When the COVID-19 epidemic began to rage throughout the world, we were completely unaware of the many effects of the virus. Seven months after the first positive case in the U.S. was detected in February, there has been a disproportionate effect on communities of color. The Center for Disease Control (CDC) has identified multiple causes that have led to this, including unequal healthcare access and income gaps, among other factors.
As a result, these minority groups are more likely to be impacted, both in contracting COVID-19 and in outcomes, than Non-Hispanic, White Americans. According to the CDC, compared to White, Non-Hispanic persons, People of Color contract COVID-19 at a rate ~3x higher, are hospitalized at a rate of ~5x higher, and die at a rate ~1.5x higher. The unequal effect COVID-19 has had on these marginalized communities is undeniable, but recently, the state of Massachusetts has undertaken a new, multilingual approach to combating the spread of the virus which is designed to target the most vulnerable areas of the Commonwealth.
The new initiative, led by Governor Baker, begins by targeting the top 5 communities with the highest-risk for COVID-19 transmission in Massachusetts: Chelsea, Everett, Lawrence, Lynn and Revere. While the average daily rate for the state at large is 4.2 per 100,000 people, Chelsea’s rate is 29.4, Revere is 20.9, Everett is 15.9, Lawrence is 14.9 and Lynn is 12.1.
These cities each share a much more diverse population with lower access to healthcare resources, higher poverty rates, and lower concentrations of English speakers than is typical in Massachusetts. With the exception of Revere, each of the cities are, on average, composed of 50% White Americans, in contrast to the Massachusetts average of 80.6%. In addition, these communities also, on average, have twice the percentage of their residents living below the poverty line. They tend to have high populations of non-English speakers: two of the communities (Chelsea and Lawrence) are majority Spanish speaking, but in all of them English is a first language for less than half of the population.
As a result, it has been hard for citizens of these communities to obtain vital healthcare services and personal protective equipment (PPE) on their own. Residents of these areas who are generally in lower income brackets also typically work in environments that are more high risk for COVID transmission, and the lack of PPE is magnified by this. Furthermore, it is speculated by the Baker administration that the lack of accessible, government issued safety information in languages commonly spoken in these areas contributes to higher incidence rates.
These communities having highly different demographic makeups than most of Massachusetts is partially responsible for the present failure of current COVID-19 policy to slow the spread of the virus in these areas. However, this new initiative (which is an expansion of the 2 month old “Stop the Spread” initiative) seeks to rectify this by providing services fine-tuned to meet the needs of those areas. The first step of the program is making residents of the targeted communities aware that they are living in high risk areas and stressing the importance of wearing a mask and social distancing. The campaign seeks to do this by not only increasing the availability of resources to these communities, such as advertising, materials, etc., but also by diversifying them. For the first time since the start of the pandemic, these materials will be available in 28 languages, specifically, those languages which are common to the areas where the resources will be deployed. A new website has also been launched (Mass.gov/StopCOVID19) which has information about stopping the spread, state regulations, testing locations and downloadable resources. It as well will be available to read in those 28 languages. It is expected that, by making these vital materials available to people who may have not been able to access them in the past, there will be a significant impact on these communities and their positivity rates. While not fully accounting for the structural inequities previously identified by the CDC, these short-run efforts will likely make strides in lowering transmission rates and keeping people safe from COVID-19.
This initiative is part of a larger commitment to fighting COVID-19 in Massachusetts that began in March and has continued through now. These efforts include limiting public gathering sizes, increasing access to and availability of testing, and an official mask wearing mandate for all public spaces where social distancing is not possible. The efforts of the commonwealth have been praised by Dr. Anthony Fauci, the nation’s top infectious disease expert, for their effectiveness in slowing the spread of COVID-19, and Massachusetts remains as one of most successful states in lowering positive testing rates. However, despite these early successes, the efforts of Massachusetts officials in preventing the spread of COVID have not been universally effective, as evidenced by those five most impacted areas. These new efforts seek to bring the benefits of a competent and effective response to the communities which have been suffering the most.
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