tag:theconversation.com,2011:/ca-fr/topics/race-and-health-87295/articlesrace and health – La Conversation2021-04-28T12:15:37Ztag:theconversation.com,2011:article/1583662021-04-28T12:15:37Z2021-04-28T12:15:37ZScarred by Zika and fearing new COVID-19 variants, Brazilian women say no to another pandemic pregnancy<figure><img src="https://images.theconversation.com/files/396852/original/file-20210423-21-1mpg3z0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A field hospital in São Paulo state, Brazil, on March 26, 2021. Brazil keeps setting new COVID-19 records, with up to 4,000 people dying daily. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/patients-affected-by-the-covid-19-coronavirus-remain-at-a-news-photo/1231952275?adppopup=true">Miguel Schincariol/AFP via Getty Images</a></span></figcaption></figure><p>“We have to avoid a pregnancy,” said Rosa, about the possibility of getting pregnant during the COVID-19 pandemic. “My feeling is that I don’t want to have a baby. What I went through in 2017 when I had Raíssa, God forbid.”</p>
<p>Rosa lives in the Brazilian state of Pernambuco. Her first child, Raíssa, was born during the <a href="https://www.cdc.gov/zika/index.html">epidemic of Zika</a> – a mosquito-borne disease that caused severe birth defects if contracted during pregnancy, among other effects. </p>
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<p>Between 2015 and 2017, some 3,700 babies in Brazil <a href="https://www.npr.org/sections/goatsandsoda/2019/10/09/768629177/zika-researchers-are-learning-more-about-the-long-term-consequences-for-children">were born with a Zika-related congenital malformation</a> of abnormally small heads. These babies are now 4 to 7 years old. Some <a href="https://www.newscientist.com/article/2208677-half-of-babies-affected-by-zika-virus-are-developing-normally-by-age-2/">began to develop normally within a few years</a>. But others face <a href="https://www.hrw.org/news/2019/05/08/brazils-zika-babies-are-growing">enormous difficulties eating, walking, speaking and seeing</a>. They require highly specialized care, and families get meager governmental assistance.</p>
<p>Pernambuco was one of the epicenters of Brazil’s Zika outbreak. Today, Brazil is an epicenter of the coronavirus pandemic, with more than 13 million confirmed COVID-19 cases, nearly <a href="https://www.worldometers.info/coronavirus/country/brazil/">400,000 deaths</a> and no end in sight.</p>
<p>Meanwhile, Zika is still circulating – though it’s much less common.</p>
<p>For Rosa and many other women in Pernambuco, the thought of navigating another pregnancy during another novel infectious disease outbreak is incredibly stressful – and their anxiety is starting to show in Brazil’s declining pregnancy intentions and births.</p>
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<a href="https://images.theconversation.com/files/396851/original/file-20210423-23-1a41nwo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Man spoon feeds his toddler child, lying in a baby seat" src="https://images.theconversation.com/files/396851/original/file-20210423-23-1a41nwo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/396851/original/file-20210423-23-1a41nwo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/396851/original/file-20210423-23-1a41nwo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/396851/original/file-20210423-23-1a41nwo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/396851/original/file-20210423-23-1a41nwo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/396851/original/file-20210423-23-1a41nwo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/396851/original/file-20210423-23-1a41nwo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Some children with microcephaly have difficulty swallowing.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/brazilian-wallace-da-silva-cruz-feeds-his-two-year-old-son-news-photo/1071527866?adppopup=true">Mauro Pimintel/AFP via Getty Images</a></span>
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<h2>The Zika-COVID connection</h2>
<p>I lead the <a href="https://liberalarts.utexas.edu/zika/">DeCodE Project</a>, a study funded by the National Institute of Child Health and Human Development. The project aims to understand whether and how women of reproductive age change their childbearing attitudes, desires and behaviors during novel infectious disease crises like Zika and COVID-19.</p>
<p>COVID-19 and Zika are distinct viruses with different modes of transmission and health effects. Neither had ever been seen before in Brazil. The novelty of such diseases generates extreme uncertainty over infection risks and a chaotic prevention response, especially for typically high-risk groups like <a href="https://utswmed.org/medblog/pregnancy-anxiety-covid19-pandemic/">pregnant people and their babies</a>.</p>
<p>Our study group conducted interviews throughout 2020 with 3,998 women ages 18 to 34 in Pernambuco. We have been monitoring them with periodic surveys since then. These women are navigating back-to-back novel infectious disease outbreaks that overlap substantially with their reproductive years.</p>
<p>Early on in the Zika crisis, it was unclear whether a fetus in utero could get the virus. Later, fetal transmission was confirmed – along with <a href="https://www.nejm.org/doi/full/10.1056/NEJMsr1604338">the risk of severe fetal abnormalities at birth</a>.</p>
<p>Now, just a few years later, COVID-19 is bringing similar uncertainty. </p>
<p>The <a href="https://covid.cdc.gov/covid-data-tracker/#pregnant-birth-infant">specific risk of COVID-19 to pregnant people</a> and their infants is <a href="https://wwwnc.cdc.gov/eid/article/27/2/20-3824_article">not yet entirely clear</a>. Early in the pandemic, evidence suggested that pregnancy posed <a href="https://theconversation.com/pregnant-in-a-time-of-coronavirus-the-changing-risks-and-what-you-need-to-know-134745">no greater risk in terms of catching COVID-19</a> or suffering worse symptoms than the general population. </p>
<p>In June 2020, however, the U.S. Centers for Disease Control and Prevention added pregnancy to the list of health conditions that make COVID-19 patients more likely to be <a href="https://www.cdc.gov/media/releases/2020/p0625-update-expands-covid-19.html">hospitalized and admitted to the intensive care unit</a>, based on <a href="https://theconversation.com/coronavirus-pregnant-women-and-infants-new-research-136639">several studies</a>. There is also evidence of increased stillbirths and preterm deliveries during the pandemic, though it is not entirely clear whether these increases result from SARS-CoV-2 infection or indirect effects such as <a href="https://doi.org/10.1001/jama.2020.12746">stress or reluctance to seek medical care</a>.</p>
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<a href="https://images.theconversation.com/files/396848/original/file-20210423-13-hiex5d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Older woman pours water on a younger woman wearing a face mask and bikini with a very big baby belly" src="https://images.theconversation.com/files/396848/original/file-20210423-13-hiex5d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/396848/original/file-20210423-13-hiex5d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/396848/original/file-20210423-13-hiex5d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/396848/original/file-20210423-13-hiex5d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/396848/original/file-20210423-13-hiex5d.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/396848/original/file-20210423-13-hiex5d.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/396848/original/file-20210423-13-hiex5d.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">A midwife from Brazil’s Kumaruara tribe in July 2020 bathes her pregnant daughter with medicinal herbs meant to strengthen her for the pandemic-time delivery.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/midwife-paje-suzete-from-the-kumaruara-tribe-bathes-her-news-photo/1226933180?adppopup=true">Tarso Sarraf/AFP via Getty Images</a></span>
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<h2>Race, class and health inequities</h2>
<p>In Brazil, where out-of-control infections have given rise to a more transmissible and deadly variant, pregnant and post-partum women are showing <a href="https://www.scielo.br/scielo.php?script=sci_arttext&pid=S1519-38292021000100253">higher death rates from COVID-19</a>. Hospitals are attributing an unusually large number of newborn deaths to COVID-19. On April 17, 2021, <a href="https://www.cnn.com/2021/04/17/americas/brazil-pregnancy-covid-intl/index.html">Brazilian officials</a> took the unusual step of asking women to avoid getting pregnant. </p>
<p>Not all people, of course, have total control over their bodies – no matter how anxious they are about a potential pandemic pregnancy. In Brazil, high-quality health care and contraceptive options are less accessible to poorer women and <a href="http://authors.elsevier.com/sd/article/S0277953617304410">Black women</a> than they are to white women and wealthy women.</p>
<p>During the coronavirus pandemic, for example, Black women from lower socioeconomic backgrounds have seen their medical care severely interrupted. <a href="https://sites.utexas.edu/decodificando/files/2021/01/1-s2.0-S0305750X20304320-main.pdf">Our data shows</a> that 58% were unable to find health services of any kind when they needed them. In contrast, 23% of wealthier white women experienced a similar neglect.</p>
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<a href="https://images.theconversation.com/files/396842/original/file-20210423-23-1p9uq86.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Health worker in full-body PPE walks a pregnant woman down a hall" src="https://images.theconversation.com/files/396842/original/file-20210423-23-1p9uq86.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/396842/original/file-20210423-23-1p9uq86.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/396842/original/file-20210423-23-1p9uq86.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/396842/original/file-20210423-23-1p9uq86.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/396842/original/file-20210423-23-1p9uq86.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/396842/original/file-20210423-23-1p9uq86.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/396842/original/file-20210423-23-1p9uq86.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">A health worker assists a pregnant COVID-19 patient in Pará State, Brazil, in July 2020.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/worker-from-the-special-secretariat-for-indigenous-health-news-photo/1227679511?adppopup=true">Tarso Sarraf/AFP via Getty Images</a></span>
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<p>And in a <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/padr.12074">2017 study I led</a> during the Zika epidemic, wealthier women in Brazil reported having more autonomy over their reproductive decisions than those of lower socioeconomic backgrounds.</p>
<p>Still, Brazilian women did their best to avoid childbearing during Zika. <a href="https://link.springer.com/article/10.1007/s13524-020-00871-x">One of our studies</a> shows temporary birth declines of 10% nationally and of 28% in Pernambuco in November 2016, roughly a year after the link between Zika and birth malformations was established.</p>
<p>It appears that women are now doing the same during COVID-19. </p>
<p>Half of the women we interviewed who want children said they intend to avoid pregnancy during the pandemic. Women who had Zika or were close to people who did are 11% more likely to say this, <a href="https://liberalarts.utexas.edu/zika/news/decode-project-pre-print-scars-from-a-previous-epidemic-among-white-and-black-women-social-proximity-to-zika-and-fertility-intentions-during-the-covid-19">according to one preliminary study conducted by my team</a>.</p>
<p>“I am really afraid of getting pregnant,” said Sônia, a 24-year-old woman in Recife, the capital city of Pernambuco state, in an interview in May 2020. “It is the same feeling” as during Zika “but now it is a little worse.”</p>
<p><a href="https://datastudio.google.com/u/0/reporting/1f9481ef-3e60-4f2d-a871-0e4d739a4163/page/h1XEC?s=teTj3FWK8yQ">Our analysis of preliminary data</a> from Brazil’s civil registry bears this out: Live births in January 2021 – roughly nine months after Brazil’s first confirmed case of COVID-19 – dropped 12% compared to last year. This information may change, however, as data is updated and government demographic data becomes available. Brazil’s 2020 census <a href="https://www.dw.com/pt-br/governo-confirma-cancelamento-do-censo-em-2021/a-57319018">was canceled</a>.</p>
<p>Our research illustrates how the effects of epidemics go beyond just mortality and health. For some Brazilian women of childbearing age, it changes their desire to become parents.</p>
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<p class="fine-print"><em><span>Letícia Marteleto receives funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, one of the National Institutes of Health in the U.S. Department of Health and Human Services. </span></em></p>Officials in Brazil recently asked women to avoid pregnancy, citing heightened risk to them and newborns. But births were already dropping; a new study attributes it to the trauma of Zika.Letícia Marteleto, Professor of Sociology, The University of Texas at AustinLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1400452020-06-10T17:16:43Z2020-06-10T17:16:43ZWhat it takes to record a Black person’s death<figure><img src="https://images.theconversation.com/files/340358/original/file-20200608-176560-7mk33e.jpg?ixlib=rb-1.1.0&rect=274%2C26%2C4068%2C2884&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Malaysia Hammond, 19, places flowers at a memorial mural for George Floyd at the corner of Chicago Avenue and 38th Street on May 31, 2020, in Minneapolis. </span> <span class="attribution"><span class="source">(John Minchillo/AP Photo)</span></span></figcaption></figure><p>On July 17, 2014, <a href="https://www.nytimes.com/2019/07/16/nyregion/eric-garner-case-death-daniel-pantaleo.html">Eric Garner’s murder by NYPD officers</a> was captured by Ramsey Orta on his mobile phone camera. Choked, handcuffed and pinned face down to the ground, Garner’s repeated calls for help, encapsulated by the phrase “I can’t breathe,” were ignored by the arresting officers.</p>
<p>Nearly six years later, the killing of George Floyd by Minneapolis Police Department officers was recorded by Darnella Frazier, a young Black woman who captured the final moments of Floyd’s life on her mobile phone. Her video shows Floyd handcuffed with his head pinned underneath the knee of a police officer, repeatedly yelling, “I can’t breathe.”</p>
<p>Like Orta’s video, the footage that Frazier uploaded to Facebook has since gone viral. Used by many media outlets, Frazier’s video has led to <a href="https://www.nbcwashington.com/news/local/dc-george-floyd-protest/2316832/">public outrage and ongoing mass protests</a>. It also assisted in the decision to fire the four arresting police officers, and <a href="https://www.usatoday.com/story/news/nation/2020/06/03/george-floyd-death-charges-derek-chauvin-police/3134766001/">to subsequently charge</a> one with second-degree murder and the other three with aiding and abetting.</p>
<h2>Bearing direct and indirect witness to trauma</h2>
<p>Often forgotten in these far too common acts of police violence and fatal police-civilian encounters, involving unarmed Black people, is the dangerous, emotional and traumatic labour of bearing witness. </p>
<p>Following Garner’s death, <a href="https://www.theverge.com/2019/3/13/18253848/eric-garner-footage-ramsey-orta-police-brutality-killing-safety">Orta’s life took a drastic turn for the worse</a>. From 2014 to 2016, Orta was arrested three times for a series of charges, which activists maintain stem from <a href="http://amsterdamnews.com/news/2020/apr/23/ramsey-orta-transferred-prison-infirmary-due-sickn/?page=2">retaliatory set-ups by the NYPD for filming the video</a>. Despite providing the footage that served as the <a href="http://amsterdamnews.com/news/2020/apr/23/ramsey-orta-transferred-prison-infirmary-due-sickn/?page=2">catalyst for the “I can’t breathe” slogan and movement</a>, Orta remains incarcerated to this day.</p>
<p>The day after Floyd’s death, Frazier returned to the scene of the killing, crying and emotionally distraught. <a href="https://www.youtube.com/watch?v=GXKMih20Ur0&has_verified=1&bpctr=1591295910">In a video</a> that has been viewed nearly 2.5 million times, Frazier pleads, “They killed this man. And I was right there! I was like five feet away! It is so traumatizing.” </p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/GXKMih20Ur0?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Darnella Frazier, who recorded the death of George Floyd, describes the trauma of doing so.</span></figcaption>
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<p>If the emotional and traumatic consequences of bearing witness to Floyd’s killing were not enough, Frazier has also encountered online harassment for recording and posting the video. In the comments section of the video Frazier uploaded to Facebook, some have <a href="https://www.kansascity.com/news/nation-world/national/article243063836.html">chastised her for recording the footage without intervening</a>. Frazier comes to her own defence, writing: </p>
<blockquote>
<p>“I don’t expect anyone who wasn’t placed in my position to understand why and how I feel the way that I do. MIND YOU I am a minor! 17 years old, of course I’m not about to fight off a cop.” </p>
</blockquote>
<p>Attempts to diminish the profound effects of bearing witness to traumatic events aim to dismiss the notion of shared trauma. As literary critic Shoshana Felman and psychoanalyst Dori Laub argue, the listener or, in this case, the viewer, becomes “<a href="https://doi.org/10.4324/9780203700327">a participant and co-owner of the traumatic event</a>.” In this sense, viewing the deaths of Garner and Floyd behind a screen can be different but equally traumatic experiences for both the person recording and for the viewer. </p>
<h2>The effects of bearing witness</h2>
<p>Viewing race-based trauma can be particularly traumatic for Black people for whom police violence is a <a href="https://www.latimes.com/science/story/2019-08-15/police-shootings-are-a-leading-cause-of-death-for-black-men">leading cause of death</a>. This realization is intensified by the danger that the mere <a href="https://global.oup.com/ushe/product/a-space-for-race-9780190858919?cc=us&lang=en&">occupation of public space</a> poses for Black lives. </p>
<p>In part, this stems from a refusal on behalf of white folks to recognize the <a href="https://fernwoodpublishing.ca/book/policing-black-lives">extensive history of race-based policing in both the United States and in Canada</a>. There is also a pressing need for white people to understand that <a href="https://www.nationalobserver.com/2020/06/05/news/calls-defund-police-grow-torontos-mayor-not-buying">policing itself is a form of harm</a>, especially for people of colour. As writer and activist Desmond Cole reminds us, police violence committed against Black people is too often treated as a “<a href="https://www.cbc.ca/radio/thecurrent/the-current-for-june-1-2020-1.5592953/police-brutality-continually-treated-like-a-one-off-in-canada-says-desmond-cole-1.5592954">one off</a>.”</p>
<p>Some suggest that using mobile phone cameras to watch the police is a means of “<a href="https://www.cogitatiopress.com/mediaandcommunication/article/view/292">prevent[ing] police violence from being used against other community members or oneself</a>.” But given that <a href="https://theconversation.com/police-kill-about-3-men-per-day-in-the-us-according-to-new-study-100567">Black men are far more likely to be killed by police than white men</a>, bearing witness on camera as a form of cop-watching has not prevented further police violence from occurring. Instead, bearing witness involves race-based trauma that attempts to hold police accountable for the pain they have long inflicted against Black people and communities. </p>
<p>As writer Kia Gregory says, acts of police violence and deadly police-civilian encounters “<a href="https://newrepublic.com/article/153103/videos-police-brutality-traumatize-african-americans-undermine-search-justice">are so pervasive, they inflict a unique harm on viewers, particularly African Americans, who see themselves and those they love in these fatal encounters</a>.” </p>
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<img alt="" src="https://images.theconversation.com/files/340348/original/file-20200608-176542-1s94iko.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/340348/original/file-20200608-176542-1s94iko.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/340348/original/file-20200608-176542-1s94iko.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/340348/original/file-20200608-176542-1s94iko.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/340348/original/file-20200608-176542-1s94iko.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/340348/original/file-20200608-176542-1s94iko.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/340348/original/file-20200608-176542-1s94iko.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A young boy holds a sign during a vigil demanding justice for Eric Garner.</span>
<span class="attribution"><span class="source">(John Minchillo/AP)</span></span>
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<p>The trauma of bearing witness extends from the person experiencing, recording or witnessing violent or fatal police encounters, to those who subsequently view and witness the recording through a digital medium, and most often <a href="http://eyewitnessmediahub.com/research/vicarious-trauma">through social media platforms</a>. Viewing such videos can induce <a href="https://dx.doi.org/10.1016%2Fj.amepre.2014.09.013">stress, fear, frustration, anger and anxiety</a>. There is medical evidence to suggest that viewing footage of race-based trauma can lead to a physical ailments, <a href="https://doi.org/10.1111/josi.12251">including eating and sleeping disorders, high blood pressure and heart problems</a>. </p>
<p>Bearing witness to these acts of deadly police violence can be traumatizing for anyone. Keenly aware of the mental health toll that police violence and race-based trauma can take, a GoFundMe campaign has raised <a href="https://www.gofundme.com/f/peace-and-healing-for-darnella">nearly US$500,000 for Darnella Frazier’s “peace and healing.”</a> </p>
<p>For Black folks, in particular, the terrifying and everyday reality that they encounter at the hands of police is a trauma that endures long after the initial act of witnessing has occurred. It is a trauma that is relived and re-experienced not only in person but behind the screen.</p><img src="https://counter.theconversation.com/content/140045/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Constantine Gidaris receives funding from the Social Sciences and Humanities Research Council. </span></em></p>Recording and bearing witness to a Black person’s death from police violence is in itself traumatizing.Constantine Gidaris, PhD Candidate, English and Cultural Studies, McMaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1372842020-05-27T16:41:35Z2020-05-27T16:41:35ZCollecting race-based data during coronavirus pandemic may fuel dangerous prejudices<figure><img src="https://images.theconversation.com/files/336560/original/file-20200520-152315-1ypwkoa.jpg?ixlib=rb-1.1.0&rect=121%2C110%2C6952%2C4792&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Racially sorted patients are surveilled, often with negative consequences.</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Brian Sinclair wheeled himself into a Winnipeg emergency room in September 2008 seeking assistance with his catheter bag. He had a bladder infection, but instead of receiving treatment, remained in the waiting room for 34 hours until his body — now lifeless — finally received medical attention. </p>
<p>Sinclair was an Indigenous man who hospital staff believed was there “<a href="https://globalnews.ca/news/4445582/brian-sinclair-health-care-racism/">to watch TV</a>,” <a href="https://www.youtube.com/watch?v=NITrHzxbhKw">appeared “intoxicated”</a> and was simply “<a href="https://www.youtube.com/watch?v=NITrHzxbhKw">sleeping it off</a>.” He was arguably triaged within what scholars of Indigenous histories Mary Jane Logan McCallum and Adele Perry call <a href="https://uofmpress.ca/books/detail/structures-of-indifference">a “highly racialized” health-care system</a>. </p>
<p>Sinclair’s case shows how <a href="https://fernwoodpublishing.ca/book/punched-drunk">stereotypes of indigeneity in Canada</a> can influence patient care with fatal consequences. More broadly, this adds to trends of <a href="https://www.routledge.com/Coming-to-Terms-with-Chance-Engaging-Rational-Discrimination-and-Cumulative/Gandy/p/book/9781138260474">cumulative disadvantage</a>, where negative circumstances that affected population groups in the past continue to affect the same groups today.</p>
<p>Is there a risk that the COVID-19 pandemic will fuel such trends in Canada, especially against the backdrop of the country’s racialized past? As a sociologist, my answer to this question is yes. </p>
<p>As a researcher affiliated with the <a href="https://www.sscqueens.org/">Surveillance Studies Centre</a>, I am also concerned with how racially sorted patients are surveilled, often with negative consequences. Therefore, as a privacy and ethics officer evaluating health data for Ontario’s <a href="https://news.ontario.ca/mohltc/en/2020/04/province-developing-new-health-data-platform-to-help-defeat-covid-19.html">Pandemic Threat Response (PANTHR)</a>, I caution the Ministry of Health and its partners against the use of race- and ethnicity-based health data in dealing with COVID-19.</p>
<h2>Collecting race data for good medicine?</h2>
<p>Canada’s attention to race during the first 100 years of immigration policy shaped aspirations of a settler colonial “<a href="https://youtu.be/mhr1Ucr7qlc?t=66">White Canada Forever</a>.” Unsurprisingly, historical racial inequalities shape Canadian experiences in health care. </p>
<p>Dr. Kwame McKenzie of Toronto’s <a href="https://www.wellesleyinstitute.com/">Wellesley Institute</a> believes that <a href="https://youtu.be/beQSp5Zbvpk?t=5">race-based data is essential for “good medicine.”</a> And many additional doctors and scholars believe that <a href="https://theconversation.com/coronavirus-discriminates-against-black-lives-through-surveillance-policing-and-the-absence-of-health-data-135906">collecting race data might improve understandings of the social determinants of health</a>.</p>
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<figcaption><span class="caption">A few local Canadian authorities have started tracking the racial data of those infected with COVID-19.</span></figcaption>
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<p>However, when race data is collected to understand the social determinants of health, it could inadvertently <a href="https://doi.org/10.1177%2F0957926504043707">legitimate biological understandings of race</a>. This is an essentialist position that necessarily ties the racial attributes and behaviours of one person to another. </p>
<p>Further, when race data is used in these circumstances, it creates more scope to arrive at racist responses to a pandemic than it does to address social vulnerabilities like <a href="https://www.youtube.com/watch?v=MA4ZfJoREZg">the poor work conditions of minority populations in essential services</a>. </p>
<h2>Linking race and health</h2>
<p>Alberta’s Chief Medical Officer of Health, Dr. Deena Hinshaw, <a href="https://www.thestar.com/news/canada/2020/04/10/race-based-coronavirus-data-not-needed-in-canada-yet-health-officials-say.html">acknowledges that systematic racism disadvantages certain populations</a>. However, Hinshaw has not yet committed to collecting such data. Initially, her Ontario counterpart, Dr. David Williams, said the province would focus on age and chronic illness “regardless of race, ethnic or other backgrounds.” Ontario now says <a href="https://toronto.citynews.ca/2020/05/06/ontario-to-begin-collecting-race-based-data-during-coronavirus-pandemic/">it will collect race-based data</a> during the pandemic.</p>
<p>Williams’ revised position certainly eases tensions with a coalition of Black health leaders that has called for attention to race. </p>
<p>Endorsed by 192 organizations and 1,612 individuals, the coalition wrote an <a href="https://www.allianceon.org/news/Letter-Premier-Ford-Deputy-Premier-Elliott-and-Dr-Williams-regarding-need-collect-and-use-socio">open letter</a> to Ontario Premier Doug Ford and other provincial officials. It argues for “the collection and use of socio-demographic and race-based data in health and social services … as it relates to COVID-19.” </p>
<p>But the use of race data may be problematic because links between health conditions and race have been connected to discriminatory outcomes in the past.</p>
<h2>Race-based medical practice</h2>
<p>Diseases like Tay-Sachs and sickle cell anemia <a href="https://www.jstor.org/stable/20058712">have discursively been described as a “Jewish disease” and “Black disease” respectively at least since the early 1900s</a>, even though these associations with races <a href="https://doi.org/10.1080/13557858.2010.541902">can lead to inaccuracies</a> in terms of who is deemed high risk. Moreover, racializing these diseases reinforced discriminatory notions of race that were tied to other policies of racial oppression, such as <a href="https://www.upress.umn.edu/book-division/books/testing-fate">anti-immigrationism</a>.</p>
<p>Because <a href="http://doi.org/10.1056/NEJMp1511294">race data are routinely associated with medical conditions and treatment</a>, many medical doctors turn to race as <a href="https://www.upress.umn.edu/book-division/books/testing-fate">illness inducing</a>, instead of examining an individual’s symptoms, individual patient history or family history. </p>
<p>Racial categories are therefore deemed scientific, despite their <a href="https://scholarship.law.umn.edu/mjlst/vol12/iss1/3/">unscientific construction</a>.</p>
<h2>Racializing COVID-19</h2>
<p>If race-based data collection is to be attached to COVID-19 in Ontario, then attention should be given to what happens when medical conditions are associated with one’s race. </p>
<p>What happens when a disease is racialized? One example of the racializing of COVID-19 are the many <a href="https://montreal.ctvnews.ca/anti-asian-racism-on-the-rise-in-canada-s-biggest-cities-amid-covid-19-crisis-poll-1.4913957">cases of anti-Asian racism across North America</a> ignited by <a href="https://nationalpost.com/opinion/conrad-black-on-covid-19-the-world-succumbed-to-a-pandemic-of-hysteria-more-than-a-virus">xenophobic hysteria</a>. </p>
<p>Another example comes from China where a McDonald’s franchise in Guangzhou <a href="https://www.bbc.com/news/world-asia-china-52274326">allegedly posted a sign</a> in April reading, “We’ve been informed that from now on Black people are not allowed to enter the restaurant” because of “rumours” that coronavirus was spreading among African people. </p>
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<p>If surveillance is the <a href="https://www.wiley.com/en-ca/Surveillance+Studies%3A+An+Overview-p-9780745635927">attention to human attributes and behaviours</a> so that people can be “<a href="https://www.routledge.com/Surveillance-as-Social-Sorting-Privacy-Risk-and-Automated-Discrimination/Lyon/p/book/9780415278737">socially sorted</a>” and potentially treated differently, then the systematic collection of race data is also a form of surveillance. </p>
<p>When rumours like those in the McDonald’s example are connected to reports generated through <a href="https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html">racial surveillance by leading health agencies that monitor COVID-19 by race</a> (like the U.S. Centers for Disease Control and Prevention), then the racial dimensions of the virus can further fuel xenophobia. </p>
<p>Therefore, a call for <a href="https://www.dukeupress.edu/dark-matters">increased racial surveillance potentially fuels racism</a>. </p>
<h2>Measuring race, fuelling racism</h2>
<p>Health scholars have raised concerns about “<a href="https://theconversation.com/coronavirus-is-not-the-great-equalizer-race-matters-133867">… how anti-Black racism, anti-Indigenous racism and other forms of intersectional violence will impact the health of our communities during this crisis</a>.” </p>
<p>In the open letter from the coalition of Black health leaders to Ontario’s political leaders, a case is made for collecting race data because, “<a href="https://www.allianceon.org/news/Letter-Premier-Ford-Deputy-Premier-Elliott-and-Dr-Williams-regarding-need-collect-and-use-socio">We cannot address what we cannot measure</a>.” But can race be measured?</p>
<p>What determines the boundary between one race and another, especially if self-identification means that race is a subjective term, not a medically objective one? </p>
<p>Prejudicial inferences from race-based data are of significant concern. It is these prejudices, contributing to historical trends of racism, that we are reminded of when recalling Brian Sinclair’s tragic death in a Winnipeg ER. </p>
<p>It is these prejudices that are fuelled by collecting race data for health care, especially when coupled with public hysteria during a pandemic.</p><img src="https://counter.theconversation.com/content/137284/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sachil Singh does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The COVID-19 pandemic presents potentially concerning trajectories for race relations. Many of these concerns might even originate within the medical profession.Sachil Singh, Adjunct Assistant Professor (Sociology), and Associated Faculty member (Surveillance Studies Centre), Queen's University, OntarioLicensed as Creative Commons – attribution, no derivatives.