For Manuel Gago, the past six months of the pandemic have been the same conversations. The same fight.
The immigrant worker advocate with the Legal Aid Justice Center has been pushing for and ensuring that new workplace and whistleblower protections are enforced to decrease spread among communities. Looking out for migrant and low-income essential workers who fear retaliation from complaining. Calming down families who worry contracting a virus means a hospital bill they can’t afford. Fact checking misinformation.
It’s an ongoing cycle, he said. And one that doesn’t stop since many of the Black and Latino people disproportionately impacted can’t work from home.
In Richmond, the impact is centered in the city’s low-income areas with largely Black and Latino populations. A Sept. 4 census tract provided by the Richmond City Health District that roughly follows district lines places between 1,300 and 1,643 of the city’s 4,052 cases as of Saturday in the 8th and 9th districts, where the city’s highest number of Black and Latino residents reside.
ZIP codes 23224 and 23234 within the Richmond area house the highest number of cases, according to the Virginia Department of Health’s Saturday report, at 1,313 and 1,625 respectively. These two ZIP codes also overlap with 8th and 9th district lines. Parts go into Chesterfield, which has the largest Latino population in the Richmond area according to the U.S. Census Bureau.
In June, the average home sales price in the 8th and 9th districts was $142,139. Both have also largely Black populations with an average of 6,129 Latinos, according to U.S. Census Bureau numbers.
The 23221 ZIP code, which includes the largely white and affluent Windsor Farms neighborhood and is part of 1st District, has 111 cases. In real estate zone 20, which includes Windsor Farms, the average home sales price was $559,494.
Meanwhile, Black and Latino residents in Richmond make up 78% of the city’s cases and nearly 87% of hospitalizations.
While the number is important, it doesn’t explain where populations are currently, said Dr. Danny Avula, director of Richmond and Henrico Health Districts. Latino cases have decreased to about 10 to 15 per week, said Avula, but they’re still almost 40% of the count in a city where they’re 7.5% of the population. In the month of August, about 10% of contact tracing calls were Spanish-speakers, compared to 20% in July, according to Avula.
The bulk of the clusters have been in essential workplaces, said Avula. Retail and medical settings. Restaurants. Warehouses. Construction companies.
These high-risk settings are often low-wage jobs worked by Black and Latino populations without paid sick leave, which advocates and legislators say is vital to limit spread, and preexisting health disparities. These last two weeks have seen a case uptick, said Avula.
“The economy was running. It never stopped because all these essential workers were still working … but we don’t protect them,” said Gago with the Legal Aid Justice Center. “A lot of people say ‘It’s because they’re doing parties’ and it’s like no. It’s because they’re working 24/7.”
Residents, community leaders, health officials and organizations have worked to bridge those health inequity gaps, build relationships and language accessibility in a pandemic that makes it structurally challenging for already vulnerable people to not be affected.
This includes physicians establishing practices in medical deserts; nonprofits planting trees to offset high heat in formerly segregated neighborhoods; a hotel program for those who can’t isolate — which Avula said its use has skewed more toward Black Richmond residents; raising money for rent support and income replacement; mask distribution; food pantries; hiring more bilingual contact tracers; testing sites in predominantly Black and Latino neighborhoods.
But attendance rates at sites are also decreasing, said Avula. In Southwood Apartments, a largely Latino residential community, 200 to 300 people would get tested. Now it’s half.
Gago said part of this stems from fear that while testing is free, hospitalization isn’t. Accessing funds through government entities can be problematic, he added, due to concerns on receiving a public charge — a ground of inadmissibility due to using public benefits that can impact an individual’s immigration process. Gago said this can be an added stressor for immigrant populations as they navigate how neighborhood socioeconomic status impacts resident access to health.
The lack of access is compounded with a historical mistrust in the health care system due to institutionalized racist practices, said Dr. Joe Fields-Johnson, a family physician opening a Spanish-speaking practice on Hull Street in the fall to widen affordable access to primary care.
“It’s the structure of our society that’s causing, through racism and bias against languages, those negative outcomes,” said Fields-Johnson. “I vehemently disagree with the idea that it’s not our responsibility to manifest policy or provide services to protect these people.”
Fields-Johnson’s clinic model doesn’t require insurance but instead, a monthly membership fee to create a feasible pathway to affordable health care in a city where 1 in 6 residents are uninsured, according to the U.S. Census Bureau.
Across the state, data from the Virginia Health Care Foundation indicates 712,000 Virginians do not have health insurance.
The city’s poverty pockets are concentrated in public housing communities and low-income areas — an aftermath of decades-long racist housing policies that redlined neighborhoods and impacted Black and Hispanic residents.
The result? Years of government neglect, little to no doctor’s offices or shaded spaces, limited access to grocery stores with fresh food and a shorter life expectancy than wealthier parts of town.
In Westover Hills, a white middle class neighborhood, residents live, on average, 20 years longer than someone in Gilpin Court, a public housing community, according to a 2015 VCU Center on Society and Health study.
With the pandemic, these structural and complex inequities established well before March exacerbated health disparities, said health officials, highlighting systemic and policy failures that sent hundreds of thousands scrambling.
“Sadly, the only way people get more serious is when it affects somebody near you,” Gago said.
Some communities can’t wait for that, he said.