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2020 Year in Review: COVID-19 reinforced geography’s influence on health

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Marion County Public Health Department Director Dr. Virginia Caine says this year she learned how fragile it can feel to not have comprehensive, affordable health care.

When she forgot her insurance card on a trip to the pharmacy earlier this year, the out-of-pocket price of her prescription — $230 — gave Caine sticker shock. 

It’s the same sort of alarm her uninsured patients often experience, she told the Recorder in September. And that sort of financial pressure has been magnified during the COVID-19 crisis.

“If I had to decide between ‘Am I going to keep my lights on’ or ‘I got to pay my rent,’ medical care may be the least of my priorities related to those former two issues,” she said.

Over the past nine months, Caine has worked to help Hoosiers understand how the coronavirus pandemic exists as a secondary pandemic alongside the social plague of racism. She says poverty and other living conditions affect health. These factors — known as social determinants of health — can explain why Black residents of Marion County have tested positive for COVID-19 at a rate nearly twice that of white residents, according to SAVI.org.

Experts say the pandemic has laid bare long-standing socioeconomic disparities for communities of color. 

“People that are poorly compensated, even in the best of times, but I think the COVID pandemic … got us particularly interested in knowing who was going to be most at risk, who was in these frontline or essential jobs where the economy can’t run without them,” Shawn Fremstad, a senior research fellow with the Center for Economic and Policy Research, told the Recorder in December.

His recent report shows workers in frontline industries are disproportionately women and Black or Latino.

By summer, health experts with the Indiana Region of the American Red Cross asked volunteers to make face coverings to help level the unequal playing field on the front lines of the pandemic.

“Black and Latinx people in all communities, including Indiana, are bearing an outsized burden of COVID-19,” Chad Priest, Indiana regional chief executive officer for the Red Cross, told the Recorder in October. “It is almost designed to exploit the fault lines in society.”

The Red Cross encourages people to wear cloth face coverings in public spaces because it’s an evidence-based public health measure, Priest said.

Black Hoosiers also are more likely to live with relatives in densely populated, impoverished areas, Caine said. She said a lack of reliable transportation, affordable housing and fresh food can plague these areas.

One Indiana senior is planting hope and healthy food options in her Hillside neighborhood on Indianapolis’ near north side — a sign of communities working to bring down barriers to equitable health during the pandemic.

This fall, at the spry age of 82, Shirley Webster donated a patch of her land to expand her garden to have a bigger impact on her mostly Black neighbors.

The American Heart Association is partnering with Webster and construction companies to expand the garden and give more people access to fruits and vegetables in an area designated as a food desert.

Though slowed down a bit by the coronavirus pandemic, the land was recently tilled and staked, and the permit process for drainage and further construction is in process. Over the next few months, sponsors will put in electrical wiring and plumbing and the finished garden will be more than 10,000 square feet.

“I’m grateful to be able to host this community garden as a way to improve the lives of my neighbors,” Webster told the Recorder in November. “I want my community to really understand how blessed we are.”

This story was reported as part of a partnership between WFYI, Side Effects Public Media and the Indianapolis Recorder. Contact Hilary Powell at hpowell@wfyi.org. Follow her on Twitter @mshilary.

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