PUBLIC HEALTH
COVID-19 in Greater Minnesota Addressing structural inequities BY CHARLIE MANDILE
T
he brutal murder of George Floyd at the hands of Minneapolis police reminds us of an ongoing reality: our society and culture does not value Black and Brown people. This tragedy is another violent symptom of underlying structural inequities and racism built into our power structures and society, and one that produces disparities in health. Our rural communities of Faribault and Northfield are not exempt. Rice County is home to approximately twice the state average of Latino immigrants, and to one of the largest communities of Somali refugees and their families outside of the Twin Cities. COVID-19 infection rates highlight the fact that Rice County is not immune from structural inequalities and racism.
Numbers from the pandemic Last month, Rice County Public Health reported that 36% of COVID-19 cases were diagnosed in individuals who identify as Black, and 33% of cases were in those who identify as Hispanic—rates far higher than the county’s percentages of 5.4% and 7.9% who identify as Black and Hispanic, respectively.
ENGAN ASSOCIATES
Creating Healing Environments for 40 Years
As of June 12, 87% of Rice County’s COVID-19 cases resided in Faribault, even though Faribault makes up just 34% of the county’s population. Overall, Rice County is home to some of the highest rates of COVID19 in Minnesota, with the sixth-highest incidence rate in the state and the second highest in the Southeast region. The statistics are shocking but not surprising. These disparities are a product of embedded inequities and underlying socio-economic disparities. Over two-thirds of the students in the Faribault school district qualify for free and reduced lunch (provided for families within 125% of federal poverty guidelines), and the disparity ratio between Latino and White poverty is among the highest in the state. These socioeconomic disparities have put Latino and Somali families on the front lines of feeling the effects of this pandemic. While many Rice County residents have the privilege of working from home, many of our Black and Hispanic residents work in jobs that have been deemed “essential,” including local agricultural processing facilities and other fabrication and manufacturing line work. Latino and Somali groups are over-represented in professions that require working in close proximity, indoors, for extended periods. While many employers supported their employees to take precautions such as PPE, testing, awareness, and paid time off, other employers did none of the above. All worksites in these industries have been impacted by outbreaks among their workers. Despite the risks, these employees have been showing up to work— while putting their own health in danger—to support their community without question or hesitation. While many businesses were shut down by state order, our Black and Hispanic neighbors worked to ensure our society had what it needed when we were most vulnerable. Work such as food production, facility and custodial services, packaging, and fabrication happens in the background for many of us, but it is essential to our daily life and activities. However, the cost of this has been borne disproportionately by our Somali and Latino neighbors.
Longstanding barriers This pandemic has amplified existing challenges for everyone. We have all had to re-think our modes of transportation, where and how we get our food, and how to go about our lives at home to ensure our own safety. This crisis has magnified structural barriers for the underserved and traditionally marginalized. For example, we have all been inundated with messages of maintaining social distance at a time when public transportation and other public services have been limited or shut down. For essential workers in a rural area, there are even fewer options to get to work or the grocery store. As a result, our communities have developed robust networks of carpooling and ride-sharing. During the pandemic, nearly all workers share rides and airspace with not just a work team, but with a carpool group. “We wouldn’t hesitate to work with Engan Associates again.” (Matt Reinertson, Heartland Orthopedic Specialists)
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AUGUST 2020 MINNESOTA PHYSICIAN
Informal networks of childcare, meal preparation, or grocery shopping are common sources of the strong community ties inherent to these cultures. While traditional structures and systems of societies have excluded
