Racial Health Disparities and Accountability Journalism

Racial Health Disparities and Accountability Journalism

Kamil Krzaczynski/ Reuters
from Local Journalists Webinars

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Race and Ethnicity

Public Health Threats and Pandemics

Camara Phyllis Jones, epidemiologist and senior fellow at the Satcher Health Leadership Institute and Cardiovascular Research Institute at the Morehouse School of Medicine, discusses how health disparities disproportionately affect people of color, particularly in relation to COVID-19, and her work on racism as a public health issue. Cheryl W. Thompson, investigative correspondent for NPR, shares best practices for reporting that educate for the public interest. Carla Anne Robbins, adjunct senior fellow at CFR and former deputy editorial page editor at the New York Times, hosts the webinar.


Dr. Camara Phyllis Jones

Senior Fellow, Satcher Health Leadership Institute and Cardiovascular Research Institute at the Morehouse School of Medicine


Cheryl W Thompson

Investigative Correspondent, NPR


Carla Anne Robbins

Adjunct Senior Fellow, Council on Foreign Relations


Irina A. Faskianos

Vice President, National Program and Outreach, Council on Foreign Relations

FASKIANOS:  Welcome to the Council on Foreign Relations Local Journalists Webinar. Today we will discuss racial health disparities and accountability journalism with our speakers, Cheryl W. Thompson and Dr. Camara Phyllis Jones, and host Carla Anne Robbins. I'm Irina Faskianos, Vice President for the National Program and Outreach at CFR. As you know, CFR is an independent and nonpartisan organization and think tank focusing on U.S. foreign policy. This webinar is part of CFR Local Journalists Initiative created to help you connect the local issues you cover in your communities to global dynamics. So our programming, we attempt to put you in touch with CFR resources expertise on international issues, and provide a forum for sharing best practices. I want to remind everybody that today's webinars on the record and the video and transcript will be posted on our website after the fact at cfr.org/localjournalists.

You have bios for our speakers and host but I will just give you a few highlights on their distinguished careers. Cheryl W. Thompson is an investigative correspondent for NPR and an associate professor of journalism at George Washington University. Professor Thompson previously spent 22 years with the Washington Post, covering law enforcement, political corruption, guns in the White House during President Obama's first term. She's also the board president at Investigative Reporters and Editors, a nonprofit dedicated to improving the quality of investigative reporting. Camara Phyllis Jones is a family physician and epidemiologist whose work focuses on maintaining measuring and addressing the impacts of racism on health and well-being. She is currently a senior fellow at Satcher Health Leadership Institute and Cardiovascular Research Institute at the Morehouse School of Medicine. Dr. Jones is previously a medical officer and research director on social determinants of health and equity for the Center for Disease Control and Prevention. And she's a past president of the American Public Health Association. And Carla Anne Robbins, our host is an adjunct senior fellow at CFR. She's faculty director of the master of International Affairs program and clinical professor of national security studies of group colleges Mark School of Public and International Affairs. Previously, she was deputy editorial page editor at the New York Times and chief diplomatic correspondent at the Wall Street Journal. So thank you all for being with us today. I'm going to turn it over first to Carla to have a conversation with our distinguished speakers. And then we will open up to all of you for your questions and to share best practices.

ROBBINS: Irina, thank you so much. And thank you so much for joining us today. This is just, we were having such a good time before this started. I'm very happy to have all the great reporters with us as well. But it was really hard to turn this off—turn it over to you. So there's a lot of questions I know out there, and an incredibly important conversation. So let's get started. I want to start with Dr. Jones, who is not just a physician, and a public policy expert, but you're also an epidemiologist. So can you start by setting the scene for us a little bit? You know, we've heard a lot about the racial disparities and the impact of COVID. And I was looking up some of the stats, I did used to work at the Wall Street Journal, so I like my numbers. And some of them that are particularly grim that struck me, the life expectancy of the black population declined by 2.7 years in the first half of 2020, wiping out twenty years of gains. The life expectancy gap between black and white Americans is now, it's six years, the widest it’s been in more than twenty years, the death rate for black Americans with COVID-19 was almost two times higher than for white Americans. The death rate for Hispanics was 2.3 times higher than for white Americans. The Coronavirus mortality rate for black people between the ages of 35 and 44 was nine fold greater than for white people in the same age group. So just to start us off, as an epidemiologist, you know, are these the right statistics to be looking at and writing about to convey the disparate impact or there are other stats we should be looking at? And is that the right way to shape stories?

JONES:  Well I, think it's important for people to hear the statistics. So I think it's very important to lift those differences up because otherwise, we live in such segregated community communities that people often don't know what how the pandemic is being experienced on the other side of town or in the next town over. So I think it's very important, but we also need to communicate especially as journalists and especially at the beginning, but even now, that it's not because people of color are more vulnerable in some kind of biological way to the virus or anything like that. What happened —well, I'll just frame it this way. When we first learned about the SARS-COV-2 virus that causes COVID-19 in December of 2019, we knew that there was no human on the planet who is immune to this, right? And if our expectation was that if opportunity were equally distributed across the world, or at least in this country, if exposure to risk were equally distributed by anything, by race, by zip code by anything in this country, then we would not see any disparities, any disproportionate impact. But what COVID-19 did was to pull the sheets off of the fact that we have a system, a society that is differentially structured by race.

Black folks, indigenous folks, Latinx folks, pacific islanders, in particular Filipinos, lots, it depends on where you are, regionally, which of these racialized groups is most impacted. But we are most impacted because we are more exposed and less protected. That's why we get more infection. Once we're infected, were more likely to die because we're more burdened by chronic diseases with less access to health care. That was true at the beginning of the pandemic. And now that we have a vaccine then, even though we are more impacted than our population numbers, we are being vaccinated at lower levels than our population numbers. The same calls to reopen that happened in April of 2020, when it first became known that people of color were more, were disproportionately impacted, some people thought they were the only ones, right? So let's reopen, reopen Minnesota, reopen Michigan, reopen Virginia, and now that we have the vaccine, but people are being insufficiently vaccinated, not only for their numbers in the population, but because of the risk. And we have calls in Texas and Mississippi and now so many more states to drop the math mandates and all, this is all a disregard for the lives I think of people of color, we are considered essential. You need to raise the numbers about what's happening. But we’re considered essential but disposable. I know I have rambled all around the bush so. So I don't know if that's a useful starting point for people to understand how to pitch stories. There’s a, there's a lot in there.

ROBBINS: So it is it is in many ways about society and public health as much as it is about disease is and is what you're saying here. And there's a lot of stories in that. From the phase of it, and maybe I should come back to that last. I'll ask Cheryl to put on her editor hat for a minute here, her editor and her professor hat as well. Dr. Jones has, Professor Thompson and Dr. Jones  has laid out a social pandemic as much as a medical pandemic and you are an expert about writing about social pandemics. I mean, you did an extraordinary story in January and listen, incredibly important investigation about that reveal the deadly police shootings of 135 unarmed black men and women since 2015, at least fifteen of the officers involved had been involved in more than one previous shooting. I mean, that's an extraordinary data journalism, incredibly important work that you did there. So Dr. Jones has laid out the social underpinnings of this not just the impact, but where we started in the first place. So putting on your editor hat, what stories should local reporters be looking at right now, that sort of go to the social underpinnings both where this started and how it's being felt?

THOMPSON: Oh that’s a, well, thank you, first of all, for your kind words, but I would say—

ROBBINS: I’m a listener, I have the mugs and the hats. I have everything.

THOMPSON: (laughs) Okay, I'll get, I'll put on that editor's hat right now. I think there are so many stories right now. For one, when I was listening to Dr. Jones, she mentioned that the state some states are dropping the math mandate. You know, one good local story would be to look at like, because I know Mississippi is one and Texas is the other and there are others. But you know, take Mississippi for instance, then I don't know if there are any local reporters on the webinar from there, but take a look and see if the numbers go up, right? That's the first thing you could do is look to see if the numbers go up, because the mask mandate was dropped, right? Texas is another place. I suspect, and maybe Dr. Jones could respond to this, as I suspect the numbers and having no scientific background, by the way, right. This is just me that the numbers may go back up. If people, you know, with the mask mandates, but that's one of the stories I would look at. With the states, of all the states that have dropped the mask mandate, look at the numbers, find people, right? It's always every story, every local story, there's got to be a human element to it, right, to make it worth reading. Carla talked about my college shooting story. It started out with a person, right? So you need that human aspect. And so I think you could find that, with the mask mandate, find out, you know, what the numbers are. And if there are people who are affected by this, that's one story I would look at. Another, I think it's still relevant, it was one that I do when this pandemic first hit. Whenever there's a lot of money involved, and there's a lot of money being thrown around, and has been thrown around during this pandemic, right? Look, there's always fraud. Right? There's always fraud. So one of the early stories I did and it's still relevant, you can still do that story is like, who's out there committing these frauds, right with this pandemic? And it just, I got lucky, and I was I had called the Attorney General of the state of Washington, who told me that his wife had been the victim, someone had called trying to say, hey, if you want your, your stimulus money, like hip, click this button, right, of course, the person didn't know that it was the AG’s wife. If they did, they were really stupid. But I suspect they didn't know. So those are the stories that there's so many. But you can start with a couple like those and always have a human aspect because having people it just puts a face on something, right? And everybody can relate.

ROBBINS: So it seems to me there's another story that you did that I thought you were going to talk about, which was about no bid contracts.

THOMPSON: I'm happy to talk about whatever you like!

ROBBINS: No, no, but it's I do think that there might be something really relevant for local reporters, because there's going to be a lot of money pushed out with the recovery act right now, the first time being pushed out on the state and local level. I mean, under the Trump administration, state, local government was being starved. So there's going to be a lot of money that's pushed out. So if you are a local reporter, how do you follow the money on a state and local level that's going to be coming from that legislation?

THOMPSON:  Now that's a great question. And I think that I mean, you've got a new relief package, 1.9 trillion, right? You have one before you got this. There are local stories, one of the local stories that I think is good is there was I think in the first package, and I don't know if people wrote about it, but there was fifteen, I want to say $15 billion, put into the food program, like it's called, oh, my god, you're testing my memory now. But it's the government. It's the biggest nutrition assistance program in the country. And that's a lot of money, right? Where is it going? How is it being spent? I mean, they're always wonderful—because the local governments and state governments get a piece of this pie. And as a local reporter, you know, your job should be to figure out to follow it. Like Carla said, follow the money, see how it's being spent, see who's in charge of it, right? You got, I mean, and not only do you follow the money, but don't forget to follow up on the money, right? So you follow it to see where it's going and then you see how it's actually being spent. You know, this is still, the PPP program, the Paycheck Protection Program money, right? that was supposed, as we all know, is supposed to go to small businesses to keep them afloat. But in fact, it went to like all kinds of businesses, big businesses, and you know, check that again and see who's getting it.

I know, we did a story, I did a story with one of my colleagues at NPR about a company that wasn't like this big, well known company, but it got money. And so we followed it to see like, okay, what kind of money were they getting? And who was, you know, who's behind this company. And it turns out that this company had just gotten like, you know, scads of money to do COVID testing. And in addition to getting this PPP money and they weren't laying off employees, in fact, they were growing, right? So and then after the story came out, they gave the money back. So you know, those are the kinds of stories that you can do, but what Carla was referring to in terms of the government contract story, you can get—the federal government has a database, and you could go there and what we did was we took a look at all the companies and people who have gotten money to do like, you know, equipment like masks and all kinds of services, right during this pandemic, and there was so much money being given away. And so what we did was we decided to look at anybody who had gotten at least a million dollar contract. And so what I found was that, and my colleagues, what we found was that companies had been created like days before they got contracts, which means they had no experience to do this, right? There were companies, that one company in particular, that not only was it created, but he had been sued for doing questionable fraudulent things and just all kinds of things, but you gotta check, right? Because we didn't know what we were gonna find, but we just took, we made the million dollars, sort of like, the marker.

There was another company out of Texas, where the guy's not speaking to me anymore, but he talked to me for the story, and so I'm good. And he was, you know, he got, it was millions, millions of dollars to, to provide like, you know, PPE but I asked him how many people are in your company and there were three: he and his wife and some third person. And I'm like, well, how do you, how do you do this if you don't, you know, you're small, basically mom and pop? And what he said he was going to do was to contract stuff out. And somebody got like millions, millions of dollars to do this. So you know, that was in Texas, he was based out of Dallas. And you know, and I found that, you know, he had other things that I didn't report about that I don't really want to talk about what since we didn't report them, but just check out people who are getting the government money, check out the companies, I can tell you, I can explain how to do that. But those are the things you should do locally and at the state level.

ROBBINS: Great. That's great. Thank you so much, Dr. Johnson, on the local level to continue that thought. So when you were president of the American Public Health Association, you led a campaign to raise awareness of racism as a public health crisis. And since then, more than 100 localities, cities, counties and states who've made declarations about that. So Cheryl has sort of told us the grim side of things. Is there good news here? I mean, had you have you seen signs that raised local awareness has had an impact on public health policy during the pandemic, in communities that made those declarations?

JONES:  So far, I'm not aware of anybody who's done a comprehensive review. There are now 183, declarations, or 183 jurisdictions, so cities, counties, eight states now, but these are distributed across thirty-three states. So the first story might be to find out if your city or county or at least your state has, if there's anybody around who's made such a declaration and look at the content of it. They vary, some of them are mostly saying hold us accountable, we recognize that racism exists, but without teeth in terms of money, or new, you know, outreach to communities or new guidelines or statutes that guide further policy action, but some of them are quite comprehensive. So the Seattle King County declaration I looked at early on, and I'm very impressed with that. But it would be to do a lay of the land, perhaps in your state and then locally and see who's out there doing it. There are thirty-three states that have done it, so that means that there's well actually thirty-two states in DC so then that means that there's another twenty-eight that haven't done it. So that's a good thing, and, and to, to maybe do a little research on what the content is, at least in your area. But as Professor Thompson was talking, I also, I started jotting down like five other quick ideas for local people.

So as the money comes down, see how much is going to your public health department. And what is going to support public health departments there. You know, during the pandemic last year, there was so much turnover, the public health, you know, directors were being tarred and feathered and quitting in droves. So find out about staffing, find out about new hires, especially as there's going to be more money to do vaccine roll out, but find out what they're even spending their time on now, is it mostly vaccine distribution now? Or are they still trying to do education around masking and distance? Are they going to be involved in preparing the schools to get ready? What do we do with testing? We still in this country have not dealt with testing in the right way we are acting as if, we are treating the COVID pandemic as if it were a health care problem, as opposed to the public health problem that it is. And so we're narrowly focused on the individual and you know, just testing people who are symptomatic or exposed to somebody who has an uncle but we're still not doing the testing of asymptomatic people, which would be kind of a population based probability sample to really understand the present day prevalence of the virus. Like if we really wanted to know how much virus it is, we wouldn't even use the numbers of positives as a measure because that's already a seven to ten day old story. We wouldn't use hospitalizations, that's already a two to three week old story. We wouldn't use deaths, that's already a three to five week old story, but in this country, with the way that public health departments have been dismantled over decades, right? And then we're really undermined the CDC and on down from there undermined last year, we really have not done a proper population based understanding that can give us a real time assessment of the amount of virus in a community and even of the subtypes. So you know, find out what is the, is the Public Health Department in your area going to be able to do something like that?

How is vaccine going to be distributed? Of course, they're all of these stories about people jumping the line. And now there are two states, Alaska and Mississippi, I think, are two states now that are opening up vaccine registration for anybody over 18 and Alaskan, over 16 in Mississippi. But that's good and what's happening there. But also the story should, here's my wish, the story should not be vaccine optimism, and everything vaccine, vaccine, vaccine, because vaccine is an important tool we have but that's a tool at the individual level. What we really need to do is still focus on the public health strategies, which for the individual are masking up, backing up that's your distance, hand washing, so wash up, but also at the government level. So here's another story I wondered about, which is the Occupational Safety and Health Administration now, is finally starting to promulgate regulations for workplace safety. I mean, they did not even when the former president you know, made meatpacking plants essential, right? That was to protect the owners of the Meatpacking plants and, and there were no rules about distance or, or, you know, like really good testing or PPE or anything. What is happening now that OSHA is getting in gear in terms of workplace safety standards?

Then, you know, this is the Council on Foreign Relations. So what is what we need to all understand is that we experienced a pandemic locally, but this is a pandemic, it's a global thing. So what happens in the next town across from you is going to impact you what happens in your state is going to spill over to other states, what happens outside of the United States is in is definitely going to affect us. Right now we are, we have a lot of backs. And we're going to have enough to vaccinate by the end of May, all of our adults in this country, but what's happening on the African continent and the like? And so the AstraZeneca hook is of interest, we don't want people to get confused in this country and think that AstraZeneca, which is now not going to be used, you know, for two days or five days, like there's they're taking a look to see if there's a safety signal with regard to clots and bleeding on the European continent. The FDA was supposed to evaluate the AstraZeneca package their application for emergency use authorization, I think that's coming up within about a month. But right now, we don't want people in this country to get confused, that AstraZeneca has been used here. It's not, we have three vaccines, the Pfizer biontech, the Moderna, and the Johnson & Johnson or Janssen. So we don't have AstraZeneca here, but what happens with AstraZeneca is going to be important.

I have one more, one more thing. And maybe I'm not at the local level, but there might be local implications. There was a lot of celebration and deservedly so about the Johnson and Johnson Merck partnership. There are many people, so from India and South Africa, especially but many other nations who are calling on Pfizer and you know Moderna, and Johnson & Johnson and others, to share the recipe, right? To share their intellectual property with other countries so that they can manufacture those highly effective vaccines that don't have the safety signal that's being investigated right now for the AstraZeneca. So that they can produce vaccine locally and we can cover more of the world. Because even if we vaccinate all of our people in the US, the more the virus is transmitting anyplace else they can be new variants in our vaccines aren't going to work. I mean, we're going to just be rolling back and forth with waves and all of that. This is a pandemic and so our interest in the pandemic cannot just be local. And it would be interesting if we framed that question about intellectual property, not as waive the intellectual property rights of these pharmaceutical companies, but partner, having the pharmaceutical company’s partner, in some kind of way, with pharmaceutical companies in other nations to create the thing. So I'm just trying to help reframe it because we're going to be, we're being vaccine hogs right now in this country. We do have the COVAX agreement with, you know, giving a little bit of money and we say, if we have extra vaccine, we're gonna pass it on. But the US most of the, you know, the northern, you know, or, you know, North world things—we're using the vaccine a lot, and other nations are not getting access to it.

ROBBINS: And that, of course, for people, all of us have relatives and friends who don't live in the United States, and many of whom live in communities that aren't, don't have access, and are not going to be looking potentially to access to vaccines, even with COVAX for another year. And you know, we're now looking at by the summer for adults, but they're talking for another year. And that's, you can say, well, you know, I can hug my grandchildren, but I'm not gonna be able to hug my cousin in Gabon. That's great. You know, you can say that that's really tragic. But it's beyond that it's a public health issue, no one's going to be able to travel, it's a macroeconomic issue. So there's lots of things that are there that, that go from the local to the global. So I'm going to, I am going to ask Professor Thompson to talk about how to find the data and all of that, but there are so many questions that are coming up, I think maybe we're before people turn on us, let me throw it open to the group. And we'll come back.

THOMPSON: And you know, journalists will turn on you quickly (laughs)

ROBBINS: Damn, they'll turn to you, why do you think I’m a professor now? (laughs) Irina, back to you.

FASKIANOS:  Right, just so for all of you, you can raise your hand by clicking on the raise hand icon, or you can also type your question in the Q&A box. We already have a couple there. And please, if when you're typing your question, if you can identify yourself. So we don't have to scramble to look you up. The first questions come from Brian Simpson, who is at Global Health Now in Baltimore, Maryland. He has one for each of us. So Professor Thompson, what's your advice for journalists not of color who want to report on racial disparities in health? And for Dr. Jones, are there models of government and other programs that have effectively reduced racial disparities in health in the community?

THOMPSON:  So Brian, thanks for your question. The answer is go for it, do it, right? It's like you don't have to be, you don't have to be a journalist of color to cover how this pandemic is affecting people of color, right? Because it's, yes, it's affecting us disproportionately. But you know, just go out there and do it. You know, it doesn't matter whether it really you're in Oregon, or North Carolina, or Maryland. They're these stories are out there, and they're ready to be had you're, you're in Baltimore, so and I'm in Maryland, you should totally understand how dysfunctional the distribution of vaccines has been in Maryland. And I say that, because I can tell you that every day, I go online, trying to get an appointment, and it's a joke. It's like, it's a running joke. Now, it's like, you know, there are a few of us who like we laugh about it every day, but except it's not funny. So one of the stories I would do is I would find out because we know that this pandemic has disproportionately affected Black folk in this country. And so one of the stories that I would do is I would find somewhere if not in Baltimore, certainly in Baltimore, probably a good place for you to do this. Find out, go to community and find out like or just check with the health department and see how many people of color have been vaccinated so far, and then compare it to the population in Baltimore, or wherever you choose to do it. And I promise you, there will be a huge discrepancy.

ROBBINS: And do all states keep demographic information like that?

THOMPSON: At some point, I think they will know when this pandemic first started. I remember going to California virtually, I mean, I you know, reached out to California, Louisiana, Arkansas, and a couple other states trying to get their numbers, and Illinois where I'm from was the one state that started keeping them early on, by race. But it was like pulling teeth trying to get the other states to report it and eventually they did because there was so many journalists and so many people were you know, upset about it, because we want to know who was being affected by this. So my guess is that a lot of states have it but also some don't. There's always gonna be you know, there's always an outlier.

JONES: An answer to, are there localities that have successfully addressed health disparities, I think that there are some that are further along than others. And the thing that characterizes those that are further along is that, especially as you talked about racial, ethnic health disparities, they have been willing to name racism, right? They've been willing to go to say the word racism and often like in the Boston Public Health Commission, years ago they had, they took every one of their employees with through anti-racism training with the People's Institute For Survival And Beyond. But they didn't say, okay, now it's time for the epidemiology department to do it, and they all did it once. Each training was half a unit and half community that is they engage even in the training for the public health department, with community engagement, making the walls more porous, between the health department and others.

But I lift up Seattle King County, which has named racism and has had a checklist for a while. So I think that the first thing that characterizes those that are on the journey is the willingness to name racism. In fact, when I was president of the American Public Health Association, and launched our association on a national campaign against racism, it had three tasks: to name racism, that is essential, right? It's necessary but insufficient. The second of the three tasks is to ask, how is racism operating here? Where you look at structures, policies, practices, norms, and values, which are really the elements of decision making, who's at the table and who's not? What's on the, you know, what's on the agenda and what's not? That's structures, structures are the who, what, when, and where of decision making; policies are the written “how” of decision making. Practices and norms are different time lag things of the unwritten “how” of decision making and values of the “why” that's the second test so that you can identify levers for intervention. And the third is to then organize, strategize to act.

So successful communities will be somewhere in that journey, I have to warn people that. Now I know like I'm talking not specifically, I'm talking out of my expertise, and not specifically to local journalists, but I just wanted to share this. What communities who will be successful need to do is to not have a three to five year timeframe in terms of investments. So often foundations will invest on three to five year, politicians will do things, because people want credit, you know? Grant, you know, applications, three to five year timeframe in terms of showing an impact. But what we're trying to do what we need to do imagine that there's a pot of dirt with poor rocky soil, and there's a little flower, pink flower that's grown up, you know, if it had rich, fertile soil, it would go this high, but it's just grown up halfway, it’s trying to hold on. And if you then enrich that poor rocky soil, that flower may grow up another quarter inch, but it won't be until the seed of that flower falls into the rich, fertile soil, that you will really see the impact of your investment. So even if you have foundations in your area, whatever, you can find out or challenge them. How would they you know, many big foundations are out of the mobilizations around anti-racism, namely racism, are making investments. But are these sustained investments? What we need to do is invest in opportunities, measure our impact in terms of changes in opportunity structures, is the housing better? Are the schools better? You know, is the environment cleaner? You know, is there a green space? That measure changes an opportunity and wait for a generation 20 to 25 years, before you expect to see differences in diabetes, or a differences in infant mortality or differences in so many of these other things. So you can just find out who is thinking about that right now? Are they trying to pluck low hanging fruit or are they trying to get at the root? And the way that I talk about it now is that we as a society, need to be willing to plant an acorn today so that our grandchildren can have shade. We have to be patient, though, in that planting in that investment.

ROBBINS: So I'm going to interrupt here, you know, journalists are not multi-generational in the way we think about stories. We're far too impatient for that. Let me recast the story which is which is which is there's a lot of money getting pushed out right now, you know, after the starving of state and local communities. If we were to look at smart planning for the use of that money, I mean, nobody's gonna plan 30 years down the road, even if they have to, even if they should be doing it. What would be a sign that they were at least trying to deal with some of the social disparities that have made this so much worse with some of that money right now?

JONES:  It would first of all be signaled by who's at the table, who's at the decision making table are communities that are already trying to solve the problems in their own communities and in their lives. Are they involved now in deciding how some of this money is distributed or not? So that would be the first signal. Really.

ROBBINS: And Cheryl, what should they be like? Would we be looking at in our communities about that that money, is it just like transparent announcements about how they're spending that will be on

THOMPSON:  If you wait for that, you might be waiting a minute. Well, every government has a budget, right? And so that money comes in, it has to go it has to be reported somewhere. I am a big believer in review of budgets, right, on a regular basis to see what's coming in and what's going out. And so but also, yeah, most states, most jurisdictions, when they get this a lot of money from the government like this, they will have I would think they would announce it. Like, oh, you know, the city of Baltimore got, you know, $200 million. Okay, well, then you start asking questions, where's it how's it going to be spent? And just and really, it goes back to following the money. And because there are lawmakers right in the city of Baltimore, in Washington in DC, right? There's the city council, they control all of it, go to their meetings, right? I am a firm believer—look, I'm a local news girl, even though I yes, I'm with NPR, but I have been a local news girl for most of my career. And I also believe that most story started as local, right? And so I was infamous for, you know, hanging out at city council meetings or board meetings where I may have been the only reporter because that's where I think you get the good stories, because I think lawmakers often or they did and that my guess is they still may, is that once the cameras are gone, and they're out of the room. They can forget that their print reporters who may be there, so sometimes they talk for you. And I say go and you know, and go and hang out and figure out how that money is being spent, right? Because they have to, there's an accounting for it, right? Another good source. A good source may be I found the city auditors and state auditors and inspector generals are really good people to get to know because they follow the money, and they know exactly where their money's going or if it's being misspent. They're usually some of the first to know.

ROBBINS: Great, thanks Irina.

JONES:  Sorry, can I just say one more thing? That as we're talking so truthfully, about following the money, the story is that, but the story is also the lives. You know, like as a public health person, so I know I'm not a journalist, you're talking about how you get to the real meaty stories and what needs to be made clear, what needs to be transparent. But if we focus on that without focusing, as you said earlier, Cheryl, about is there going to be an uptick in death? Well, that's not even that's not even an interesting story, that's a tragedy. And so I don't know, I don't know what the news hook is on that, because we have become so numb with you know, 537,000 and counting deaths, and we have been treating them—well, here's an angle. So we've been treating these as local stories, we've been treating these as the individual families that are impacted, or maybe like the workplaces, but we haven't been treating these as a loss to the society. And when I define racism, so my work is on racism. I'm going to just tell you my definition and get to the point. Racism is a system of structuring opportunity and assigning value based on the social interpretation of how one looks, which is what we call race that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities and saps the strength of the whole society through the waste of human resources. And we have been treating the deaths, the COVID-19 deaths, as individual stories as opposed to understanding how those the loss of those people is sapping the strength of the whole society. That would be, yeah go.

THOMPSON:  I was gonna say, I'm gonna respectfully like, challenge you a little bit on this. I think, on the contrary, I think it's a really interesting story, right? That's why the news media is we're obsessed with this. Right every day, every day, There are countless stories. And I also, I also respectfully disagree that people don't care that we don't care anymore. I can't tell you I read those stories. I know people who have died from COVID. I lost a girlfriend two weeks ago I grew up with in Chicago, right. I mean, we all know somebody. I think those stories are. I think they have serious impact. I mean, the New York Times is amazing series. Recently, the Post has done really good work. I mean, those stories are just out there and people are affected by it.

JONES:  Oh I hope I didn't say that they weren't important. I think they're important. Yes and I think that it should go beyond. So I'm not I was not, oh absolutely. We've got to know, we've got to tally up. And we've got to know the human faces. So if I seemed like I was saying something, otherwise, I agree with you. But what I'm saying is, the way that we've been presenting the stories is narrow. So we've been presenting them as my girlfriend who died, my teacher, my son, my, you know, father, as opposed to what is this doing to the whole nation? So it's not only a local loss, but it's sapping the strength of the whole society?

THOMPSON:  Oh, and I think that's clear to from everyday when I turn on CNN, and the numbers are there, 24/7. I get up before the morning, they're the numbers of pandemic numbers, right? And, and so I think we do I think, you know, but it's been a year, right? And I think that we haven't become immune to it. We haven't, I don't think people have, but it's like, at some point, we know this is going on, but okay, but now what we do as journalists, you know, what do we have to frame stories, right? We have to decide, you know, okay, we're right about this but what else do we need to write about, right? Because so now it's the vaccinations, right, that's the hot story of the day. It's like, people are getting vaccinated quickly enough, right?

JONES:  I guess, as a public health person, the fact that the vaccinations are the story is troubling from a public health perspective, because we are so vaccine optimistic that the governor of Texas feels like oh, well, we can just reopen everything now and eliminate mask mandates, not understanding that the vaccine is one tool that's slowly being rolled out, but that the most effective tool that we have are the public health strategies and the masking and in this way, maybe journalists are shunting our view, okay. And I don't know if it's old story, new story stuff.

THOMPSON:  Really? Yeah, we need to talk after this.

ROBBINS:  This is fast. We've seven questions in here. So I will turn it back to Irina.

FASKIANOS: All right, so let's go to Leoneda Inge-Berry, who's at WUNC Public Radio, so North Carolina public radio station. We know that disproportionately high rate blacks and Latinos have suffered from COVID-19 illness and death. Why do you think the CDC did not take race into consideration during distribution of vaccine? Do you think the distribution model should have been shaken up essential workers, grocery store workers, manufacturing workers, bus drivers, food workers, should have been first?

JONES:  So yes, in fact, there was the National Academies of Sciences, Engineering and Medicine had consensus panel that promulgated the guidelines which had the phasing that were adopted a little bit, you know, the ACIP, the Advisory Committee on Immunization Practices, made certain advice about the phases that we all know about that went to the CDC, but they didn't pick up the National Academies thing about within each phase, how do you use a vulnerability index? Because knowing the, if you're going to have nursing homes in the first phase, which nursing homes first? You know, you don't, you can't hit all the nursing homes at once. And they were actually recommending that each state use a vulnerability index to identify the 25% most impacted so that never even got to CDC. So I agree that it's wrong. And then when we had the phasing when Georgia did so that phase one a with you know, healthcare workers and nursing home long term care facility, but they didn't include long term care prisons, or, you know, jails or detention centers, just some kind of long term care facilities. And they didn't include all essential workers, as you say, just health care workers. But then the second phase was supposed to be other essential workers. Third phase was 65 And up in Georgia, they put all of those 65 and up into phase one, a plus, which then flooded, you know, used up all of the availability and still teachers and others still are waiting to be able to get in line in many places.

THOMPSON: And you don’t think we should be writing about that? Because we are.

JONES:  Yeah, we should! Why, did I say we shouldn’t? Okay, good, I don't understand—

ROBBINS: It’s just putting politicians in charge of public health decisions. I mean, that's but once you put it in the hands of the states—

JONES:  Right, you are. And what we're not recognizing is that there are two kinds of vulnerability, their structural vulnerability, or structural risk, I would say an individual risk. Structural risk is when you put more in harm's way, individual risk has to be do with your age or individual vulnerability. But what we have done is blinded ourselves to structural risk, because in this country, we're so narrowly focused on the individual that it makes systems and structures either invisible or seemingly irrelevant. So we have not been, they did a little bit of the structural risk at the beginning, those who are more exposed by virtue of workplace and by virtue of where they live, but they only took some workplaces somewhere lived, they didn't take, as I said, all the essential workers who you know, in the warehouses, meatpacking plants, transportation, grocery stores, and all of that, and they didn't take everybody where they live. And because they didn't take prisons, you don't hear anybody talking about prisons, really, maybe if you're in a locality, that is, that would be a good story. But, um, so. So it reflects, you know, I'm I go philosophical. And Cheryl goes like, yes, but to write this story. So I mean, we're the whole gamut here. But I think that part of the underlying story is that we don't see structures. That's what keeps us from seeing racism. That's what keeps us from seeing the structural risk that accounts for the fact that black young people are, what, eight times to nine times more likely to die from COVID-19 than white young people, because we are the ones who are delivering the food and doing all of these things. (And in prisons?) That's right. That's exactly, we're not doing the prisons. That's right, but we're at more risk, we're at more risk. So  that, so that is a good, that's an interesting framing, if you will, but I don't know how philosophical framing goes.

THOMPSON:  We have written about I mean, there have been many stories about inmates dying from COVID. As a matter of fact, I communicate with a former, actually, he used to run the Mississippi Department of Corrections, and now he's in prison for corruption, told another story. And he communicates with me and to let me know, like, you know, oh, this is how many people got COVID in the prison today. And this is, you know, so people are writing, but just for anybody who's who's writing about Mississippi, who's on this call, you may want to check into the prisons and see, um, but at the same time, those are the kinds of stories where you kind of need access. And like, I don't know, a lot of reporters who, and there are some because I'm fearless for the most part, except when I think I might die. But who want to go into the preview now, it's like, it's hard to get now to get access because government, you know, shut down, it's really hard. It's way harder to do journalism and those kinds of stories during this pandemic, but those stories have been done and they've been done really well. And, and I think they're way more out there to be done. And, you know, start at the local level, start with your, you know, see what's going on in your community, talk to people, right, talk to people, you'd be surprised at what the story is that people know. And they're just waiting for someone to ask them.

FASKIANOS:  So this is a question for you just for you, Cheryl, from Jessi Dodge a buffalo bulletin, she works as a photojournalist for a weekly in a very small town in Buffalo, Wyoming. Like you mentioned, finding people on issues as a necessity, what recommendations you have for talking to people and helping talk them into for lack of a better phrase being included in the story, especially where everyone knows who they are?

THOMPSON:  Okay so , I don’t have, can I use another analogy other than the pandemic analogy of getting someone to talk? So last year, I did a series for NPR, on sex offenders who had absconded. And the government had no idea where these people were, and they were like, 25,000 plus that I could account for around the country, right? And so one of the there was a there was a case I ran across of a woman in Missouri. I wanted to talk to who was a victim of sexual abuse when she was five. And I called and calm and she just wasn't having it. Find out what's on Facebook. Now you guys know social media is like the place to go if you want to track people down, right? So went on Facebook, found her page, I left her message, didn't respond right away, did it again, she finally responded, and I mean, it took a lot. And so then when I was talking to her, you know, I said, Listen, I could come up to Missouri, I will come up, my producer will come. You know, I'll take you to dinner, and we can talk. And she said to me, and by the way, the person who sexually abused her was her best friend's dad. When she was five. They were in kindergarten together when the abuse started.

So she called me back she agreed to do and then she called Probably about a couple of days later she says, you know, no, I don't think so. Because like, I really can't afford to go out to dinner. And I'm like, you don't have to pay, NPR will pay, I'll pay, somebody else will pay. So she agreed to do it. And so I went and it took she was really reluctant to open up. I mean, we're talking about scars from she's like in her 30s. Now we're talking about, you know, old scars that heal slowly. And the first night I just took her to dinner. And we just chatted, we didn't even talk about the case, right? We didn't even talk about just talked about because you have to get people to open up to you and warm up to you. And so Jesso, I said to you, you know, go out there and, you know, go gingerly, but people want to talk most people want to talk again, they just people don't ask them. They don't think their story is important. They don't think their story matters, you know, and you come out there and you know, spend a little time with them. Right? Because one thing that journalists do, were good at, based on the news parachuting in and parachuting out, right? That's what we do, right? Well, okay, this was a story today, next week, it's something else, but go and like, you know, get to know people in the community and just hang out and spend a little time. And you know, if she won't talk to you, or he won't talk to you, you know, find one of their neighbors or somebody they know who might be able to sort of get them to warm up to you. And I hope that was the question she was asking was how to get people to talk to you. Was that her question? Okay.

FASKIANOS: Thank you, let's go to Ben Sessoms of the News And Observer in Raleigh, North Carolina. This is for Dr. Jones. You mentioned earlier about how our communities are segregated and how that insulates us from understanding issues related to race in our communities. That's the case in the area I cover, Raleigh. Can you talk more about how this made COVID worse for black Americans that live in segregated communities specifically how this makes those communities more vulnerable to exposure, sickness and death?

JONES:  So first of all, the fact of the residential segregation is long. But the other observation just human nature is people never compare themselves to those who have less than what they have, they always compare themselves to those who have more. So the so the, the white gaze, even though it might not be you know, upper classes is away from people who are poor. What COVID, what this has to do with COVID-19, is that so you could investigate, okay, I'm trying to put it in a journal thing, but—

THOMPSON: I’ll translate for you.

JONES:  Perfect (laughs) So, so first of all, the reason that there are more people of color in frontline essential jobs is not just because we want to do that kind of work. It's a failure of the public schools, which is related to how in most places, public schools are still funded based on local property taxes. So if you have a racially segregated and disinvested community, it'd be interesting to look at the patterns of disinvestment like active disinvestment in communities, like what decisions to take things out to take out gas stations, or grocery stores, or banks, or pharmacies or whatever. But disinvested communities, then that has a low property tax base and so interesting to look at, to compare the property tax basis across neighborhoods. But anyway, a poorly funded school often results in poor educational outcomes and another whole generation loss. So then you have these people who are trying to make it who are now, you know, in these frontline positions where they don't have good sick pay or anything like that and have to go to work. You know, if they want to feed their families in the light coming back to houses that might be small and cramped, and might have many generations living in it. So then a young person who's going and running Uber Eats, might come back in may have gotten sick, and the grandmother is here, and then they die, or, you know, they don't have you know, but one bathroom to wash up in at all.

So the fact of the disinvestment it's, you know, fine to have racially segregated communities with this, you know, we don't need to live next to one another if somebody is bothered by that. But the fact that the communities are disinvested and it makes it easier to do that, because of the racial segregation, and the, you know, redlining and all the history behind, that is what has created these conditions and most of us are in our own bubble of our own communities, our children's schooling like that and have no idea that they're people just across town. Now I'm going to go into one of the things I often say just across town who are just as kind, funny, generous, hardworking, smart as we are, but are living in very different circumstances. It might be interesting to identify churches, for example, that have made partnerships, or schools that have made partnerships across different kinds of town. And what has happened when that thing has happened, how have people's interest in and knowledge about what's happening somewhere else and their connection with people on the other side of town, how has that kind of intervention, of doing what I call bubble bursting, actually had a positive impact? But the COVID stuff is all about how racism has structured our opportunity and assigned value and it's deep, it's generations deep. Very many people don't know about the history of their own place and I don't know if there are different historical things that you could pick up one a week or something about the history of a given neighborhood or the history of how that road got put where it did, or the history of why the, you know, where they bury the solid waste, I can never remember what that's called. But anyway, you know, why the location of different environmental hazards? Or how did it come to be that the bus transfer station was put in that neighborhood? Those things would make it very real for people to understand that it didn't just so happen, that people of color are living in certain conditions and white people in other conditions are that black people are more are overrepresented in poverty and white people overrepresented wealth. So if you have an interest in history, just dig down different little pieces of history about the adverse conditions or the country club on the other side and maybe every week do a different one.

THOMPSON:  And you know, back and piggyback on that. You mentioned the churches, you know, black churches are really good place to go, if you're looking for a story. Black churches know what their parishioners, I’m Catholic so I use the word parishioners, but they're members, right? They know about their members there, it's close knit black churches are real close knit clan. And so you know, if you're looking for a story in a community, start with the church and ask, you know, and talk to the Minister there and see who they know and what they know. And I'm sure it is a really I'm, I'm sure churches have lost a lot of congregants during this pandemic, might sort of interesting to see particularly like small church, right and see if they've lost people. Just another local story idea.

ROBBINS: That raises in, we were almost done. So I'm going to take the prerogative here of asking my Final Jeopardy question. So it something that Dr. Jones said and something Professor Thompson has said that raises this, which is at some point, we will go back to something that people will declare normal, except it's not going to be normal, because we will have lost 600,000 Americans. And some communities will have lost many more people than other communities. And so as the reopening starts, I would like to ask both of you, where would you go, to document this to report on it? To see what —President Biden always talks about that empty seat at the table. I mean, one thing that I know I would do is a reporter is I would go and look at high schools to see how many kids come back. What the dropout rate is going to be, you know the loss of an entire generation of kids who decide not to graduate from high school. That's, that for me, that's my story that I would do. But I'm going to, I'm going to I'm going to put it back to Dr. Jones. I'm going to give Professor Thompson the last the last word on,

JONES:  You can go first because I don't have a thought yet. I'm still thinking.

THOMPSON: Oh! I'm gonna take advantage of that.

ROBBINS: So, as we reopened, how do we how do we cover you know, what's happened to these communities and start documenting, you know, how they've been transformed by this experience?

THOMPSON:  Well, I think it's interesting. You mentioned the high school graduation rate, look at the kids in elementary school have fallen, and in high school, who have fallen so far behind, because of homeschooling. Like there's a kid on my block. He's like, I don't know who might see this, I don't want to say, but he's of color. I’ll just say it he's Hispanic. And he I see him every day. And I'm like, I want to say like, he's out there playing basketball like, aren’t you supposed to be in school? That's what I'm thinking to myself, right? But both his parents work and he's you know, like a preteen and I’m thinking, shouldn’t you be studying or something? And so I always wonder, like, after this pandemic, after we get past, you know, this thing, which at some point, I hope we do get past, what has happened with the kids in our in our schools, you know, like, not only not graduated, but how far behind have they fallen, right? And I just wonder that, and I don't have kids so you know, I don't know, but that's one of the things that I wonder. And so I think, yeah schools is a really good place to tap into to see, you know, the toll that this pandemic has taken. And I still go back to the churches, I think the churches are another really good place.

And let's not forget the universities, right, because these kids, they're down and for loss of them are down in Lauderdale for spring break, and I'm thinking Oh, okay, um, you know, partying and having a good time. And I totally get that. And I wonder, you know, when I go back to campus, because we're supposed to be in person in the fall, like, who's not coming back? Who's not coming back because of this pandemic? So that's, that's the other place I would go, and also, I would look at I know, another toll that has been taken is like these kids, these students, these college students in particular, like a lot of them don't have a place to go, right. They have food insecurities, there's all kinds of things that have happened during this pandemic that I think it's worth taking a look at, to see how people have been affected.

ROBBINS: Dr. Jones, last word for you about when we start coming back, to see to see how particular communities have been transformed by this?

JONES:  So I'm not sure how you would do it. But I would, perhaps look at changes in age structures of the populations in different communities, like, in some communities, first of all, the proportion of people gone. But some communities is going to be mostly older people who've been affected and in some communities is going to be older and really impacting younger. I would take a look at the positive and see where our investments going. It's not the impact of the pandemic, but it's the response. And I've been talking about, don't just try to bring me vaccine, bring me some vaccine plus, bring some vaccine plus investment in the conditions of my community and my life, because if you don't, then when COVID-23 comes or whatever the new ones going to be, it's going to be the same story. We can't allow that. So to do some tracking of differential investment. And so I guess I would just close it with three principles for achieving health equity that I articulate, and maybe even, maybe, oh, I would love it if people did this story to take these three principles and then interview different people. What do these mean for you in this community? What do these mean in response with regard to our COVID-19 response?

The first principle is valuing all individuals and populations equally. The second is recognizing and rectifying historical injustices and the third is providing resources according to need. And I'll give you a little hint of how you could start thinking about operationalizing each of those, first of all, valuing all individuals and populations equally, just think, what does that word valuing mean to you? And you can kind of go and think, well, how do I value my children or my nieces and nephews or whatever? It involves investment protection, celebrating, you know, inviting all of these things. So we could generate here fifty valuing words in two minutes, right? So are we doing that for all individuals and populations equally, right? Often, that's manifest, as I said before, and who's at decision making tables and who's not whenever somebody such a decision making table or finds himself at one, they should look around, say who's not here. So that would be another story is just like who's making the decisions and who's not here who has an interest in this proceeding? is a very important question. The second of the three principles, recognizing and rectifying historical injustice. So I already talked about digging up some of the history for different locations or differential adverse exposures or, or whatever it is that’s your interest or your hook. So then recognize it, journalism has a big role in that, and then who's working to rectify it? Maybe people don't even know that history, so maybe the story would be the start of rectify. The third is an actually though there, you know, there's conversation about reparations. And so what do people think that might look like, I think it's Asheville, North Carolina, and a few other cities now have actually passed, you know, statutes or whatever that are about reparations. So to see maybe there's somebody around you.

The third, providing resources according to need has two parts. The first part is have people established a metric of need on which everybody agrees. It could be the number of people per 100,000 who have died from COVID-19. It could be infant mortality rates, it could be like whatever it is, but agree on a metric of need. But then the second part is for those who are distributing resources, the politicians and all to have the political spine when they get some resources, the money that Professor Thompson is talking about we need to track. Is that going to need? The vaccine that this National Academies of Sciences said we should be providing according to need with a vulnerability index? Is that happening? And often when it doesn't happen, it's because of a lack of political spine because everybody feels needy because people do not know that there are people who have less than they do they only compare themselves to those who have more. But anyway, to ask that question, how do you interpret and how are you implementing these three principles would be a very interesting story to me, like a feature type of thing.

ROBBINS: That's great as we as we play the thank you so much as we play the extra music, Cheryl is going to say something really quickly.

THOMPSON:  Dr. Jones, I had on one thought, look around if you're looking for a local story about this pandemic, look in your community at the businesses that have that don't exist anymore, right? The mom and pop particularly in the minority communities, right, they were, you know, they may have been struggling before now they're gone. Right? So pay attention that that also makes for good local story. What happened to these people and chances are they you know, they may or may not have gotten the PPP, right, that may have helped them. But I would look at businesses because I think you're going to see a huge change in communities in terms of businesses, so and if anybody wants to talk about a story, or you know, I'm happy to do. You can DM me on Twitter @CherylWT and I'm happy to talk to a story, local story with you.

ROBBINS: It's great and we're gonna we will share it with an email Dr. Jones's extraordinary talk to Oregon State earlier this year, last year, which I recommend to everyone. Turn it back to Irina. Thank you so much.

FASKIANOS:  Thank you all. This is a terrific conversation, really appreciate your taking the time into all of you. I'm sorry, we couldn't get to all your questions. But obviously, we have willing participants here to speak with you directly. So I encourage you to follow Carla Anne Robbins on Twitter @RobbinsCarla, Cheryl @CherylWT and Camara @CamaraJones. You can also go to CFR.org,ThinkGlobalHealth.org and ForeignAffairs.com for the latest developments and analysis on COVID-19 pandemic. And also please do send us an email to local [email protected]. If you have ideas or suggestions for future webinars, we want to stand by here and be a resource for all of you. So please do send us your feedback and your ideas. So thank you all for being with us.

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