Tag Archives: minorities

COVID Slams Ethnic Minorities

As the COVID-19 vaccination program rolls out erratically across the US, research increasingly shows that health inequities underlying who gets infected will also affect who gets vaccinated.

In telling statistics reported by the CDC and KFF, people of color are more likely to be infected or hospitalized, and more likely to die from the coronavirus.

The numbers are stark.

Compared to whites, American Indians are 1.9 times more likely to be infected, African Americans nearly 3 times more likely to be hospitalized, and Latinx people 2.4 times more likely to die.

Asian Americans are the highest risk for hospitalization and death among any ethnic group. In San Francisco, it’s reported that  Asian Americans consistently account for nearly half of COVID-19 deaths.

It’s impossible to ignore the disproportionate toll of the pandemic on racial and ethnic minorities. Even though all communities are at risk for COVID-19, the socioeconomic status of people of color, and their occupations in frontline, essential and infrastructure jobs puts them at greater risk of exposure to the coronavirus.

For minority communities, it means that where you live and where you work shapes how the virus impacts your health, while inadequate access to healthcare makes you more vulnerable to its consequences.

“The pandemic has exposed the “underlying health disparities, social determinants of health, systemic inequalities and discrimination contribute to the disproportionate impact the virus has had on all communities of color,” said Adam Carbullido of AAPCHO, at an EMS press briefing on February 12, about health inequities in the pandemic.

Health advocates predicted that an inequitable distribution of vaccines was inevitable, given the high rates at which Blacks, Latinos and other ethnic groups were being infected and dying in each wave of the pandemic.

This is borne out by data from the Kaiser Family Foundation (KFF) which is tracking vaccine distribution. For example, fewer black people are getting vaccines despite a higher rate of COVID 19 cases. In Delaware only 6% of Blacks were vaccinated though 24% were infected, and in Louisiana, only 13% of Blacks received vaccines though 34% were infected, while in Mississippi, 38% of Blacks were infected but only 17% got the vaccine.

However, the lack of disaggregated racial data at the state and national level is hobbling equitable distribution of the COVID-19 vaccine, noted Dr. Daniel Turner-Lloveras of the Latino Coalition Against COVID-19. Currently only 20 US states are reporting racial data.

Given that it’s primarily Black and Latino workers in essential jobs,  it’s imperative to consider who’s at high risk when making decisions about reopening the economy, he added.

If we cannot quantify racial disparity in vaccine distribution, warned Lloveras, it will be difficult to develop interventions to ensure vaccines are given to those who need it most.

Health disparities between whites and people of color that are impacting vaccine distribution, are “gaps that have become chasms,” said Lloveras. The vaccine roll out “inherently prioritizes a population that is not reflective of the people who are disproportionately affected by the coronavirus”, added Virginia Hedrick, of the California Consortium for Urban Indian Health.

In American Indian country, inequitable vaccine distribution is merely a reflection of the historical trauma inflicted on indigenous communities that has negatively impacted their health and wellbeing over the long term, said Hedric resulting in the highest rates of diabetes, heart disease and substance use disorders. Its only because of advocacy that the Indian Health Service has a separate vaccine reserve allocated to urban and tribal Indian American communities.

Barriers to Better Health  & Vaccines

Several other factors create barriers to better health and getting a vaccine among people of color.

Ethnic minorities tend to live in densely populated areas which makes social distancing difficult, and often in multi generation family homes which put elders at risk. They may use public transportation which could expose them the virus, and lack health insurance or healthcare access.

Farmworkers and the elderly face similar barriers in the form of digital literacy, language barriers and internet access, said Lloveras.  With stay at home orders in place, telehealth depends on who has access to technology. He suggested providing Internet access hotspots and community classes on computer literacy to expand digital access for underserved minorities.

The lack of a robust public healthcare system requires that we provide the technology to help people see a doctor and register for vaccines.

In Asian communities, added Carbullido, patients of Asian descent report fear in getting help they need because of emotional trauma caused by racism and xenophobic attacks associated with the virus.

Yet, many ethnic minorities are reluctant to get their shot because they mistrust the government. Kaiser Family Foundation’s vaccine tracker data reports ‘fear of side effects” prevents people from obtaining the vaccine.

Lloveras proposed ‘a gigantic digital patient engagement project’ to address vaccine hesitancy to set the path to herd immunity and a semblance of normal life .

Missteps in California

Each state’s scramble to acquire and distribute vaccines signaled an unpreparedness for a public health crisis like the coronavirus, said Dr.David Carlyle, President and CEO of the Charles R. Drew University of Science and Medicine, calling California’s missteps in the pandemic a “failure of public policy.”

When MLK Community Hospital, a 130-bed facility at the epicenter of the pandemic in Los Angeles County tried to transfer its sickest patients to nearby tertiary hospitals for oxygenation, they were repeatedly refused because because their patients did not have health insurance. When the vaccine roll out flatlined mid-February, high volume vaccine centers (LA Forum, Dodgers Stadium) in LA county closed mid -February, because supplies of vaccine doses ran out. Commercial pharmacies placed vaccination sites in smaller, less diverse towns like Huntington Beach, Irvine and Newport Beach, while Los Angeles, a city of 8 million was allotted just one site.

“In my estimation we weren’t prepared for COVID 19.” Carlyle concluded.

A Robust Rescue Package

Given the lack of a robust public health system, panelists urged Congress to bolster the public health infrastructure with a bold COVID 19 rescue package for testing, treatment, vaccine distribution.

They called for increased investment in public health and community-based organizations (CBOs) that serve marginalized communities which have more chronic medical issues and higher risk factors for complications of COVID19.  CBOs are vital in reaching communities of color and other hard hit communities, by providing culturally and linguistically appropriate services where government and private institutions have fallen short. Supporting CBOs could mitigate the health inequities of the COVID19 crisis, said Carbullido.

The pandemic overwhelmed most healthcare systems which were not prepared or adequately funded creating crises like the MLKCH that Carlyle called “a  perfect example of the inhumanity of equities in healthcare.”

But “the pandemic has not created these inequities,” concluded Hedrick, “it’s simply highlighting them.”

More information is available at:
https://bit.ly/vaccines-race-data
https://ccuih.org/


Meera Kymal is the Contributing Editor at India Currents
Photo by Ivan Diaz on Unsplash

Silicon Valley’s Success Sits on Toxic ‘Superfund’ Sites

At the Front Door – a column on climate change in our lives

The Environmental Burdens on our Neighbors

Silicon Valley has been one of the greatest wealth generators in the United States. Yet this wealth has come at a price, one that hasn’t been shared equally amongst the residents of the Bay Area. The more ‘visual’ costs, such as skyrocketing rents and urban sprawl obscure the more subtle, but far more dangerous and long-terms costs right beneath our feet. Literally. The true cost of Silicon Valley’s success is in the ground you stand on. Santa Clara County is home to 23 superfund sites, the most of any county in the United States. If you live in the South Bay, you are never more than a short drive from one of these sites. If you live in Mountain View, Sunnyvale, or San Jose, you can probably walk to one.

A site gains a superfund status if it scores above a 28.5 or higher out of 100 on the EPA’s Hazard Ranking System, which is a measurement of the site’s threat to human health. Sites must reach a certain level of severity before they can be designated as a ‘superfund’, which lets the government to force the parties responsible to perform cleanups or reimburse the government for EPA-led cleanup. There are also hundreds of other toxic sites which don’t qualify as superfund sites which are scattered across Silicon Valley.

To understand where we are, we need to look at where we have been. Silicon Valley earned its name by hosting semiconductor and microprocessor companies such as Atari, Fairchild, Hewlett-Packard. These companies used a solvent called trichloroethylene (TCE) in their manufacturing process. TCE is now a known human carcinogen and can also cause birth defects. After use, the TCE was poured down drains or kept in storage tanks which subsequently leaded and contaminated local groundwater.  In some instance, the pollutants can re-emerge as vapor and result in ‘toxic plumes’ or ‘vapor intrusion zones’.

The environmental burden of these sites fallen unevenly upon the shoulders of people of color and the poor, as most sites “are predominantly situated in Mountain View and Sunnyvale, and Santa Clara County cities which are comprised of the highest percentage of low socioeconomic immigrants of color.” Unsurprisingly, the whiter cities of Palo Alto and Cupertino host far fewer sites.

I live in northern Sunnyvale and I can easily walk to half a dozen, three of which are collectively called the ‘Sunnyvale Triple-site’. The vapor intrusion zone from this site encompass 400 homes and four schools, including the majority-Latino San Miguel Elementary School. Polluted in the 1980, the site was only fully cleaned up in the last decade and is now closely monitored by authorities.

Superfund sites are not the only environmental legacy of the economic boom. Another is traffic, a problem which plagues most of the Bay area, and Highway 101 is the “area’s most toxic industrial belt, with contamination impacting air, water, and soil.”

It is not a coincidence that Highway 101 through the same areas of Sunnyvale, Mountain View, and San Jose which host the highest concentration of minorities (and superfund sites).

The highway also runs through East Palo Alto on its way to San Francisco. East Palo Alto is diverse city with 61%  of its residents identifying as Latino, 15.6% African American/Black, and 11% Asian. The median income in 2018 was $58,783, a far cry from the average of $137,000 in whiter neighboring Palo Alto. Children in East Palo Alto are 2.5 times more likely to suffer from asthma as children in the rest of San Mateo County, and life expectancy is 13 years shorter.

And East Palo Alto isn’t an exception but rather part of a trend, a paper published by researchers at Santa Clara University noted that,

“Environmental burdens are concentrated along transportation routes and industrial centers that represent Silicon Valley’s rapid development. Hispanic populations, people of color, and socially vulnerable populations…are more likely to be exposed to multiple environmental hazards than other groups.”

The term ‘environmental burdens’ doesn’t quite convey the truth that our neighbors who bear these ‘burden’ will be sicker and die sooner than our neighbors without such burdens.

I felt two things when I learned this: shocked and lucky. Shocked, because I had no idea of the history of pollution and injustice which underlay the success of Silicon Valley.  And lucky, because while traffic is annoying I don’t live in an area where I have to worry that car exhaust will damage my health or the health of my family. Nor do I have to decide between affordable housing and living in an area which could be exposed to toxic vapor plumes.

And now I feel determined, because I can do something to help my neighbors who do have to worry about these things. I can vote for people who take environmental issues seriously, and who support clean public transportation. I can advocate at the state and local level for our legislators to ensure that the benefits and burdens of success are distributed more equally. I can speak up because we are all part of this community, and it is my responsibility to help my neighbors.


Erin Zimmerman was trained as a Climate Reality Leader in 2019 by the Climate Reality Project, but has been active in the environmental movement for over a decade. Erin holds a PhD in Political Science from the University of Adelaide, where she focused on environmental degradation and its impacts on country and regional stability in Asia. She is currently the Chair of the Speakers’ Bureau of the Santa Clara Chapter of the Climate Reality Project  and an active member of the Legislative and Policy team.

Edited by Meera Kymal, Contributing Editor at India Currents.

Image by Hermina Olah Vass  @beautymakesasound

References
Fagone, J. and Dizikes, C. (2019). “SF’s Treasure Island, Poised for Building Boom, Escaped Listing as Superfund Site.” San Francisco Chronicle.
Greenaction. (2019). “East Palo Alto, California.” Greenaction.org.
Nieves, E. 2018. “The Superfund Sites of Silicon Valley.” The New York Times.
Pellow, D. N. & Park, L S-H. (2002). The Silicon Valley of Dreams: Environmental Injustice, Immigrant Workers, and the High-Tech Global Economy. NYU Press.
Rao, A. and Scaruffi, P. 2013. A History of Silicon Valley: The Greatest Creation of Wealth in the History of the Planet. Omniware Group.
Reilly, C. (2018). “Silicon Valley’s ‘Middle Class‘ Earns 7 Times US Average.www.cnet.com.
Schlossberg, T. 2019. “Silicon Valley is One of the Most Polluted Places in the Country.The Atlantic.
Siegel, L. (2015). “Building Trust at the Triple Site, Sunnyvale, California.” Center for Public Environmental Oversight.
Solof, L.E. (2014). “Bay Area Student Involvement in the Environmental and Food Justice Movements: A Narrative of Motivations, Experiences, and Community Impact.” Doctoral Dissertation. University of San Francisco; The Faculty of the School of Education.
Stewart, I. Bacon, C. Burke, W. (2014). “The Uneven Distribution of Environmental Burdens and Benefits in Silicon Valley’s Backyard.” Applied Geography. 55: 266-277.
Stock, S. Paredes, D. and S. Pham. 2014 (12 May). “Toxic Plumes: The Dark Side of Silicon Valley.NBC Bay Area.
Sustainable Silicon Valley. (2020).
United States Environmental Protection Agency. (2020). “What is a Superfund.

 

The Census? It’s Not Over Yet!

On October 13, the US Supreme Court granted an appeal from the Trump administration to halt Census2020 on Oct 31, in a shocking reversal that will end the count sooner than expected. An earlier injunction by a California District court had allowed an extension because of disruptions caused by the pandemic.

The decision left states and census advocates scrambling to meet an impossible December 31 deadline to review, process, tabulate and report census reapportionment and redistricting data.

This means that the Census Bureau has just six weeks – not six months – before delivering apportionment counts to the President.

What Will Happen
What’s likely to happen is that the final enumeration will be inaccurate. Historically hard to count populations -minorities, people of color, and marginalized communities – will be undercounted in the final tabulation.

That, in turn, will impact the distribution of resources – funding for roads, schools, hospitals, food assistance and health services – that vulnerable communities rely on. The consequences for marginalized communities are dire. The pandemic has already restricted their use of safety net resources, but an undercount will threaten their access to those resources for the next decade.

Pushback against the new ruling has been swift.

Justice Sotomayor, dissenting from the grant of stay, wrote that “The harms caused by rushing this year’s census count are irreparable. And respondents will suffer their lasting impact for at least the next 10 years.”

Civil rights advocates say it blatantly disrupts a census count that has been ten years in the making. They denounced the Trump Administration’s countless efforts to sabotage the census for political gain, calling the ruling a dismaying decision that “undermines American livelihoods as well as our democratic system.”

Census advocates echoed this view at a briefing hosted by The Leadership Conference on Civil & Human Rights and Ethnic Media Services on October 20.

“Everyone in America regardless of political affiliation or ethnicity, should be deeply troubled by the President’s attempt to undermine and misrepresent data from the 2020 Census,” said John Yang, President & Executive Director, Asian Americans Advancing Justice (AAJC).

Marc Morial, President and CEO of the National Urban League which spearheaded litigation against the Trump directives, called the Supreme Court a ‘willing co-conspirator’ that has “aided, abetted, facilitated” the administration’s effort to politically interfere with the census….and to cheat the American people of their constitutional right to representation.”

The Constitution is clear. It mandates that ‘all persons’ – not all citizens – must be included in the decennial census and in the apportionment count. Advocates at the briefing called Trump’s executive order an attempt to amend the US Constitution.

Impact of the Ruling
The ruling underscores historic attempts to erase undercounted communities from the census and ongoing efforts by the Administration to keep non-citizens off the decennial.

Up next is a Supreme Court hearing of a Trump directive that seeks to exclude non-citizens from the congressional apportionment. Earlier, a ruling by federal judges in New York found the executive order unlawful.

These legal challenges undermine the democratic process on which our country was founded, said panelists. A flawed count will affect apportionment – redistricting legislative districts based on newest population counts and redistributing seats to represent those districts in the House of Representatives. In undercounted areas, marginalized communities risk losing fair representation in government.

What’s at stake is the constitutional intent of the count.

How Census2020 played out
Census officials have planned Census2020 for ten years. When COVID19  hit, they outlined a timeline to ensure they would reach an accurate count during the pandemic.

The Bureau spent over $6.3 billion on a campaign to get the count out.  It bolstered partnerships with community organizations and civil rights groups at national and local levels to encourage participation in the census.

“The Administration’s refusal to let Census Bureau experts determine the best schedule for completing the count and reporting results really created enormous chaos and confusion in the field,” said Vanita Gupta, President and CEO of The Leadership Conference.

Census2020 is one of the largest decennials, but the run up to its final count has been buffeted by natural disasters and an unrelenting pandemic, making it the most difficult of enumerations.

“We have worked so hard to push our communities to participate in the census and tell them how it will benefit their lives,” said Yang, so rushing to transmit apportionment data to the President by December 31, completely undermines those efforts.

Minority communities will take the fall
Experts agreed that rushing the census will shortchange minority communities.

Historically, self-response rates from communities of color nationwide tend to be lower than non-Hispanic white and US self-response rates. Latinos, tribal areas, Blacks and swathes of Asian residents need more targeted outreach – “more door knocking enumeration” – which requires extra time.

Panelists called a Census Bureau statement that it had topped 99% completion rates ‘a myth’. That rate only refers to households on the address list, but do not indicate if all householders were included or completed the census forms. “Do not be fooled,” warned Morial, “if there was fake news, this is it!”

The perils of an undercount include overcrowding in schools and hospitals, and congestion on roads. It will put communities in a tough spot that will be hard to recover from. Hastily tabulated data will harm the nation, but that risk falls disproportionately on communities of color.

“Make no mistake about it. There has never been an accurate count of Latinos in a decennial,” said Arturo Vargas, CEO of NALEO, referring to historical interference that has denied Latino participation in the census, whether it was asking Latino immigrants to boycott the census, or barring their inclusion in it. “The odds are consistently against a census that fully includes all (almost 60 million) Latinos.”

Morial pointed out that “The Black population count was already in jeopardy from the start,” because African American communities have not even reached the national self-response rate of 68%.

In Indian country, that rate is 25% below the national average, said Kevin Allis, Leader of the National Congress of American Indians (NCAI), arguing that his community is invisible to the rest of the country. In 2010, Indian country suffered an undercount twice the national average.

Allis also pointed out that the federal government has a treaty and trust responsibility owed to tribal nations (covering infrastructure, health and education and economic development), in exchange for millions of acres that tribal nations ceded to the US for settlement. Chronic underfunding has created disparities in Indian country. A census that falls short, will further decimate the funding and representation promised in those treaties, warned Allis.

It’s not over yet
“It would be a mistake for anyone in the public or the media to think that the Census is over,” said Gupta. What is over is the data collection process from a 150 million housing units. In the next phase, the Bureau will process raw data to produce a count that accurately reflects every US community. Data will determine the distribution of real resources in neighborhoods.

It’s a massive and complex undertaking that needs time, says Census Bureau experts (the Gov. Accountability Office and the Commerce Department’s Inspector General).

Rushing the census will force the Bureau to cut corners and compress vital quality checks that could skew data and create errors, advised Gupta. “The ramifications will last decades.”

The data processing phase is crucial to ‘fill in the blanks’  added Vargas. Checks and remediation are needed to ensure that forms are complete, all household members included, and to fix erroneous and duplicate responses. It requires meaningful consultation with stakeholders to deal with disclosure avoidance systems and make sure nobody is left behind.

Flawed data will lead to flawed decisions that harm everyone, warned Allis.

It takes time to integrate quality indicators that measure and translate census data into accurate apportionment counts. If you erase people from the census, the domino effect at play will see federal programs and fair elections start to fall.

Political interference has reduced a six month process to two, and that will undermine the integrity of the count, so we need to “excise politics from the process,” urged Morial.

The Bottom Line
Without an extension, millions of people will be left out of the count. That includes people in rural and tribal lands, people of color, people with low incomes and people experiencing homelessness.

“In a lot of ways this has always been the Trump administration’s goal, from the failed citizenship question, to Trump’s unconstitutional memo to erase undocumented immigrants from the count. The administration has been trying over and over again to dictate who counts in this country,” stated Gupta.

Congress Must Act to Salvage the Census
There isn’t a clear roadmap ahead if the Census Bureau is forced to produce an inaccurate count.

Advocates at the briefing urged Congress to take immediate steps to reset the course of the census and stave off damage that could last the next ten years. They suggested the public put pressure on congressional delegations to free the census of political and partisan interference going forward.

The Leadership Conference has endorsed  a bipartisan bill to save the census, and asked Congress to push back the reporting deadlines by 120 days each – extending the reapportionment deadline from December 31 to April 1, 2021, and the redistricting deadline from April 1 to July 1, 2021.

“Congress has to set a clear path forward” Gupta added, because it is their constitutional responsibility to protect the integrity and accuracy of census data.

“Look. The decennial census sets a standard for data quality that must be preserved,” said Yang. “It should be something the US Census Bureau achieves without interference.”


Meera Kymal is a contributing editor at India Currents

Photocredit: Photopin

Who Gets Healthcare In The Pandemic?

“Where do you go for healthcare?” I asked a group of African American participants whom a local pastor had gathered together at a neighborhood church in inner city Dayton.

The year was 1990 and I was running community focus groups for a Wright State University School of Medicine pilot initiative to identify the healthcare needs and barriers among the city’s indigent population.

An elderly woman turned to me. “Honey,” she said, “I get into a tub of hot water and pray.”

I’m reminded of her response whenever the current healthcare crisis lays bare the inequities that continue to haunt the American healthcare system for communities of color.

The individuals in those community health focus groups of thirty years ago had no health care at all, a sobering fact that one participant drily summed up, saying, “You must be very dense to ask people in this community to describe their healthcare status.”

Many people in those inner-city communities, like the woman who sought relief in prayer, spoke of turning to religion, herbal teas or home remedies to find healing. When these failed, they went to local emergency rooms or trauma centers to find medical help.

It was clear from those conversations that those focus groups were the face of underserved minority communities who had little or no access to healthcare systems or providers. An unforgiving mix of financial insecurity and limited or no health insurance gave few if any, a chance at the healthcare services to which more privileged members of society had easier access.

But what quickly became evident, was that the community did not trust the healthcare system because they perceived the cultural bias within it.

“Everything boils down to economics,” said a participant. “Where the dollars are, is where the healthcare providers are.”

It appears that little has changed since then.

That cultural bias exists, said Dr. Tung Nguyen at an EMS media briefing on June 19, because, the ‘default position’ in the American healthcare system is that healthcare is designed to give medical attention to average, ‘default’ patients who happen to be primarily “white, English-speaking, employed and well educated.”

So, as a result of “building a public healthcare system that is based on a racist principle of what works for white people,” said Dr. Nguyen, minorities have paid a terrible price in the coronavirus crisis.

The pandemic has upended the health and lives of people everywhere, but in the US it has unmasked systemic inequities in the medical infrastructure that undermine how communities of color access their healthcare. Data  from the COVID-19 crisis is revealing the chasm between those who do and don’t get healthcare, and how race and ethnicity affects who survives or succumbs to the coronavirus.

Racial and ethnic disparities are “even more marked” in data examining COVID deaths, said Dr. Nguyen, a Professor of Medicine at the University of California (San Francisco). He was referring to a  Brookings Institute report which showed that Black and Hispanic/Latino people are experiencing some of the highest fatality rates from COVID-19, compared to white people.

Dr. Nguyen pointed out that in the age group 35 to 44,  “the risk of dying is ten times more for blacks and 8 times more for Latinx compared to non-Hispanic whites. For ages 75 to 84,  the risk is 4 times more for black and 2 times more for Latinx.”

The Brookings data also showed that among those aged 45-54, Black and Hispanic/Latino death rates are at least six times higher than for whites. In April, 70% of Louisiana’s COVID-19 fatalities were African American while in Michigan, Detroit’s primarily black tri-county area accounted for nearly 85% of the state’s COVID-19 deaths.

That trend was also confirmed by a recent CDC report showing that the coronavirus hurts racial and ethnic minority groups at higher rates across every age group.  The data shows that African Americans and Latinos are at increased risk of getting infected, being hospitalized, or dying from COVID-19. African Americans are 5 times more at risk, and Hispanic or Latino persons are 4  times more at risk from COVID19, than white persons.

The numbers don’t lie. Minority communities are getting hit hard and it’s time to reset the ‘default position’ in American healthcare.

America has approached public health the wrong way for years, argues Dr. Nguyen.  The healthcare infrastructure is wasteful.  Despite flaunting the most expensive healthcare system on the planet, a Commonwealth Fund study put the US at the bottom of 11 developed countries ranked on healthcare.

A John Hopkins report found that Americans spent more money ($9,892 per person) on healthcare but received a lower standard of care compared to other developed nations; ($ 7,919 per person in Switzerland) in 2016.

The US has the worst life expectancy among comparable countries. For example,, the United States ranks 29th in infant mortality and 26th for life expectancy, with an average life expectancy of 79 years among 35 OECD countries.

“The reason is that we spend money on the wrong things, and we are wasting money for the outcomes we get,” explains Dr. Nguyen.

Public health should focus instead on factors that contribute the most to low life expectancy, such as “ income equality, low levels of education, exposure to violence, along with other key determinants like employment, housing and food security, and climate change.”

“These are the proper topics for public health to work on in the future” he suggests.

Going back to normal after the pandemic will depend on making effective structural changes to the patchwork  US healthcare system. It will be a Herculean task to reinvent the healthcare infrastructure after the COVID19 crisis, but the future of American public health must ensure that race and ethnic disparities inform its outcomes.

By 2045, non-Hispanic whites will no longer be the majority, so spending money on the ‘wrong things’ and looking at health disparities as an afterthought “will not work as a path to the future,” Dr. Nguyen advised.

“My slogan for this is that there is no health quality without equality.” He recommends addressing the disparities in the healthcare system first to raise the quality of care.

He pointed out for example, that metrics for healthcare quality which look at disparities, only work when the metrics are broken down by race and ethnicity.

“So, if an average healthcare metric like “the number of people with hypertension who have blood pressure control,” is not broken down by race and ethnicity, it becomes meaningless because it only represents an average for everybody. In the future, national measures for quality will need to report it by race and ethnicity to have value.

The pandemic has exposed how racial and socio-economic disparities affect access to healthcare in 2020. If advances in medicine and healthcare practices in the last thirty years remain out of reach for every American, just as in1990, then the fragmented healthcare system is unfair and outdated. It’s certainly unworthy of the hefty price tag attached to it. The future health of Americans is in jeopardy unless we build a public healthcare system that switches the ‘default position’ of who gets healthcare, from white, to one that reflects the changing face of multi-ethnic America.

“As the saying goes, we shouldn’t waste a good crisis,” urges Dr. Nguyen. “Some good needs to come out of the pandemic.”

Meera Kymal is a contributing editor at India Currents


Photo by Adli Wahid on Unsplash

 

 

Draw The Lines That Shape Your Future

In 2018, Stephanie Hofeller, the estranged daughter of Republican strategist Thomas Hofeller, released files from her deceased father’s disk drives that eventually led to the Supreme Court decision to remove the controversial citizenship question from the Census.

The Hofeller files had a significant impact– they confirmed that politicians and political operatives were creating strategies to disenfranchise minority communities and manipulating redistricting laws to favor one race and one party.

Thomas Hofeller was credited with masterminding the 2001 and 2011 redistricting process for the Republican Party. He travelled the country wherever Republicans controlled the legislature and redistricting process, and rigged political maps to give Republicans an unfair advantage in winning elections and holding on to legislatures.

The citizenship question was born from Hofeller’s tactics to gerrymander voting districts in favor of the Republican party.

In Texas, Hofeller discovered that thousands of Latinos and minorities could be eliminated from the decennial by adding a citizenship question to the Census. In an unpublished study  he concluded that adding the citizenship question to the census would be ‘”advantageous to Republicans and Non-Hispanic Whites” when voting districts were redrawn.

Stephanie Hofeller shared this information with watchdog group Common Cause who added it to their legal fight challenging legislative maps her father had drawn for North Carolina. The information then made its way into lawsuits challenging the citizenship question at the Supreme Court, which eventually decided to axe the question from the Census altogether.

Political and gerrymandering schemes like these deter vulnerable minority communities from participating in the census, warned Kathy Feng of Common Cause in a briefing organized by Ethnic Media Services. She emphasized that politicians could exploit redistricting to skew power in their favor, making it increasingly important to ‘advocate vociferously’ for everyone to be counted in the census.

Feng urged communities to get involved in the redistricting process to increase their voting power and ability to elect a candidate of their choice.

As the nation grows more diverse, the changing face of America has to be reflected at every political level. Elected officials must voice the needs and concerns of the neighborhoods and communities they represent, instead of serving their own political interests.

When this does not happen, communities suffer.

What Redistricting Does

Voting districts are redrawn every ten years to reflect population shifts in communities across the country and ensure equal representation for all residents.

By law, once the Census is complete by December 31, the Census Bureau must release data on how many people live in each state and determine how many representatives will be allocated to each state in Congress.

Redistricting is an attempt to set the balance straight.

But when redistricting gets distorted, the imbalance can devastate communities.

Gerrymandering Hurts Communities

In 2012, Koreatown, the densely populated Korean American community in LA, was carved into four different districts along a valuable piece of real estate on the Wilshire Corridor that local politicians coveted for its donors, businesses and development prospects.

Koreatown is a largely immigrant, non-English speaking community that fell prey to politicians who illegally gerrymandered district boundaries, and formed voter blocks based on race, to give themselves the advantage in future council elections.

Despite appeals challenging the division, recounts Feng, during the 9/11 media blackout, the legislature split the community “into four different pieces behind a cloak of secrecy,” denying Koreatown residents a chance for more balanced and greater political power.

In another example of unfair redistricting, Watts, a predominantly African American and Latino community in SoCal was hit by a freak snowstorm in 2003, and appealed to congressional, assembly and senate offices for emergency aid. At the time Watts was split into three different districts and residents were told, “We don’t really represent you.” Feng described how residents “were essentially ping-ponged from one office to another and it took more than a week for the state to finally declare an emergency.”

If the communities in Watts were combined into a single district, they would have had enough voice to demand the state and federal help they deserved.

“The districting process not only can determine which candidates will win in specific districts, but also can determine which party ultimately controls our local, state, and federal legislatures,” writes Douglas J. Amy,  a leading expert on electoral voting systems at Mount Holyoke College. “In a very real way, then, the political manipulation of district lines devalues the vote and undermines the democratic process.”

Census Challenges Impacting the Redistricting Process

Redistricting can be complicated by populations shifting across district and state lines over a ten year timeframe, but this year operations have been hobbled by the unprecedented restrictions imposed by the coronavirus pandemic.

People remain hard to count due to COVID-19

The Census Bureau faces a challenging task counting everyone with quarantines keeping people isolated and out of reach. If enumerators cannot gather data from hard to count, quarantined households, an accurate census count may be impossible. The decennial could exclude people who don’t self-respond because they have no computer or broadband access, and  “others may not even be sure about responding,” said Feng.

The Census Bureau has extended the timeline for data gathering through October, and redistricting could begin by July 31, 2021.

But it’s unlikely that lines can be redrawn in time before the next primary elections for federal and state candidates. 

The US population is on the move

Last year, the Census Bureau released data showing that the US population was moving southwards.  UC Berkeley reported that  the California housing crisis created an exodus from the Golden State as a shortage of affordable homes and low rents forced middle and low income people inland and to the south.

“In a recession or when times are hard, people move,” commented Feng.

Migration has an impact on how many seats are apportioned to each state for congressional representatives, because district lines have to be redrawn to reflect revised population counts.

As long as California’s population remains static, the state will retain its current quota of 53 representatives. But if the census count reveals a decline in population as people move to other states, CA will lose congressional seats. Projections from Election Data Services indicate that Texas and Florida are on track to gain congressional seats as more people move south. Between 2010 to 2019, cities in Texas –  Houston, San Antonio, Austin, Fort Worth and Dallas – added the most people.

However, redistricting lines were drawn ten years ago and do not accurately reflect the current numbers of residents – populations shrink or increase as people move, are born or immigrate in each district.

“Ultimately you want to make sure that each district has an equal number of residents.” confirmed Kathy Feng. Essentially each district must have the same voice when it comes to electing their representatives, not just in Congress, “but all the way down to the state legislature, city council, and school board.”

The term ‘resident’, Feng clarified, means every citizen, immigrant, and undocumented person in the district, not “just the number of voters.”

Reform Redistriction

Traditionally, legislators were responsible for redrawing district lines, a practice that Feng called “self-serving” because legislators were influenced by partisan interests or preserving their own ability to rerun for office.

California led redistricting reform by selecting 14 independent commissioners from diverse communities, to inform the redistricting process by gathering input from public forums around the state. Citizen commissions offer communities an opportunity to share information and form districts based on where they reside.

In Culver City, “People lined up as if they were going to a rock concert rather than a public hearing” about their community,” recalls Feng.

California’s award winning initiative has set the national standard for independent redistricting through public engagement. Nine states have followed its lead. Michigan is giving power back to communities by adopting new rules to allow for the creation of a citizen’s commission to redraw lines.

By standing up to be counted, people could eliminate partisan gerrymandering in their districts and shape the future of their communities.  Equal representation from redistricting will empower minority communities if they choose to participate more actively in the census.

Meera Kymal is a contributing editor at India Currents


Coverage for Census 2020 has been facilitated through a grant from the United Way Bay Area.

 

image: Elkanah Tisdale, Wikimedia

images: Kathy Feng, Common Cause

South Asians Hit Hard by COVID Need Help

As the death rate from COVID 19 in the US spirals toward 100,000, one fact is alarmingly clear. While the virus severely affects seniors and people of all ages with serious underlying medical conditions, it has hit communities of color the hardest.

“South Asians are suffering across the country on a level we haven’t ever seen,” says Lakshmi Sridaran, Executive Director of SAALT, in a recent call to action to the community.

Minority communities are more at risk because long standing disparities in health, social, and economic status make them more vulnerable. Many South Asians work high risk jobs as healthcare workers, domestic workers and grocery store workers. South Asian workers are employed in meat processing plants, and as Uber and taxi drivers. As a result of the pandemic many face economic hardships and limited access to healthcare services or even proper protection while performing their jobs.

“So many have fallen sick. Too many have died,” adds Sridaran.

SAALT is responding to the crisis by facilitating the National Coalition of South Asian Organizations-direct service organizations that are doing critical work to support those most impacted by the pandemic:  They offer services to provide food, health and financial assistance to victims of the pandemic that include undocumented immigrants as well as domestic violence survivors.

Sridaran is urging all South Asians to support and uplift the hardest hit people in our communities at this challenging time.  Links are provided below.

 New York, the epicenter of the pandemic

New York, the US epicenter of the COVID-19 pandemic, has among the largest South Asian populations in the country. Community leaders are reporting that the official data on infection and fatality rates are inaccurate and don’t reflect their experiences.

Many South Asians in Queens and the Bronx work as domestic workers, as drivers, in grocery stores, or delivering packages – without PPE or adequate healthcare. Those who are undocumented don’t even have access to government aid.

What’s more, so many community members are out of work, leading to a level of food insecurity not seen before. In response, community organizations and volunteers have shifted their work to set up mutual aid networks to deliver food and medicines and provide cash assistance and childcare.

Support them at Desis Rising Up and MovingAdhikaarSapna NYC

South Asian Domestic Violence Survivors

Community leaders from domestic violence organizations are especially worried about survivors. There’s been a drop in crisis calls – because survivors are trapped at home with their abusers and don’t have the space to make calls. And, many domestic violence shelters aren’t accepting people right now out of fear of COVID-19. Domestic violence organizations are delivering groceries, helping survivors apply for public benefits, and finding alternative shelter arrangements.

Support them at Daya Houston (TX)Raksha (GA), Maitri (CA),  Narika (CA)Asha Kiran (AL)Sahara (CA)South Asian Network (CA)Apna Ghar (IL)

South Asian Immigrants

People who are undocumented have no access to government aid or relief. South Asians in immigrant detention are stuck in crowded facilities where there have been reports of COVID-19 outbreaks and over 100 migrants could be deported back to India any day now. Even if released from detention many cannot afford the unduly high bonds. South Asians on H-1B and H-4 visas fear losing their jobs and falling out of status with dim prospects of finding another job in this uncertain economy. Immigrant rights groups are fighting these injustices at every level.

Support them at Bond Funds: Fronterizo Fianza Fund, SAALT’s local partners on the border: Detained Migrant Solidarity Committee and Avid in the Chihuahua Desert, Mutual Aid Funds: South Dako­ta DREAM Coali­tion & South Dako­ta Voic­es for Peace and Jus­tice for Mus­lims Col­lec­tive Com­mu­ni­ty Relief Fund

These organizations are doing “lifesaving work right now” says Sridaran.

Click on the link for a full list of the National Coalition of South Asian Organizations.


Image Credit: Pixabay 

We Are as Strong as Our Weakest Link

Coronavirus has overtaken how people are living their lives and is now controlling their psyche – as it should.

Reaction has ranged from indifference to paranoia. On one end of the spectrum, reckless students from University of Austin chartered a plane and flew to Mexico for spring break. 44 of them contracted coronavirus. On the other, fake news circulates, conspiracy theories go viral on WhatsApp, and people self-medicate with chloroquine, leading to paranoia.

What is fact and what is fiction?

Ethnic Media Services video briefing on Coronavirus

Ethnic Media Services held a video briefing last Friday, March 27th, with a panel of medical health professionals and advocates who are on the forefront of coronavirus research, work, and policy. The panelists addressed current information about the virus, safety measures, and effects on marginalized communities.

Dr. Daniel Turner-Lloveras, Harbor UCLA Medical Center, and Dr. Rishi Manchanda, Health Begins, spoke about overlooked populations and how their health will actually determine the efficacy of COVID-19. Turner-Lloveras pressed that we need to ensure access to public health for those that are undocumented or without health insurance. 43% of undocumented immigrants are without health insurance and are high risk populations if they contract the virus. 

Additionally, the pandemic has the potential “to disproportionately affect communities of color and immigrants,” Dr. Manchanda confirmed. He expanded that the reason for this is that these populations are at a “greater risk for exposure, have limited access to testing, and have severe complications.”

Dr. Rishi Manchanda briefing community media outlets

Many frontline staff for essential services belong to such communities and are at a higher risk of exposure because of their contact with the public. People on the frontline are unable to take time off due to the nature of their job and their dependency on the income; many continue to work while sick. Infection can spread from work to home and into these communities due to the density of housing.

Once exposed, vulnerable populations have limited access to testing for a multitude of reasons – fear of the healthcare system, lack of health insurance, inability to communicate their needs, and underlying racism. 

Infection from this virus can cause complications leading to chronic illness. The risk of developing chronic illness is higher for communities of color. Research shows that African American, Latinx, and Asian Americans have an increased probability of having chronic illness, over white populations; “Asian Americans, Native Hawaiians, and Pacific Islanders are at twice the risk of developing diabetes than the population overall.”

The nascence of a pandemic brings with it a pressing need to address the gaps within the structural framework of the public health system in America. If we are unable to effectively help disenfranchised communities, then we are ineffective in controlling the spread of the virus. 

“By caring for others, you’re caring for yourself,” Dr. Turner-Lloveras urges. 

Public health is not an economic drain or a privilege, it is a right. Dialogue around healthcare has long forgotten the systemic racism embedded in it; the wealth gap limits the accessibility to health care or good health care. NAACP studies have found connections between coronavirus and negative impacts on communities of color. 

But racism has moved beyond just health…

Asians and Asian Americans are experiencing racism at higher rates. Manju Kulkarni, Executive Director of Asian Pacific Policy and Planning Council, recounted a story of a child experiencing verbal and physical assault for being of Asian descent at a school in LA. Since then there have been around 100 reported cases a day of hate towards AAPIs on public transit, grocery stores, pharmacies. Kulkarni and her team at A3PCON are doing everything in their power to legislate and educate.

That said, it is our social responsibility to stay informed and updated. “Bad information is deadly,” states Dr. Tung Nguyen, University of California, San Francisco, as he gives quick rundown of what is known about COVID-19 thus far:

  • Currently there is no known vaccine or immunity from COVID-19. 
  • Vaccines are 12-18 months out, if the vaccine was approved for phase 1 testing today.
  • COVID-19 has exponential spread; if there are 200,000 cases this week, there will be 400,00 cases next week, 1 million cases the next week, and 4 million cases by the end of the month.
  • COVID-19 is an infection that leads to sepsis and those with sepsis require ventilators; this has led to a national shortage of ventilators.
  • There is a 1.5% – 4.5% death rate from COVID-19.

Information to keep you safe:

  • Have the healthiest person leave the house to get essentials.
  • Have a room to disinfect in before entering primary areas of the house.
  • COVID-19 is in the air for 3-6 hours, lasts 24 hours on cardboard, and on steel and metal for 72 hours.
  • Clean commonly touched objects – faucets, handles – with disinfectant.

If you are sick, call your hospital or provider in advance. Hospital resources are currently limited and telehealth measures have been put in place to assess patients from a distance. You can find more on the CDC website

Dr. Tung Nguyen and Dr. Daniel Turner-Lloveras, both gave one big takeaway – the best thing one can do during this pandemic is STAY AT HOME

Abide by the shelter in place regulations and continue to keep the dialogue about the pandemic open. The coronavirus pandemic has reminded us of the need for awareness, the importance of early containment, and the accessibility of health care to colored communities/immigrants. 

Srishti Prabha is the current Assistant Editor at India Currents and has worked in low income/affordable housing as an advocate for children, women and people of color. She is passionate about diversifying spaces, preserving culture, and removing barriers to equity.

America, Let’s Take a Selfie?

It is Census Day, a snapshot of our country, but what is happening with the census during the COVID-19 outbreak? 

A panel of experts shared information at a telebriefing held on April 1, 2020, in partnership with Ethnic Media Services

Though Census 2020 kicked off on March 12th, the deadline has been EXTENDED to August 15, 2020.

This gives everyone more than enough time to complete the NINE question survey. That’s right, only nine questions. 

There are no questions related to citizenship, so everyone living and working in the States – should respond to the census  regardless of citizenship status.

Ditas Katague, Director of California Complete Count  and a census outreach veteran, shared  interesting insights into census statistics. So far, 37.9% of Californians have already filled out the census; the national average is 38.4%. California leveraged its efforts to address diversity within California by budgeting  $187 million to increase the count – a significant increase over the 2 million budget Katague received for the 2010 census. California is a difficult state to count because of its teeming diasporas; hopefully this larger budget will be able to address the needs of those who have been undercounted in the past. 

Eleven million out of California’s forty million residents are hard to count. June Lim, Demographic Research Director of Asian Americans Advancing Justice, explained that hard to count populations include immigrants, non-English speakers, older people, and minorities that distrust the government. Asian and Asian Pacific Islanders are a demographic that is “least likely to respond because they believe the census bureau won’t keep their information private.” However, everyone is protected by Title 13 of the U.S. Code and personal information cannot be given to anyone, including the President.

“Our communities will be taken more seriously if we’re counted,” stated Basim Elkarra, Executive Director of CAIR,  a sentiment that was endorsed by the other speakers. It is imperative that minorities get the representation they deserve. The census determines “power, money, and data”, Katague emphasized, because it has become more transparent than before that “data drives emergency funding.”

The US Census Bureau has suspended activity because of the pandemic and is planning to start census efforts again on April 15th. People  do not need to worry about anyone knocking on their door amidst the fear of spreading coronavirus, especially if they respond online, by phone at 1-844-2020-0274, or mail. 

The best way to avoid contact with the virus and to continue social distancing is to complete the census online.

For more information, reference our previous article here!

Coverage for Census 2020 has been facilitated through a grant from the United Way Bay Area.

Srishti Prabha is the current Assistant Editor at India Currents and has worked in low income/affordable housing as an advocate for children, women and people of color. She is passionate about diversifying spaces, preserving culture, and removing barriers to equity.
Coverage for Census 2020 has been facilitated through a grant from the United Way Bay Area.

I am Kashmiri. Hear me!

I did not believe that I would live to see the day when my family could rightfully return home to Kashmir. Article 370 being revoked in Kashmir on Aug 5 2019, is one of the best decisions by the Govt of India to restore secularism in Kashmir, a land whose demography has been changed by the systematic targeting of its minority Hindus/Sikhs. 

For me the relief is personal, since my own family (parents, siblings, relatives, friends, neighbors), along with other Kashmiri Hindu communities, was part of the mass exodus in 1990, when we were brutally targeted and cleansed from Kashmir by militant Islamic groups aided by Pakistan.

As is well known and documented, in 1990, mosques throughout Kashmir blared threats to all “kafirs,” (non-believers)  “Ralive, tsalive, ya galive” (Convert to Islam, leave, or die). Various terror groups posted posters on our doors declaring, “Allah-o-Akbar, infidels get lost. Jihad is approaching.” Thousands chanted on the streets, “Kashmir banawon Pakistan, Bataw varaie, Batneiw saan”  (“We will turn Kashmir into Pakistan, with Kashmiri Hindu women, but without their men”). 

We were terrified. I remember the mobs that roamed our neighborhood with slogans of wanting to rape and kill Kaffirs. Hindu families with girls were especially vulnerable. My mother kept poison ready, having taught me, even at 8 years of age, that we both needed to  poison ourselves if any terrorist entered our home. I began to regret being born a girl.  

My parents and relatives finally decided that they could not live with this constant looming threat. We fled from our homes, carrying just a few belongings, hoping that we would be able to come back in a few months. 

Life as a Refugee

In Jammu I smelled the fragrance of freedom for the first time and felt welcome. This was a change from my experiences growing up in Kashmir, where we always felt ostracized; be it a cricket match, when stones were pelted at our homes to mourn a Pakistani loss or when we hoisted the Indian flag or tried to celebrate our Independence Day (August 15th) or Republic Day (January 26th). 

Life in Jammu came with its own challenges. We were refugees in every sense of the word—distressed and helpless, living in tents, until we found rooms for rent. Even the weather was punishing, with temperatures rising up to 48 degrees Celsius, a shock for us Kashmiris who were used to much milder climes. The sudden change of climate  took the lives of many refugees, as they lacked adequate protection against the elements in their tents. 

I was a student at the time and often fainted from starvation. There were no facilities for students, so we tried to study under the shade of trees in the searing summer heat. There was little support from local, state or national government bodies-our only aid came from the local Hindu community and organizations like BJP, Shiv Sena, and RSS.

During this mass exodus, no ruling political party made an effort to support our families. Nor did they ever address the trauma we live with. The last 29 years have been brutal. Many Hindu Kashmiris, including my own grandparents (who were in their sixties at the time we fled Kashmir), passed away as refugees, longing for a chance to return to their motherland. 

Kashmiri Hindus are the original inhabitants of Kashmir. Named for the Sage Kashyapa, it  was our home for thousands of years. We gave up our ancestral lands, our communities, our places of worship, and our futures. The removal of Article 370 has revived hope in my community, as is evident from the many private and public celebrations that followed. Even though it’s too late for my elders, the new status offers a ray of hope for the rest of the community: a chance to return home, to pray in historic family temples that have been abandoned for decades, to once again be Kashmiri in every sense of the word-irrespective of our religion. 

I finally have hope that we will see a dismantling of the systematic infrastructure that oversaw the genocide of the Kashmiri Pandits. The abrogation will allow an Indian citizen, of any faith, to live where they like and pursue occupations of their choosing. The abrogation of Article 370 finally delivers on the promises of the Indian Constitution. 

Ruchi Kolla was born in Srinagar. She now lives and works in the Bay Area. This is her first piece about life in Kashmir.

 

Autumn Blues

Splayed on 75-year-old Kamala Krishnan’s bedside table are three books: Life After Death by Deepak Chopra, Reaching to Heaven by James Van Praagh, and Love and Death by P. Rajagopalachari. These books are a constant reminder that the hereafter is no further than an arm’s reach away.

Krishnan’s is the typical story of the elderly Indian American immigrant. After the death of her husband, she moved to America to live with her daughter. “Truly, I wish to die and not trouble her like this,” says Kamala Krishnan, with a betraying quaver to her voice.

Krishnan’s daughter, Kshetra Srinivasan, admits that this exhortation frequently occurs and usually accompanies a disagreement over something as trivial as a dinner menu that might consist of something as egregious as a green salad. “In India, only cows eat raw food like let-tooce. Here…” Krishnan shakes her head with patent dismay. It’s not really the salad that is the subject of the discourse between mother and daughter. The subtext is helplessness, loss of independence, cultural chasm, and a normalizing process that is frighteningly unfamiliar.

An elderly Indian grandmother, living in a retirement facility
An elderly Indian grandmother, living in a retirement facility

Seniors who immigrate to the United States to live with their children face the daunting challenge of having to adapt to a new way of life. Their frame of reference is limited to their families who, more than likely, are ambivalent custodians of tradition and culture. These seniors face language problems; receive limited or no economic or health benefits; encounter family conflicts; are not fully aware of programs for seniors and are at a loss to spend their time productively. They feel lonely and fall victim to depression and delirium.

Dr. Rita Ghatak, Director of the Geriatric Health Services at Stanford University Medical Center, confirms the cultural issues embedded in older adult care.  “Listening and quiet acceptance go a long way,” she replies to my question of how our generation should cope with supplanted elderly parents.

The brochure that is handed to Stanford Hospital patients has this introduction to her program: “Welcome to Aging Adult Services (AAS) at Stanford. This is a program devoted to meeting the needs of older adults and their families and providing them a continuum of care with support and resources.” What leaps out at me is the phrase “and their families.” It seems a much-overlooked aspect of adult care. “The family is the advocating unit for adult care,” Ghatak emphasizes.

Medical Needs

Usually medical advice is sought as a last resort among South Asian families. As adults age, common symptoms like tiredness, apathy, and memory loss mask parameters of more chilling diseases such as Alzheimer’s, dementia, and chronic depression. Families are fooled into believing that these issues are part of the natural process of aging. “Besides, anything to do with mood and cognition has stigma associated with it,” Ghatak adds. So even if families are in the know, they sometimes don’t seek medical attention.

Ghatak relates a case where the parents immigrated to the United States to live with their children. The father, who had undiagnosed borderline dementia, had trouble adjusting into the affluent (and isolating) neighborhood, which exacerbated his condition. The family was forced to address the father’s ailment the day he went for a walk, got lost, fell, injured himself, and was taken to Stanford Hospital. The doctors at the emergency diagnosed and put him on a treatment course for dementia, which worked well. But once he got discharged the follow-ups were not performed. Besides overcoming the stigma surrounding the diagnosis of dementia there was the more practical issue of medical insurance coverage.

Insurance Complications

Insurance is such a huge problem that internist Caroline Stratz blames the system for failing the elderly, calling it, “the Mediocrity of Medicare.” In a heartfelt piece she wrote for the Los Altos Town Crier on January 20, 2010, Stratz agonized about having to withdraw from Medicare because of the steep drop in reimbursement rates. “When I started my practice nearly 10 years ago, colleagues advised me against accepting MediCare patients because reimbursement rates are low.” But Stratz held on to her ideals about the kind of medicine she would practice. Then this year, Medicare reimbursements dropped by a further 20 percent and she could no longer justify the lowered compensation.

The price of healthcare is so steep that, without insurance, the elderly have few options. It is estimated that in 1996, average annual managed care spending for depression was $6,777 and for dementia it was $11,114.
So what is the solution? According to Ghatak, to forestall medical costs, the elderly need a regimen of good diet, good exercise, and engagement with the family, community, and society.

Social Implications

Sarada Sankaran’s story is a textbook case of engagement. She is 71 years old and is a self-confessed computer addict. She habitually delves into the brightly lit stratum of our sphere that we call connectivity via cell phone, email, Facebook, and a blog. She drives, watches CNN/MSNBC, practices yoga daily, goes to the library, and is currently working on a Tamil drama script. She is sprightly, alert, and converses with her college-age grandchild well beyond the midnight chime of the grandparent clock. “I’ve adapted to this culture,” she says, “I have no qualms about shedding the sari and donning sweatpants. I’m in this country for my grandkids and I need to be able to relate to them. I believe in the power of now.” Truly amazing! But hers is not the typical story; it is the inspirational one.

Most elderly parents in the South Asian community help the family unit in definable ways: housekeeping, cooking, babysitting, helping with homework and, in some cases, driving grandchildren to activities. It is when role, responsibility, and ownership are not clearly defined that problems crop up. When Krishnan moved into her daughter’s house, she happily took on the task of cooking for the family. However, as the grandchildren grew into teenagers, the idea of eating grandmother’s freshly prepared Indian meals daily challenged their assimilated palates. Krishnan’s role in the household slowly began to erode, leading to her morbid fascination with death and despair.

An old picture of an Indian grandmother, in India, now living in a foreign country to be closer to her kids and grandkids.
An old picture of an Indian grandmother, in India, now living in a foreign country to be closer to her kids and grandkids.

Isn’t depression just part of aging? According to National Institute of Mental Health, temporary emotional experiences of sadness, apathy, grief, and despondency are normal. However, if these conditions persist, and they interfere significantly with the ability to function, then treatment should be considered. To recognize that a problem exists is the first step to a cure. In most cases, that is probably the hardest step. When parents are burdened with the demands of jobs and rearing young kids, the needs of elderly grandparents are bundled and swept behind the phrase  “when I have the time.”

There is a glow in Krishnan’s eyes as she returns from a trip to the grocery store. “The girl there recognized me,” she says sounding breathlessly like a young girl herself. “She gave me this packet free!” Krishnan reaches inside her bag and pulls out a packet of biscuits. Such a small gesture, with such a large reach.

According to Himanshu Rath of Agewell, a charity providing support to the elderly in India, “Collectively we celebrate the old. At home, we often ignore them. We say: ‘Have you had your medicine? Have you eaten?

Here is the remote control.’ And then we get on with our own lives.”

Managing Expectations

Initiator of the punctuated Google group, THATHA’s “R” US (thatha means grandfather in Tamil), Krishnamachar Sreenivasan understands how easy it is to fall into a blue state. His resume lists The Mitre Corporation, SRI, Hewlett Packard, and Agilent as employers. He is considered an expert in the field of computer performance evaluation and analysis of multiprocessors. The weeks following his retirement, however, his achievements were cold comfort. “I woke up in the morning and the only thing I changed was my remote battery.” It took great effort and considerable control before he came to grips with his changed situation. “I realized that there’s an unfavorable bias towards seniors. I had to do something to impact people around me.” He started a radio show on KLOK 1170 AM, a community service call-in program that airs every Wednesday from 11 to 12 pm every week, which aims to connect volunteers with those who need help.

Shifting the lens to the other end of the generational view, I queried some teenagers on living with elderly grandparents. “I love my grandmother, but I don’t understand her and she doesn’t understand me,” said a 14-year-old, adding, “She obsesses about food.” A college graduate explained that it was nice to find the warmth of her grandparents when she came home from school. “Not that I shared deep emotional moments with my grandparents,” she added. Her grandparents were there through her middle school and high school and she grew up with lots of religious events, good Indian food, Indian music, and Indian television.

Hesitatingly, she admitted that she’d been more attuned to their company when she’d been younger, but by the time she left for college, there was a large language, cultural, and generational barrier. “I did envy my Caucasian friends who were able to share a deeper emotional bond with their grandparents that was not complicated by language and culture.”

In September 2009, New York Times columnist, Patricia Leigh Brown wrote an article about the 100 Years Living Club, an all-male Sikh group of elderly immigrants. The group meets regularly at a mall in Fremont, Ca. to stave off feelings of isolation and alienation. According to Brown, late-life immigrants come to the country clinging to hopes and dreams of family togetherness, only to find that American society isn’t responsive to these cultural expectations.

A Growing Trend

Studies indicate that America’s ethnic elderly are the most isolated group in America and, yet, this group continues to grow. According to the 2007 census, one in three California seniors is foreign-born. It is estimated that the elderly constitute four percent of the global population (419 million) and there are approximately 350,000 Indian American elders, nationwide.

Yoga classes for seniors, to keep them engaged and provide them with more activities
Yoga classes for seniors, to keep them engaged and provide them with more activities

In his book gravely titled The Gray Dawn, Peter G. Petersen argues that, with the increase in life expectancy and decline of birth rates, the numbers of seniors will continue to grow, creating a demographic shift. The magnitude of this shift will result in seniors outnumbering the working age population. This will have a dire consequence on the economies of developed nations. This is partially borne out in Japan where it is predicted that, by 2015, one in four Japanese citizens will be 65 or older. As this shift in balance continues to dilate, Japan is looking at its trade surplus withering into deficit, driving industry and innovation overseas.

As public policy shifts are considered, ethnic seniors need to be part of the proviso. This group’s spiritual, physical, and psychological well-being becomes a critical parameter to social and economic prediction.

Local programs like the Community Ambassador program for Seniors (CAPS) and the India Community Center(ICC) offer a plethora of possibilities for seniors. ICC’s seniors program is designed around clubs and activities from simple socialization, yoga, and Bollywood dancing to round table discussions. Sankaran is an active member of the ICC senior program. Krishnan is a registered member, but finds it difficult to make it to the sessions. Krishnan informs me that conversations at the ICC Senior Center are wince- and wonder-worthy, ranging from daughters, daughters-in-law, financial crises, recipes, oil spill, medical problems, travel to India, and Bombay Jayashree ( a Karnatik music vocalist). Everybody is encouraged to participate.

One Friday afternoon I see Outreach cars pull in like grand limousines at the ICC-Cupertino parking lot. From these cars the elderly slowly emerge like stars, dressed in swathes of silk and serge. They grandly ascend the steps to the facility. I watch the way they enter and mingle with each other. This time, place and moment is theirs. They own it. I quietly leave, reminding myself that my time is just around the corner.

(Names of seniors have been changed at their request to preserve anonymity)

Jaya Padmanabhan is a prize-winning fiction writer and is currently in the process of writing a novel.


 Institutionalized Living

Hindi movies like Baghbaan and Lage Raho Munnabhai pillory the boomer generation for contemplating nursing homes, assisted living facilities, and retirement homes for their elderly parents. Newspapers decry the oursourcing of senior care with articles titled “Old Age Homes Against Our Culture.” But the times, they are a-changing. The harsh critical glare of disapproval is dissolving under the circumstances of nuclear double-income family units. Living in elderly group housing with nurses and doctors on call and the ability to talk about “the old days” is sounding more and more attractive. Canadian resident Saroj Sood voluntarily opted to live in a South Asian Assisted Living facility in Surrey, UK. She quoted the Vedas as justification for her move. Sood explained how the last of the four stages of a Hindu life, the “sanyasa” stage, requires renunciation of society and meditative solitude.

In the United States, South Asian elder institution options are limited to just a handful. In my research, I was able to source only two: AristaCare Nursing Homes, catering to elderly Indians, with three locations in New Jersey and Pennsylvania, and a retirement facility, ShantiNiketan, in Tavares, Florida. ShantiNiketan is advertised as a retirement community for Seniors of Indian origin. Iggy Ignatius, the founder of the community project, says that he wanted to give it an “ashram” feel. The gated property consists of 54 condominiums, 35 of which are sold. There are Assisted Living facilities in the Bay Area catering to other ethnicities: Aegis Gardens in Fremont for elderly Chinese and On Lok Senior Health Center in Oakland for Filipino Americans, but none for South Asians. Is our diaspora equipped to handle the growing numbers of elderly?

 


Resources

Northern California

Outreach

Outreach’s Senior Transportation Program offers transportation options for seniors that can take them to any destination within the county. http://www.outreach1.org/seniors/seniors_mainpage.html. (408) 436-2865

India Community Center

With locations in Milpitas, Cupertino and Fremont, the India Community Center offers yoga classes for seniors, round table discussions, Jollywood dance classes opportunities to participate in theater, knitting club, bridge club or even a computer class. Subsidized lunches are provided to seniors as part of the program.(408) 934-1130 or check the website: http:indiacc.org/node/293

CAPS – Community Ambassador for Seniors Program

CAPS ambassadors serve seniors and their families by assisting with questions related to identifying local resources, programs, and services in the Tri-City area (Fremont, Newark, and Union City, Ca). Senior Helpline: (510) 574-2041

Stanford’s Adult Aging Services (AAS)

Stanford’s AAS program offers consultations, assessments, home visits, and general outreach assistance. Here is a list of some of the options:

• Geriatric Out-Patient Clinic and Consultation Service (650) 387-6777

• Dementia Support Program (650) 723-1303

• Partners in Caring (650) 725-4137: A program that helps older adults in their homes

• Strong for life (650) 725-4137: A muscle strengthening exercise program

Southern California

National Indo-American Association for Senior Citizens (NIAASC)

National Indo-American Association for Senior Citizens (NIAASC) started in 1998, serves Indian American seniors across America, “through information, referral and advocacy services.” http://www.niaasc.org/
Southern California

Dial-a-Ride services

Most cities in Southern California offer Dial-a-Ride transportation services to senior citizens (60 years of age or older), and individuals with disabilities.http://dpw.lacounty.gov/PDD/Transit/Page_01.cfm

Neighborhood Activities and Nutrition (NAAN)

Seniors are encouraged to visit Artesia’s Senior Center where they can form clubs and intermingle. The two big deterrents for South Asians, language and diet, were addressed by the Oldtimer’s Foundation, a community-based organization that began serving a weekly vegetarian Indian meal, cooked by a local restaurant owner and paid for by the county’s office of aging. (662) 272-5276