrimination, residential segregation, and bias in healthcare settings also explaining some of the variation in black, white disparities (Braveman et al., 2011 ; Williams, 1999 ; Williams & Jackson, 2005 ).

Afro-American Healthcare & COVID-19

Speaking of the disparities in health care among Blacks and Whites brings me to another topic – Covid-19.  As most people in the world are now acutely aware, an outbreak of COVID-19 was detected in mainland China in December of 2019.  Coronaviruses are a family of viruses that can cause mild to moderate upper-respiratory tract illnesses such as the common cold, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).  When an infected person coughs or sneezes, the new coronavirus may be transmitted through expelled droplets. These droplets can enter a person’s system through “contact routes,” such as the mouth, eyes, or nose. It is also possible for the droplets to be inhaled into the lungs.

The concept of COVID-19 hit the news airways like the plague.  Folk ran out and emptied the grocery story of every roll of tissue paper, alcohol and contamination cleaning products.  Addictions rose, folks died, both individuals and establishments lost their lives, and the country was shut down.  This would cause the sanest person to question the reason for living. 

Statistical data document that African Americans have a worse health profile and higher rate of death than White Americans for practically every illness. Broader surveys of self-assessed health using a comparative framework have found that African Americans are nearly twice as likely as White Americans to rate their health as “fair” or “poor,” and twice as likely as White Americans to rate their health as “fair” or “poor,” and that self-rated health is a strong predictor of sickness and early death (Bratter and Gorman, 2011).  Middle-class African Americans have a better health profile than their less affluent counterparts, but many report serious health challenges as common in their families.

Much like the prisoner many Black Americans suffer the same inequalities of healthcare whether locked up or free.  With that said how will Black Americans come out as the victor during these turbulent times?

What We Know

Black communities share common social and economic factors, already in place before the pandemic, that increase their risk for COVID-19. Those factors include:

  • Living in crowded housing conditions. “Crowded living conditions are a difficult challenge that is the result of longstanding racial residential segregation and prior redlining policies,” Golden says. “It is difficult for 10 individuals living in a three-room apartment to appropriately physical distance.” She says advocacy on these broader policy issues could help prevent future disparities in disease outcomes.
  • Working in essential fields. Golden notes that people working in environmental services, food services, the transportation sector and home health care cannot work from home. These positions put workers in close contact with others.
  • Inconsistent access to health care due to lack of insurance or underinsurance. Being able to afford doctors’ visits, medications and equipment to manage chronic disease is essential to lowering the risk of death from COVID-19 and other conditions. For instance, a patient with badly controlled diabetes or asthma due to inconsistent treatment is more at risk for severe, even deadly, coronavirus infection.
  • Chronic health conditions. Golden points out that people of color have a higher burden of chronic health conditions associated with a poor outcome from COVID-19, including diabetes, heart disease and lung disease. In a study cited by the U.S. Centers for Disease Control and Prevention (CDC), about 90% of those hospitalized with severe COVID-19 had at least one of these underlying medical conditions.
  • Stress and immunity. Studies have proved that stress has a physiological effect on the body’s ability to defend itself against disease. Income inequality, discrimination, violence and institutional racism contribute to chronic stress in people of color that can wear down immunity, making them more vulnerable to infectious disease.

Distrust

Why is that the Black American holds on to memories of years gone by when it comes to their health.  The now infamous Tuskegee Syphilis study is perhaps the most widely known study exclusive to African Americans males.  Yet in present day the number of references to this experiment in conjunction with the COVID-19 vaccine are astronomical.  African  Americans  have  experienced  something  that others have not: the unique combination  of racism, slavery and segregation. It has caused African  Americans to develop  not  only  different  behavioral patterns, values, and beliefs but also different  definitions, standards, and  differences  in  value  systems  and  perspectives(Randall,  1996). Distrust  of  the health  care  system  by African  Americans  runs  from  the  feelings  or  ill  gains for  participation  in clinical trials to being used  only as guinea  pigs. In addition,  there  are feelings  by  African Americans  whether  the physician,   intentional   or not,  do  treat  minority  patients  differently  than  White patients  (Lake,  Snell,  Perry,  & Associates  2004).  If that is true then the reluctance to take the vaccine is valid.  Additionally many Americans feel that the vaccine was rushed and not enough due diligence has been put forth.

The Fight for the #Vaccine

This is like something from a movie…more than half a dozen doctors and nurses at New York area hospitals said they were upset at how the vaccine was being distributed at their institutions. They described what had happened to The New York Times but asked that their names not be used because hospitals have shown a willingness to fire or punish employees for speaking to the news media during the pandemic.

At some major hospitals in Manhattan, doctors and nurses have recalled scrolling through social media and pausing to make a snap judgment each time they saw a selfie one of their colleagues had posted of getting vaccinated: Did that person deserve to be vaccinated before they were?

“We feel disrespected and underappreciated due to our second-tier priority for vaccination,” a group of anesthesiologists at Mount Sinai Hospital wrote to administrators over the weekend.

Health care workers said rumors were proliferating in WhatsApp groups and amid the banter of the operating room. Stories have begun to circulate of a plastic surgeon who managed to get vaccinated early, of doses being thrown out at one Manhattan hospital because of poor planning. On group chats, doctors debate how — and whether to — try to get vaccinated ahead of schedule.

At Mount Sinai Hospital, some doctors told others that you could talk your way into receiving a vaccine just by getting in line and repeating that you do “COVID-related procedures,” one Mount Sinai doctor, who requested anonymity for fear of retribution, recalled.

A Coronavirus Story

Will Stone


More than 300,000 people have died from COVID-19 in the United States.

It is the latest sign of a generational tragedy — one still unfolding in every corner of the country — that leaves in its wake an expanse of grief that cannot be captured in a string of statistics.

The numbers do not reflect that these were people. Everyone lost was a father or a mother, they had kids, they had family, they left people behind.

There is no analogue in recent U.S history to the scale of death brought on by the coronavirus, which now runs unchecked in countless towns, cities and states.

We’re seeing some of the most deadly days in American history.

During the past two weeks, COVID-19 was the leading cause of death in the U.S., outpacing even heart disease and cancer.

Yet the most deadly days of the pandemic may be to come, epidemiologists predict.

Some of those deaths could still be averted. If everyone simply began wearing face masks, more than 50,000 lives could be saved, IHME’s model shows. And physical distancing could make a difference too.

No other country has come close to the calamitous death toll in the U.S. And the disease has amplified entrenched inequalities. Blacks and Hispanics/Latinos are nearly three times more likely to die from COVID-19 than whites.

There’s evidence that socioeconomic factors, not underlying health problems, explain the disproportionate share of deaths. The disease, reveals the chronic neglect of Black and brown communities in this country.

Though the numbers are numbing, for bereaved families and for front-line workers who care for people in their dying moments, every life is precious.

Online Learning Cheat Sheet


 The ups and downs of the global economy have sent more learners back to school to retool or add credentials to their résumé. Additionally, we all have experienced the uncertainty of the COVID-19 pandemic. Online learning allows learners to address their professional development needs at a time and in a manner that may be more flexible with their lifestyles. To succeed online, you need a few basic technology skills and pointers on how to stay safe; you also need to evaluate online programs carefully, communicate clearly, and develop good study habits.

Prepare to Learn Online

You should have a few basic technology skills down pat before you enroll in any form of online learning, whether it’s a single online course for fun or a fully online bachelor’s degree program. Make sure you know how to

  • Attach a microphone and headset to your computer (or use what’s built in)
  • Create folders and subfolders on your computer’s hard drive or a flash drive to help facilitate organization of coursework
  • Open your preferred Internet browser and navigate to various websites
  • Open multiple browser windows, either in separate floating windows or in multiple tabs in a single window
  • Send and receive emails with attachments
  • Save and open attachments, including audio and video files
  • Download and install applications and application plugins

Stay Safe While Learning Online

Stories abound about the dangers of the Internet, but a few simple measures can go a long way toward ensuring that your online experience is safe and worry-free. Follow these guidelines:

  • Make payments for classes, books, and the like only at a secure site with https:// as the prefix.

    Create a single word processing or spreadsheet file where you keep all your login information. Save that file securely with a password. You then have to remember only one password rather than many.

  • Never tell your password(s) to anyone.
  • Don’t disclose your life story to classmates. Maintain some privacy.

    If you need to provide contact information to your instructor or peers when working on a group project, provide only information necessary to complete the project, such as your school email address and your mobile phone.

Questions to Ask as You Evaluate Online Programs

Many schools offer online courses, but not all schools are created the same. To help you decide where to apply, ask yourself these questions as you investigate online programs and their staffs:

    Is this school or program accredited (proven to meet academic standards by an agency approved by the U.S. Department of Education)?

  • Are the courses self-paced or instructor-led?
  • How many class hours (total time in hours) a week will each course take?
  • What is the student/faculty ratio?
  • What is the student retention rate?
  • Who are the faculty and what kind of training have they received?
  • When do classes begin?
  • What if I need to stop out (temporarily withdraw)?
  • Is financial aid available?

    What are the minimal technology requirements (hardware and software) for taking an online course at your institution?

    What are the minimal technology competencies a learner must have to take an online course at your institution?

    Will I be expected to be online at a specific time to conference with my instructor or classmates?

Communicate Clearly in Online Courses

Communication is vital in all forms of education, and online education is no exception. The following tips can help you communicate effectively online:

  • Get to the point. Succinct writing is valued.
  • Always reference other authors — use proper citation methods! Your instructor will tell you which specific method to use.
  • Don’t type in all caps. It’s like shouting.
  • Be aware that anything written can be misconstrued. Try to write as if your grandmother would read it — use polite and professional language without innuendos or sarcasm.
  • If you’re working on a group project, copy the instructor if you’re using email so that they know your group’s progress.
  • Don’t be afraid to use the phone. It’s okay to call the instructor if you have a question.
  • Don’t overpost in discussion forums. If your instructor asks for 2 posts, 4 is fine, but 14 is too many!
  • If possible, communicate special circumstances as soon as possible (family emergencies, vacations, and so forth), not after the fact.

A Few Habits of Successful Online Learners

Some of the most successful learners are those who learn self-discipline with respect to their study habits. The lack of pressure that comes with meeting face-to-face is absent in the online environment. Therefore, it’s important to heed the following suggestions for establishing good study habits for online learning:

  • Set a schedule for studying and log in frequently (daily, if possible).
  • Print the syllabus, instructor contact information, and course calendar on day one.
  • Read all rubrics (documents outlining assessment criteria for assignments) and guidelines carefully, and self-check before starting assignments and again before submitting them.
  • Find out how to use the library services for your institution. Seek credible resources for your work, and don’t just rely on Google or Wikipedia.
  • Double-check citations and references for accuracy. Avoid plagiarism!
  • Compose assignments in a word processor and save everything before transferring it to the online environment.
  • Actively participate and interact with your classmates and instructor. Don’t be a wallflower.

Source: By Susan Manning, Kevin E. Johnson

Labor Day and Covid-19

Hopefully, summer won’t end the way it began. Memorial Day celebrations helped set off a wave of coronavirus infections across much of the South and West. Gatherings around the Fourth of July seemed to keep those hot spots aflame.

And now Labor Day arrives as those regions are cooling off from COVID-19. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, warned Wednesday that Americans should be cautious to avoid another surge in infection rates. But travelers are also weary of staying home — and tourist destinations are starved for cash.

“Just getting away for an hour up the street and staying at a hotel is like a vacation, for real,” says Kimberly Michaels, who works for NASA in Huntsville, Alabama, and traveled to Nashville, Tennessee, with her boyfriend to celebrate his birthday last weekend.

Lifting Restrictions for Summer’s End

In time for the tail end of summer, many local governments are lifting restrictions to resuscitate tourism activity and rescue small businesses.

Nashville, for instance, gave the green light to pedal taverns this week, allowing the human-powered bars-on-wheels to take to the streets again. “They’re not Nashville’s favorite group, frankly. But fairness requires this protocol change to take place,” Mayor John Cooper said, noting the city’s dramatic reduction in new cases. This week, the city also raised the attendance cap on weddings, funerals and other ceremonies.

Elsewhere, Virginia Beach tried to get some leniency for its struggling restaurants over the holiday weekend. But Virginia Gov. Ralph Northam rejected pleas from the mayor, at the encouragement of Fauci. The country’s top health official has encouraged governors to keep restrictions in place to avoid another holiday-related surge.

“Sometimes, as we start to lift restrictions, the impression that people get is ‘Oh, that must mean it’s safe,’” says epidemiologist Melissa McPheeters of Vanderbilt University. “We want to make sure we don’t give that impression, because this disease has not gone anywhere.”

Some communities have gone the other direction and reimposed restrictions, especially for the three-day weekend. Santa Barbara, California, has banned sunbathing to avoid another surge in cases.

Schooling Screws Up COVID Circles

On a Sunday afternoon, out-of-towners walk the tourist district in Nashville, where many attractions have reopened — with restrictions. All dance floors are closed and restaurants and bars must close by 10:30 p.m.(Blake Farmer/WLPN)

There’s also a new X-factor with summer’s last holiday weekend. In many states, schools have resumed in-person classes. So families and friends meeting up are now more likely to expose each other to the virus, even if they tried to keep a tight circle over the summer.

“If those bubbles now have kids that went back to school and are interacting with others or they’ve gone back to sports and the bubble has since expanded, that ability to be safely together in a gathering is probably less likely,” says epidemiologist Bertha Hidalgo of the University of Alabama-Birmingham.

And yet, getting together safely — preferably outdoors — is still worth a try, Hidalgo says. She says people’s mental health needs a boost to get through the next few months.

“If you can do the safe things now before winter hits and that cold weather hits, then you’ll be more resilient to get through any bad times that may come,” she says.

In drivable destinations like Nashville that have welcomed visitors throughout the pandemic, tourism has not bounced back entirely. But on some weekend nights, the neon-soaked tourist district can draw a crowd.

Still, as time goes by, some travelers are willing to take more risks to get back to activities that feel normal.

 

Kaiser Health

COVID-19 Puts Medication #Abortion in the Spotlight

COVID-19 Puts Medication Abortion in the Spotlight

Only patients in a limited number of states have access to “no-test” medication abortions. During the COVID-19 crisis, 12 states issued policies that attempted to limit abortion access during the outbreak, such as deeming abortion “non-essential.” Most of these state policies have been blocked by court order or lifted as states start to re-open. In Arkansas, patients must have at least one negative COVID-19 Nucleic Acid Amplification Test (NAAT) test in the 48 hours prior to the procedure.

These new restrictions are in addition to existing barriers to abortion services. In 18 states, telemedicine abortion has been effectively prohibited; 5 states explicitly ban telemedicine for medication abortion, while 13 states require the prescribing clinician be physically present with the patient. The “no-test” model is also not an option in the 14 states requiring patients receive an ultrasound before an abortion, and in the 13 states with in-person counseling requirements. This leaves 23 states in which the “no-test” model could be used to provide medication abortion.

Medication abortion via telemedicine is a method that can be used to safely provide women with access to abortion care while social distancing, preserving personal protective equipment, and limiting risk of exposure to coronavirus.

A new telemedicine protocol –“no-test” medication abortions– has been developed in response to COVID-19. This approach, based on studies conducted outside the US demonstrating its safety, enables many patients to safely obtain abortions without needing in-person tests or exams. This approach, along with other telemedicine protocols, however, would not be available in many states because of state laws and policies that prohibit its use.  

Currently, in 23 states, providers could adopt this method to offer medication abortion because there are not laws or policies that prohibit its use. However, in other states, laws explicitly ban telemedicine abortions or make them impractical by requiring the prescribing clinician to be physically present with the patient, ultrasounds before abortions, or in-person counseling.