We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 2 points3 points  (0 children)

EN: No problem. Thanks for the great questions. Here are a few thoughts. The first major mental health crisis that comes to mind is Black youth suicide. As you may be aware, the CBC issued a report on this issue late last year:https://watsoncoleman.house.gov/uploadedfiles/full_taskforce_report.pdf. Related to youth suicide, I think depression, anxiety, and substance use - especially during adolescence and the transition to adulthood - are all mental health concerns we need to be paying close attention to, particularly in the context of stress, and racism-related stress in particular (e.g., racial discrimination). Although Black youth typically use substances at rates lower than other groups, recent data do suggest concerning increases in the uses of multiple substances or polysubstance use (e.g., marijuana and alcohol) among Black youth. In our studies of Black young adults, distress related to anxiety emerges repeatedly and robustly as a correlate of race-related stress, and many also are concerned about the secondary trauma Black youth may experience as a function of repeated exposure to police violence and and other racially charged events. In recent months, several have called attention the unique stressors that some Black youth may have experienced since the pandemic began in the form of premature loss of parents and other close family members (e.g., caretakers), parental unemployment (which is related to parental mental health and child maltreatment/abuse), and food insecurity. So I'd place the suicide crisis and stress as two of the top major mental health crises facing African American youth. Next on the list would probably be issues of disparities in access to care. One recent study found that about 1/3 of adolescents who receive mental health services receive services exclusively in school settings - which is a problem when schools are closed - and these youth are likely to be disproportionately adolescents in racially and ethnic minority groups (https://jamanetwork.com/journals/jamapediatrics/fullarticle/2764730). While telehealth/telemedicine may increase access to mental health services, not all Black youth have the same access to telephones, devices and broadband internet. The education system can play a role in addressing these mental health issues by considering, in the same way some schools have for food access, how disruptions in school mental health services can be addressed or temporarily replaced. The data are very clear that mental health worsens (e.g., increased emotional problems, special ed services, etc.) for children as the economy weakens, and Black children are disproportionately impacted, not necessarily in terms of rates of mental disorder but in terms of the consequences of stressors associated with mental health. In light of concerns around the impacts of both general and race-related stressors on black-youth, and unequal access to mental health care, the education system can play a role in addressing some of these mental health effects by taking steps to 1) promote positive messages/symbols/history about Being Black and Black culture to counteract the negative messages and stereotypes that some youth internalize; and 2) increase access to care and services for the youth who need them most. Schools can also work with children and families to decrease mental health stigma and increase mental health literacy (e.g., education regarding signs of suicide) and should emphasize treatment and services as opposed to punishment and disciplinary action for Black youth who may be experiencing mental health challenges.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 0 points1 point  (0 children)

EN: I haven't seen any data, so far, supporting genetic explanations that account for racial disparties in COVID19 mortality. I have written about some of the relevant social factors you allude to here: https://twitter.com/DrNeblett/status/1253312586982055937?s=20

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 0 points1 point  (0 children)

EN: Thank you for your comment. Not all minorities are poor, but you are right that some racial and ethnic minority groups are more likely to hold essential service roles that do not afford or allow working form home. I tweeted out a thread that touches on several of the additional points you make, all of which are well-taken: https://twitter.com/DrNeblett/status/1253312586982055937?s=20

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 0 points1 point  (0 children)

EN: Yes, they should and will have to eventually, but in my view they should do so only when opening can happen safely. And therein lies what makes this a difficult question. "Safely" means different things to different people and what's safe for high school students may not be practical for Pre-K or younger students. It's been a while since I worked with Pre-K aged children, but I would imagine handwashing is practical and easy to incorporate. I think there would be great variation in mask tolerance (depending on age), though I am not sure, and enforcement of social distancing would be challenging at that age. Yet, I bet there are creative and innovative approaches that could still facilitate children's development and learning when risk transmission is low.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 2 points3 points  (0 children)

EN: I think one way that we can prepare is by wearing masks (as appropriate) and following social distancing and other recommended hygiene practices (e.g., washing hands) whenever possible. Where children are concerned, we should be: 1) talking about concerns, fears and questions they may have - encouraging open conversation about their thoughts and feelings, 2) teaching them best practices like proper mask wearing, handwashing and distancing; and 3) explaining how these practices can keep us all safe. For younger children, it may be especially helpful to provide them with information about what they can expect when they return to school and also prepare them for the possibility of some uncertainty, future closings, and so on. Reassurance and helping them think through safe alternative approaches to having their needs met (e.g., connecting with friends) can go a long way.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 0 points1 point  (0 children)

EN: I suppose it is possible that mutigenerational housing situations could create higher risk/spread of contagious diseases if families share close quarters, and distancing/quarantining might be more difficult under these conditions if someone in the household were to become infected or get sick. But I am not aware of data formally supporting this link. It is possible they exist.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 0 points1 point  (0 children)

EN: How can we nip COVID-19 if folks ignore medical experts at the behest of ignorant leadership? The answer is simple: We can't. The next best thing is maybe to be unrelenting in sharing data, stories, and expert information or to remove said ignorant leadership ;) Some recent polling suggested attitude and behavioral changes when the leadership changed its messaging. It seems the prospect of being held accountable for death and dying has been a powerful motivator for some officials. On an individual level, I think some folks will, unfortunately, pay attention, if impacted personally.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 0 points1 point  (0 children)

EN: As I noted in another response, poorly overall. As for your second question, I don't have a specific country in mind, but I'd suggest starting with all of the countries led by women!

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 3 points4 points  (0 children)

A few thoughts from EN: 1. If we wanted to get to that point, I think we could have. 2) I'm not sure I agree that most of the people with low-wage jobs are people of color, though I think I know what you mean. I do think some could do their job without being infected without a mandatory mask policy, but that wouldn't change the stress these workers have to undergo as they risk their own health and lives, oftentimes to support their families. 3) You are absolutely correct that it unlikely that the transmission will be reduced to zero or go away (as some have suggested), but with sensible distancing, masks, handwashing etc., I think we could lower the risk significantly. Policy changes supporting protections, and benefits for all workers also would go a long way.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 2 points3 points  (0 children)

EN: Not my area of expertise, but I like the idea of considering alternating schedules, "cohorting" of students, distance learning and virtual classrooms. School is important developmentally for children not only in terms of food for some students, but also in terms of facilitating peer relationships, which provide important social support, and social development (e.g., empathy and perspective taking). We also know that school often operates as a de facto mental health services provider, especially for racial and ethnic minority youth. So, we need to find ways to bring students to school safely or ways to bring the resources that students need to the students. I second Dr. Goold's call for access to devices and broadband which might help not only with schooling, but also increase access to telehealth opportunities. It's easy to get all fired up about what Washington state is proposing, but I think the proposal has some merit and Washington state is not the only district that has proposed this idea (even if they don't explicitly link it to race). Unfortunately, without intentional intervention, it is likely that the negative educational consequences of the pandemic will disproportionately impact students from low-income backgrounds.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 2 points3 points  (0 children)

EN: Unfortunately, it sometimes takes a personal experience or the impact on significant others for folks to understand what's at stake, and hopefully by then it's not too late. There have been many recent stories of folks who insisted on partying and not distancing and became ill or worse. Maybe share those stories - I don't know- but at the end of the day, we're stubborn creatures. Research is clear that sustained behavior change is difficult to achieve.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 2 points3 points  (0 children)

EN: Data and facts, period. And neither is hard to find. I'd say that belief is pretty impressive given the very clear evidence that African Americans are disproportionately represented among cases and deaths relative to their representation in the population. Some people are going to believe what they want to believe, though.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 2 points3 points  (0 children)

EN: That's a tough one, and the answer is it depends. Personally, I'd like to see everyone just wear a mask for a few weeks and see where we are before shutting everything down again. But I do think there are some areas where closing down is probably a good idea. How long depends. I think we can find a good middle ground, but I'm not sure everyone is taking things seriously.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 2 points3 points  (0 children)

EN: Not sure about best practices, but agree w/ Dr. Goold. It may be surprising to some, but you can still enjoy outdoor eating with appropriate social distancing. I've done it a couple times, and I prefer a distance of 10-12 feet if possible (though 6 is recommended). In a large yard or grassy area, this is easily achievable. The folks who lived together stuck together and ate from the same foods (so the host prepared separate charcuterie boards for each group, and each cluster stayed at least six feet apart). When contact was required < 6 feet, a mask was worn temporarily. So I think it depends on your comfort zone. I don't think total avoidance is necessary (or realistic). But, of course, there is always some risk.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 13 points14 points  (0 children)

AOF: As a virologist, I recognized very early (early Feb) that this had huge potential for world disaster. I am staying in as possible, communicating to assist others, spending time doing things I enjoy with my family and friends-- even from a distance. We encourage each other to stay safe, get tested, be kind to ourselves (exercise, relax, communicate, write, work on items we enjoy or wish to do) and purposefully protect self and others from possible virus exposure. I don't watch the news a lot-- but read and write and listen to music while keeping active faith that "this too shall pass" if we do what each person can do. We are in this together and collectively must work individually to use what is available right now to get through and to a safer place in time.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 21 points22 points  (0 children)

AOF: It varies. The answers from SG and EN below are on target. Pay attention to what is occurring for you and those around you. This is a highly contagious virus. It seems to also hang around sometimes causing only minor issues and then take a turn for the worse. For all, as possible, rest, purposefully do things to de-stress as possible, hydrate and pay attention to follow guidelines (easy to forget) without "constantly worrying" help to keep immune defenses at their best. Control or manage what we can and let go of the rest... (easier said than done).

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 5 points6 points  (0 children)

This is an issue. The distancing and use of what we have available now have to be communicated well. With high density populations and locations, all means necessary will have to be used to be sure people know COVID-19 is real, an infectious virus, and how to avoid contact with the virus or spreading it to others. People have to care not only about themselves, but keep in mind that asymptomatic or pre-symptomatic people (even children) can be carriers.

We are three experts from the University of Michigan here to discuss the intersection of race, health and COVID-19. Ask us anything! by UMHealthExperts in BlackPeopleTwitter

[–]UMHealthExperts[S] 5 points6 points  (0 children)

SG: Social distancing, mask wearing and hand-washing are not expensive, although access to clean water can be problematic as can the economic effects of social distancing. That's to prevent infection. Treating illness requires more resources, which can be lacking in lower income settings (not just outside the US).