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Maine has nation’s worst COVID-19 racial disparity

Maine now has the nation’s largest racial disparity in coronavirus cases, with statistics showing that members of the state’s small but growing Black communities are contracting COVID-19 at a rate more than 20 times that of white residents.

Maine has among the lowest COVID-19 infection rates in the country on a per-capita basis. But the picture is dramatically different for Black residents, a growing number of whom are recent immigrants with lower incomes, more limited access to health care and less job security even before the pandemic.

And this is no statistical anomaly caused by Maine’s small minority population.

As of Saturday, Black residents accounted for at least 713 of the 2,578 COVID-19 cases in Maine where the race of the individual is known – a staggering 27.7 percent of cases – despite the fact that Black residents represent just 1.4 percent of the state’s population. Even when including the 360 individuals of unknown race or ethnicity, Black residents still account for 24.3 percent of all cases.

No other state had such a large disparity — a gap of more than 25 percentage points among cases where the race/ethnicity were known — between the size of the Black population and that community’s share of cases, based on an analysis of racial case data compiled by The COVID Tracking Project.

COVID-19’s disproportionate impact on Black communities in Maine and across the country comes at a time when large-scale protests and rallies have thrust the issues of racial justice and systemic racism into the national conversation.

The Maine Immigrants’ Rights Coalition, which includes 69 grassroots groups and agencies statewide, called the disparity “enormous and growing” earlier this month.

“The black and people of color communities are in unfathomable pain, distress and devastation due to the disproportionate impact on their overall well-being as well as limited access to services in the midst of the pandemic,” said the Maine Immigrants’ Rights Coalition’s board of directors.

STARK NUMBERS

Maine’s COVID-19 disparity becomes even starker when examining the numbers on a per capita basis.

One out of every 27 Black residents has tested positive for the COVID-19 disease caused by the coronavirus, based on case numbers from the Maine Center for Disease Control and Prevention and 2018 population estimates from the U.S. Census Bureau. For white residents, that figure is one case for every 725 people.

More recent immigrant arrivals in Maine largely from central African nations are likely not captured in those two-year-old population estimates.

But the 2018 Census figures suggest that Black residents of Maine are 26 times more likely to have tested positive for COVID-19 than white residents. Only in South Dakota, another predominantly white and rural state, are Black residents more likely to have tested positive than in Maine.

An analysis by the Maine Center for Economic Policy yielded similar results, albeit using a different method of analyzing the numbers.

That analysis showed an infection rate of 1.4 for every 1,000 white residents in Maine as of June 20. The rate among Black Mainers, by comparison, was 37.6 for every 1,000 residents. That means Black Mainers were more than 27 times more likely to have tested positive for COVID-19, according to data shared by James Myall, policy analyst at the left-leaning center.

Data from the Maine CDC suggest that, unlike in other states, Black residents of Maine are not dying of COVID-19 at disproportionately high rates. And the total number of COVID-19 cases in Maine remains low compared to other states.

But state officials are well aware of the growing disparity and are working with community organizations in cities with larger immigrant populations to increase access to testing and safe isolation spaces while stepping up educational programs.

Dr. Nirav Shah, director of the Maine CDC, lists racial minorities alongside residents of nursing homes and other “congregate care” settings as his agency’s top priorities.

“The number of individuals who have been affected by COVID-19 who happen to be racial and ethnic minorities is categorically, unacceptably high, and unacceptable to every single person who is working on the response,” Shah said on Friday. “We are making strides and we are attempting to do better in partnership with members of those communities. But … I will be the first to acknowledge that we have more to do there.”

HOTEL ROOMS FOR ISOLATION

On Friday, Shah announced an arrangement with hotels in five cities — Portland, Lewiston, Augusta, Waterville and Bangor – to provide rooms to COVID-infected individuals who cannot safely isolate at home, whether because of vulnerable people in their family or crowded living conditions. While the rooms will be available to any infected people who need them, the effort appears largely aimed at reducing transmission risk in immigrant communities.

Hermeet Kohli, an associate professor in the University of Southern Maine’s School of Social Work who serves as board president of the Maine Immigrants’ Rights Coalition, said the pandemic has brought to the forefront disparities in health care and housing.

The state needs more interpreters, “trustworthy contact tracers” in impacted communities and more support for the Black, Indigenous and People of Color (BIPOC) communities who fill many essential jobs, Kohli said. Additionally, there are increased worries about education impacts on children in families.

“This disproportionate systemic discrimination needs to be addressed ASAP in our neighborhoods, communities, and our political leaders need to step up and direct resources and monies to provide the short term services to the affected individuals, families, and communities,” Kohli wrote in an email. “Our Governor’s office also needs to create a long term plan to fight systemic racism that is the root cause of these disparities.”

NATIONWIDE PROBLEM

Nationally, Black residents have been hit disproportionately hard by the coronavirus pandemic in terms of infection rates, deaths and the economic toll caused by layoffs and widespread business closures.

Black residents account for 24 percent of deaths nationwide – or nearly 25,000 people as of late last week – despite comprising 13 percent of the country’s population, according to The COVID Tracking Project’s Racial Data Tracker. The project, which is a joint venture with the Antiracist Research and Policy Center at American University, compiles COVID-19 case and death reports filed regularly by state health agencies across the country for analysis.

The disparity gap in Maine was at least 25.5 percentage points when comparing the state’s Black population (1.4 percent) and the percent of COVID-19 cases where race/ethnicity was known (26.9 percent), based on figures for June 17, the last date for which nationwide data was available. The gap shrinks slightly to 22.2 percent among all cases, including those where race/ethnicity data of patients was unknown.

The COVID Tracking Project’s Racial Data Tracker presents data on its website using only cases were the race is known because the percentage of unknown cases varies significantly by state. Under either scenario, however, Maine had a larger disparity than all other states.

Black residents also comprise less than 2 percent of the population in Maine’s two northern New England neighbors, Vermont and New Hampshire. But in both states, Black residents account for less than 10 percent of the cases in which the race of infected individuals is known and had racial disparities of 6.9 and 4.6 percentage points, respectively.

Some states have reported high ethnic disparities within Hispanic communities. In Wisconsin, for instance, Hispanic or Latino residents make up roughly 7 percent of the population but account for 37 percent of COVID-19 cases where ethnicity is known.

Unlike in many other states, Maine is not seeing disproportionately high death rates among Black residents. Maine CDC data lists only one Black resident among the 102 deaths reported as of Friday, compared to 89 deaths among white individuals. The race or ethnicity was unknown for 10 individuals.

Maine CDC does not release racial data on COVID-19 cases at the county or ZIP code level, making detailed analysis of where cases are occurring more difficult. Shah said the agency is looking at providing more detailed geographic information in the future but in a way that avoids inadvertently identifying infected individuals in areas with small minority populations.

It is clear, however, that the majority of COVID-19 cases among Black residents are happening in Cumberland and Androscoggin counties, among the immigrant communities living in or near Portland, Lewiston and Auburn. Advocates say those clusters are emblematic of the systemic socioeconomic and racial problems

“One thing that we are trying to say over and over again is that the disparities we are seeing are representative of the disparities we see always: the kinds of jobs people have access to, the wages people get in those jobs, the higher risks people face at those jobs,” said Hannah DeAngelis, director of refugee services for Catholic Charities Maine, which works closely with Maine’s immigrant communities.

OUTREACH TO IMMIGRANTS

A coalition of community organizations including Catholic Charities has been working with Maine CDC since March to educate immigrant families – often in their native languages – about ways to reduce the risk of infection and then help avoid transmitting the disease to others.

Those efforts include pamphlets and informational videos in roughly a half-dozen languages, including Somali, Arabic, French and Lingala.

Immigrant community leaders say such tailored outreach appears to be helping overcome some of the language and cultural barriers that could be contributing to the disparity in Maine.

“Every time we get information from the CDC or other organizers, we share it with them in their language … and that’s why there is less risk than before,” said Mohamud Barre, executive director of the Maine Access Immigrant Network, which helps provide a bridge to health and social services for new Mainers.

More recently, coalition partners are working on increasing access to testing in minority communities and assisting affected families with such things as obtaining food while in isolation, arranging for child care and providing alternative spaces for infected individuals to isolate.

Dr. Mohammed Hassan, a community health worker with the Maine Access Immigrant Network, said housing is obviously a key factor in the disparity.

Recent immigrants and their families tend to live in more crowded conditions that make it all but impossible for an infected person to isolate from others. And in cities like Lewiston, many families live in older, tenement-style apartment buildings that have multiple stories but only a single entrance and exit, raising the risk of transmission.

Additionally, immigrants often hold so-called “front-line” jobs during the pandemic.

“They have no chance to work from home, so they are compelled to go to work because of economic necessity,” said Hassan, who was a physician in his native Somalia.

HEALTH CARE WORKERS

According to the Maine CDC, just over 300 of the 743 health care workers who have tested positive for COVID-19 in Maine – more than 40 percent of this higher-risk group – were identified as black or African American. That’s because immigrants fill many of the direct care, personal assistance and custodial jobs at nursing homes, group homes and other health care facilities.

Additionally, immigrants comprise a major part of the workforce at many local manufacturing or processing facilities, including at the Tyson Foods plant in Portland that had an outbreak of 51 COVID-19 cases last month.

Shah, the Maine CDC director, pointed out that some of these workers are among the asylum seekers from central African nations who arrived in Maine by the busload last summer after crossing the U.S.-Mexico border. Mainers responded by helping house, feed and care for the new arrivals, even organizing a July Fourth picnic for about 150 asylum seekers near Portland Head Light in Cape Elizabeth.

“Even more of them are playing a critical role in our economy during this time, working in places like grocery stores and other parts of the essential food chain, such as food processing plants, under very difficult situations,” Shah said Friday during his daily briefing. “Those are the same individuals who we came together a year ago to help, who are now, in turn, helping us on the front lines themselves.”

Maine CDC is working with outside organizations to set up mobile testing labs near immigrant communities to help break down transportation, logistical and psychological barriers to accessing testing.

Jackie Farwell, spokeswoman for the Maine Department of Health and Human Services, said the agency, in addition to arranging isolation space in hotels, is also contracting with 10 community action programs around the state to provide food, transportation, housing assistance, and other basic necessities to households under isolation. Additionally, DHHS is working with Catholic Charities Maine to arrange for translation, interpretation and “cultural brokering” for those in isolation.

DeAngelis, the director of refugee services at Catholic Charities, said decision makers must trust leaders in immigrant communities who “are experts of their own experience.” That could mean creating new models and systems for engaging with immigrant communities rather than trying to impose existing systems on them.

But DeAngelis said another major part of addressing the disparity is “just saying out loud that we see how systemic racism has disproportionate impacts” on immigrant and minority communities.

“We are concerned that we have the worst disparity in the nation on COVID,” DeAngelis said. “So even acknowledging that would go a long way.”

By Kevin Miller, Portland Press Herald