Monday, January 18, 2021

Polls Show Americans' Loss of Trust in Electoral System

The Hill recently released a January 8-11, 2021 poll showing 49% of respondents did not have confidence in state election authorities' ability to fairly and accurately count their votes.  Disaggregated by political party, only 29% of Republicans and 73% of Democrats were confident in their state's electoral authorities.  Similarly, the overall confidence in American electoral systems was less than half at 42%; with Republicans at 19% and Democrats at 67%.  

These numbers show a troubling loss of trust in the election process by conservatives, which is indicia of potentially more violence as an adopted means of addressing political grievances.  Elected officials and law makers would be well advised to heed these trends as one more reason to focus on decreasing the unprecedented levels of political polarization in American society.

For more analysis on these poll numbers, watch Professor Rashawn Ray and Professor Sahar Aziz on The Hill TV.

 

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January 18, 2021 | Permalink | Comments (0)

Friday, January 15, 2021

Bibliography of Books on Muslims and Islam in the US (1965-2020)

For a variety of reasons, Muslims in America are in the public spotlight. As a result, the demand for information and analysis on Muslims and Islam in the United States has risen. In an effort to provide a resource for academics, advocates, journalists, and others, we created this bibliography of over 250 books published between 1965 and 2020 focused on Muslims and Islam in the United States. We did not include books that focus primarily on Islam and/or Muslims outside of the United States.

The bibliography is categorized by subject matter and chronologically with the most recent publications first.  The categories include anthropology, biography, health, history, law, political science, reference, and sociology. If you find any relevant books are not included in this list, we welcome you contacting us with the citation of your suggested book addition.

The latest version of the bibliography with books published in 2020 is now available here.

 

January 15, 2021 | Permalink | Comments (0)

Wednesday, January 13, 2021

They Want to See the Manager: Mistaking Democracy for Consumption (Prof. Saru Matambanadzo)

They Want to See the Manager: Mistaking Democracy for Consumption

 

The events of January 6, 2021 have been a fertile source of discussion for many legal scholars and experts. As Congress attempted to certify the election of President Joe Biden in Washington, D.C., mobs of right-wing agitators stormed the Capitol and forced their way inside. The rioters had been whipped into a frenzy during a rally held by President Trump and his surrogates. Bursting through barricades and climbing over walls, the mob, entered the halls of Congress. They brought guns and weapons. They broke windows and entered private offices, destroying and looting government property as they went. Five people, including one police officer, died as a result of the riots.

It was really an exercise in White invulnerability as well. Fascinating how when your life matters, authorities manage not to shoot you with bullets or blind you with bean bags, or spray tear gas at you. Mostly. There was also a perception that President Trump’s loss is a loss for White privilege and White supremacy in the United States is likely and underlying motivator for those who participated. This mob was overwhelmingly white, seen sporting Confederate flags and shirts, and carrying banners endorsing White supremacy and Anti-Semitism. The mob was also comprised of fairly middle class and even upper-class people, with one individual flying to the protest in a private jet.

It was a stunning display of how White privilege accords safety, security, and the benefit doubt to individuals even when they are in the wrong. It provided crucial information about who has the right to protest and how this protest should be received, as Professor Eddie Glaude pointed out in an interview with NPR. 

By this time, there has been a lot of popular commentary on what the Times of India dubbed the Coup Klux Klan. Commentators have focused on the mob’s disdain and disregard for democracy, the halls of Congress, and our national democratic institutions.

No justice no peace

Some have focused on Republican complicity and the subsequent bipartisan disavowal of the rioting and looting mob in the wake of the crisis. Still others have examined the violence deployed by the individuals who entered the Capitol Building. And others have focused on the seeming lack of security, and the uneven enforcement of “law and order” that would have been vigorously and forcefully applied if the individuals storming the Capitol were Black, Latino, or Muslim.  

Throughout the commentary, I kept thinking about how familiar the hostile entitled violence looked and felt. Of course, unhinged White mob violence will look familiar to those who study the history or race in the United States. Rabid hostility about the possibility of a multiracial majority coalition organizing together to exercise power in the United States spurred White mob violence during Reconstruction, and violence and hostility that continued into the Jim Crow Era. It would also look and feel familiar to those for who understand how Black communities, businesses, and homes were destroyed by White Mob violence in late 19th and early 20th Century incidents like the Springfield Massacre of 1908 in Illinois, the  Tulsa Race Riots of 1921 in Oklahoma and the Rosewood Massacre of 1923 in Florida, among others. But as critical race commentators have also pointed out, such rambunctious displays of wanton violence, looting, and rioting by White people, typically perceived as harmless, also occur when sports teams win or lose.

But to me, as a survivor of low wage large department store retail work, the violent mobs of looting angry White people besieging the capital reminded me of something else: Black Friday. In the United States, “Black Friday,” is the “first” Christmas shopping day after the “Thanksgiving Celebration.” On Black Friday, people in the United States follow a celebration that mythologizes our violent colonial past, which is painful for many indigenous people in the United States, with a day in which centers finance capitalist consumption. Because people are often desperate to obtain consumer goods at low prices, a sort of frenzy emerges on Black Friday which often results in injury and rioting over televisions, slippers, and other Christmas presents.

The echoes of Black Friday mobs, large groups of desperate but entitled mostly White persons demanding to be heard and served, placed into sharp relief the nature of President Trump’s attempted coup. I started thinking about how the mob of disgruntled angry White people were reminiscent of a pissed off group of customers demanding that their coupon for 1 Free Republican President be honored. I don’t think I was alone in seeing this. Anyone who has worked a low wage public facing customer service job in food service or retail or those who have worked a low wage patient facing job in health care recognize the cut of the mob’s jib. What I saw was what I often feared as a young worker, what I still cringe to see as an adult: angry economically privileged White people who are demanding to see a manager.

The Karens and Terrys (which may be the male equivalent of Karen) did not get what they wanted. The idea that making your voice heard gives you license to engage in violent abusive behavior no matter the cost reduced the Capitol building to an Olive Garden and Congress to the errant managers that needed to be dressed down. While some may say this trivializes what happened last week, we must understand how difficult, how volatile, how dangerous customers in retail and service can potentially be.

These are the people who wander around Target openly carrying a gun when the store policy is no firearms on the premise. And there are no consequences. They are the people who violently bully the retail associates asking them to wear masks at the door. They are the people who yell at service employees over small things. These people live in a have it your way world where they are petty despots.

Security guards and police had trouble subduing them or just failed to take action in many moments. And members of Congress hid from them. Even the Republicans who were pretending to be their allies barricaded themselves in their offices when they were the managers sought by Karen and Terry. But understand that retail workers and service workers subdue frothing at the mouth angry individuals like this on a regular basis – often whole groups of them.

Rioting angry insane entitled White people like the ones at the Capitol are what retail associates, waitresses, bouncers, and bartenders deescalate all the time in the United States. And it is good to remember this as many of us seem willing to say that retail workers and service workers do easy jobs. When Karen and Terry climbed the walls and demanded to see the manager the police and Congressmen, who are paid way more than workers in the restaurant industry, retail, or customer service, were afraid to engage with them and deescalate the situation.

None of this removes the reality that the mob of rioters and looters seemed deeply sympathetic to White Supremacy and conspiracy theories. And this analysis does not excuse the fact that if Black or Brown people had engaged in similar behavior, barging into a secure government building and damaging property, breaking windows, stealing, and looting, we would be speaking about blood flowing down the steps of the Capitol building. While there have been some consequences in terms of arrests and job losses, had the protestors been Black, Brown, Latino, or Queer, we would be mourning a situation in which the National Guard and Washington, D.C. police would have murdered or injured many people.

What my analysis above does provide, however, is the revelation of how class privilege and White supremacy allow some people to perceive foundational democratic institutions as matters of consumer choice and privilege. It also reveals how Whiteness and class privilege intersect to create systemic forms of protection and security for some people, while denying it to others. And it reveals how class privilege and White Supremacy function together in ways that marginalize working people across lines of class solidarity.

In closing, the following caveat is in order. There are historical reasons why Black persons and other people of color are not part of the group of demanding consumers labeled as Karens and Terrys. There are bad individual customers among minority groups, but the systemic exclusion of people of color from stores and places of public accommodation has rendered their relationship to retail and service more precarious. But that is another post.

-          Saru M. Matambanadzo, Moise S. Steege, Jr. Associate Professor of Law, Tulane University School of Law

 

January 13, 2021 | Permalink | Comments (0)

Monday, January 11, 2021

America's Glaring Double Standards

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In recent weeks, Americans and the world have gotten a racial and religious double-dose of the double standards that fuel law and policy in this country. While many would like to think that equality and egalitarianism are the order of the day, recent events prove otherwise. Just a quick look at the Christmas bombing in Tennessee and the Capitol riot in Washington D.C. lay bare the two Americas that exist for Muslims and racial minorities.

It was just hours into Christmas day when a suicide bombing detonated an RV in downtown Nashville. To grasp the gravity of this event altogether, consider the rarity of a suicide bombing in the United States. Most would associate such behavior with Muslim terrorists abroad, but this was a home-grown American. Yet this shocking and startling event hardly made headlines—and when the came, they were not the type that one might have seen had the bomber been Muslim.

The problem is, no one ever really learned about this man’s religion. In a scathing opinion piece, If the Nashville bomber were Muslim, he would be called a Terrorist, Dean Obeidallah notes that the fact we did not learn of his religion means that it is safe to assume was not Muslim. For if he were, that would have been the first thing we learned. Instead of “terrorist,” “extremist,” or “religious fanatic,” the media used terms like “loner,” “recluse,” and “quiet life” to describe the individual.  As the author describes, “Of course, if [he] were Muslim, there’s no way there would be a nuanced analysis of his motivation like the one we’ve seen in headlines. Nope, it would be assumed by most that since he’s Muslim, he had to have a political agenda.”

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Muslims have felt the sting of this double standard, particularly the sensationalism of a suicide bombing hardly getting media play. Meanwhile, back when Timothy McVeigh bombed a federal building in Oklahoma, many in the media automatically assumed it was the work of Muslims. Underlying this harsh double-standard is a logic that assumes Americans cannot be religious extremists or take the shape of what was formerly believed to be the provenance of fanatics from the Middle East.

Not to be outdone by the Christmas bombing, On January 6, 2021, rioters inspired by the words of the sitting president, stormed the Capitol Building in D.C. In the process they wreaked havoc on the building itself, breaking windows and doors, and ransacking offices of congressmembers. At least 5 people died in the event, including a pregnant woman who was shot and a police officer who died as result of the melee. There had not been such an attack on the Capitol in the modern era.

Perhaps the most noticeable fact of the events was that the police were woefully outnumbered and underprepared for what unfolded. Despite that the president had been riling up his base to attend the protest weeks in advance, despite that on social media there were all sorts of indications that the protest would turn violent, and despite that just prior, the president made a speech that prodded his followers to march to the Capitol Building and to “show strength,” the cops were overrun in just minutes.

It is here that the spectacle begins. One need only remember the George Floyd protests, just the summer before. Images of police running down protestors, pushing, kicking, and beating, firing rubber bullets, and hardly hesitating to use pepper spray were a permanent fixture on the news. In the very same city. From those protests, if there were any clear message sent to the groups of Black Lives Matter organizers and protestors, it was that “we will use lethal force.” Here it is backwards as this image shows how police responded to Black protest.

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Fast forward to the Capitol riots, and the joke becomes obvious.

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While the George Floyd protests in D.C. were peaceful, the capitol rioters were violent—and had weapons. They came to fight. Yet it is almost as if the police gave them a free pass. No bullets, no rubber bullets, no baton beating, sparingly-used pepper spray, and very little armed force was used. Instead, there is a photo of a police officer taking a selfie with one of the protestors. Law professor Anthony Farley noted the irony and asks why these protestors were not treated to drone strikes as in other parts of the world: 

Screen Shot 2021-01-11 at 9.21.03 AM

As unpalpable as these events are for our society, they do the uniquely good work of showing us who we are. As another law professor, Khaled Beydoun described in a tweet:

Screen Shot 2021-01-11 at 9.22.00 AM

 

January 11, 2021 | Permalink | Comments (0)

Thursday, January 7, 2021

Black political power in the South

Renuka Rayasam of Politico recently wrote an interesting article entitled "The Southern state where Black voters are gaining in numbers, but not power".  She contrasts Georgia with Mississippi and provides insight on how Black voters can shape the Democratic Party's future in the South, if the Party can earn their trust and support.

January 7, 2021 | Permalink | Comments (0)

Tuesday, January 5, 2021

Triaging Public Health Services Based on Race: What Are The Legal Challenges? By Christopher Ogolla.

According to the CDC, race and ethnicity are risk markers for other underlying conditions that affect health including socioeconomic status, access to health care, and exposure to the Covid-19 virus.[1] For example, American Indian or Alaska Natives are 4 times more likely to be hospitalized for Covid-19 and 2.6 more times to die, compared to White non Hispanic persons. Black or African American non Hispanics are 3.7 times more likely to be hospitalized and 2.8 times more likely to die from Covid-19 compared to White non-Hispanic persons.[2] The disparate impact of the Coronavirus has drawn national attention to how public health resources are used in times of emergency. In light of these circumstances, if states were to prioritize racial minorities in public health emergencies, such as distribution of vaccines during a pandemic, for example, would that focus survive equal protection challenge? Put succinctly, can we triage public health services based on race?

As an example, California’s Covid-19 vaccination plan includes this statement: “One of the primary efforts of the Community Vaccine Advisory Committee will be to help ensure vaccine planning supports all Californians, but particularly for individuals in communities that are disproportionally impacted, including Latinos, African, Americans, Native Hawaiians, Pacific Islanders, and other Asians including Filipinos.”[3] Will this plan pass constitutional muster?

The Supreme Court has countenanced the use of race in public programs when it is narrowly tailored to achieve a compelling governmental interest. The downside of this standard of review is that public health agencies, particularly those offering services to the underprivileged or victims of poverty, may be barred from giving preferential treatment in services to groups based on ethnicity, even if those groups may be in dire need of those services.”[4]

Professors Schmidt, Gostin and Williams, writing on whether it is lawful and ethical to prioritize racial minorities for Covid-19 vaccines, note that “there is no direct precedent in which courts have considered race in allocating scarce health care resources.[5] They write that “[s]trict judicial scrutiny would not permit vaccine priority strategies. First, a healthcare worker could not give priority to vaccinating persons from minority groups, for instance, by skipping White people waiting in line at a health care facility. Second, public health agencies could not provide vaccines exclusively, or in large shares, to geographic areas identified by race alone.”[6] Nevertheless, they suggest that a vaccine distribution formula could lawfully prioritize populations based on factors like geography, socioeconomic status and housing density status that would favor minorities de facto, but not explicitly include race.”[7]

The geographic/ proportional distribution suggested by Schmidt et al., would be consistent with other race neutral suggestions or solutions for other affirmative action-based programs, such as school admissions.  In Fisher v. University of Texas at Austin, 136 S.Ct. 2198 (2016) (Fisher II), the Court affirmed diversity in higher education as a compelling state interest, and held the race-conscious admissions program in use at the time of petitioner's application lawful under the Equal Protection Clause. We could analogize the geographical distribution to University of Texas, Austin's use of top 10% plan, where the university used a race neutral method of equalizing the structural inequities by guaranteeing acceptance of students who graduate in the top 10% of their graduating class.  This plan cures the obstacles that minorities often face in getting admitted to elite universities: parental educational background, attending under-resourced schools because they are located in economically depressed neighborhoods, kids having to work to support the family, language barriers, low socio-economic status, etc.[8]

However, this legal analogy flounders in times of a pandemic. Unlike the school admission cases (where the lack of diversity that elite schools are trying to improve is a self-inflicted wound), Covid-19 is an emergency, a disaster of epic proportions. As of this writing, there are over 21 million confirmed cases and over 356,000 deaths in the United States.[9] During a pandemic, there is more urgency and a race neutral alternative might not be as equally effective. For example, vulnerable populations might slip through the cracks while waiting for their priority groups. One can conclude that race-based policies have the greatest chance of passing strict scrutiny during pandemics.[10] But will they? This will depend on how the Justices view racial inequalities during a pandemic. For example, after acknowledging the serious nature of the pandemic, Justice Kavanaugh, in his concurring opinion in Roman Catholic Diocese of Brooklyn, New York v. Cuomo  writes, “[B]ut judicial deference in an emergency or a crisis does not mean wholesale judicial abdication, especially when important questions of religious discrimination, racial discrimination, free speech, or the like are raised.”[11]

All in all, focusing on vulnerable populations in vaccine distribution is likely to succeed only if it doesn’t explicitly use racial categories. Even though using a race neutral distribution plan presents little or no constitutional challenges, if success (and here success is defined as getting the vaccine to the most neediest people to reduce the pandemic) means focusing on vulnerable groups, whether delineated by race or socioeconomic status, shouldn’t such a distribution plan be countenanced? Put differently, if admission to colleges and universities based on race can be narrowly tailored to achieve a compelling governmental interest, then surely a plan that benefits a race can be upheld on the basis of urgency due to COVID-19.   Then again, maybe not. In July 2020, Oregon state lawmakers passed the Oregon Cares Fund. This state fund was meant to steer coronavirus relief money directly to black Oregonians and black-owned businesses.[12] The state earmarked $62 million of its $1.4 billion in federal Covid-19 relief money to provide grants to black residents, business owners and community organizations enduring pandemic-related hardships. However, a Mexican-American and two white business owners sued the state, arguing that the fund discriminated against them.[13] Although the lawsuit has not been decided yet, the outcome will have far reaching implications on any state planning to distribute vaccines or any public health services based on racial categories.

[1] CDC COVID-19 Hospitalization and Death by Race/Ethnicity, available at https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html (Updated Nov 30, 2020).

[2] Id.

[3] See Covid-19 Vaccination Plan, State of California. Interim Draft, 14-15 (Cal. Dept. Pub Health, 10-16-2020).

[4] Christopher Ogolla, Will The Use of Racial Statistics Survive Equal Protection Challenges? A Prolegomenon for The Future, 31 N.C. Cent. L. Rev, 1, 19 (2008).

[5] Harald Schmidt, Lawrence Gostin & Michelle Williams, Is it Lawful and Ethical to Prioritize Racial Minorities for Covid 19-Vaccines? 324 JAMA 2023 (Nov. 2020).

[6] Id., at 2024.

[7] Id.

[8] Professor Eang Ngov, Barry University Dwayne O. Andreas School of Law. (Pers. Comm., Dec 6, 2020).

[9]See John Hopkins University, Corona Virus Resource Center available at https://coronavirus.jhu.edu/ (last visited on Jan 5, 2021).

[10] Ngov, supra note 8.

[11] Roman Catholic Diocese of Brooklyn, New York v. Cuomo, 2020 WL 6948354 * 8 (Nov. 25, 2020) (Kavanaugh, J., concurring).

[12] Dirk VanderHart, Fund to help Black Oregonians cope with Covid-19 put on hold. OPB Dec. 18, 2020. https://www.opb.org/article/2020/12/18/oregon-cares-fund-black-community-business-covid-19/

[13] John Eligon, A Covid-19 relief fund was only for black residents. Then came the lawsuits. N.Y. Times Jan. 3, 2021. https://www.nytimes.com/2021/01/03/us/oregon-cares-fund-lawsuit.html

January 5, 2021 | Permalink | Comments (0)

Sunday, January 3, 2021

Pedantic Racism as Legal Commentary on Pandemic Vaccine

Dear 2021,

If you have a way to inoculate against the pandemic of COViD-19, do you have a vaccine against the virus of racism? Do you have a way to crush racism and the overt/subversive tactics used to silence/belittle/demean/marginalize/kill black and brown folks? And do you have a way to crush the pedantic racism masquerading as legal commentary? 

What does pedantic mean?

In frequently asked questions about the word "pedantic," the Merriam Webster Dictionary explains, "Pedantic is an insulting word used to describe someone who annoys others by correcting small errors, caring too much about minor details, or emphasizing their own expertise especially in some narrow or boring subject matter."

In short, welcome to the academy. Welcome to higher education. Welcome to the upper echelons breeding racist thought processes. 

The word, "pedantic," arrives in Middle English via French in 1580's/1600's in the midst of the Renaissance period during the Elizabethan and Jacobean ages.

The word is also said to have origins from Latin via Greek. According to the Latin Lexicon

paedagōgus, i, m., = παιδαγωγός, lit. a slave who took the children to school and had the charge of them at home, a governor, preceptor, pedagogue (cf. praeceptor).

So while the definition and usage of pedantic have expanded and constricted from ancient times to the post-modern era, what has remained the same is the idea of a pedantic person not being someone particularly welcome. Someone who quibbles over small matters losing sight of the big picture.

Pedantic racism entails people walking around not realizing they are being racist as well as those who are racist and don't feel inclined to correct themselves.

Now 2.5 days into 2021, I realize the pedantic racism will continue to fester even as the end of the pandemic nightmare is in sight.   

"Diversity" Nonsense

Professor David Bernstein (George Mason Law) writes in The Volokh Conspiracy, "Diversity" Nonsense Cost Tens of Thousands of Lives. Professor Bernstein teaches Constitutional Law, Evidence, Expert and Scientific Evidence, Products Liability,  and Torts and is considered an expert in Constitutional Law, Product Liability, Torts,  and Tort Reform. Professor Bernstein's extensive scholarly record would confirm such. Yet in his recent blog post addressing delays in the Moderna Vaccine, he may have considered conducting a search on Google. For legal scholars, Google often serves as a point of initial assessment. Conducting a preliminary Google search may have provided more insights to his pedantic legal musing published in the Volokh Conspiracy blog. 

Professor Bernstein was concerned that "Moderna Delayed its Vaccine Trials to Ensure it had 'Enough' Minority Representation." He then goes on to question the delay on account of failure to include an array of racial and ethnic groups in the testing sample.  He writes:

This is particularly egregious because apparently Moderna felt the need to ensure sufficient representation of Hispanic Americans. Even if you buy the dubious notion that there is a significant chance that vaccines will have significantly different effects by "race," what race are Hispanics supposed to be, exactly? The average American Hispanic is about 3/4 European by descent, based on DNA studies. Essentially, then, Moderna allowed tens of thousands of people to die to ensure that "enough" white people who happen to have Spanish-speaking ancestors were included. 

When questioned on his initial post about the scientific evidence of this discussion, he updates his post as follows:

UPDATE: Some readers have questioned where I got the notion that American Hispanics are, on average, mostly European in origin. The answer is from this study, published in the American Journal of Human Genetics: "On average, we estimate that Latinos in the US carry 18.0% Native American ancestry, 65.1% European ancestry, and 6.2% African ancestry." That's a bit off from the 3/4 I cited but:

 

(a) those figures add up to only 90%, the rest is assumedly unknown, so if you add 10% or so to each, you get up to 71.5%. Maybe it's a bit lower, maybe a bit higher. And

 

(b) then you have to consider the fact that the study uses the "Latino" category, whereas I (and FDA-approved studies like Moderna's) use "Hispanic." Hispanic Americans include non-Latinos whose ancestors (or themselves) immigrated from Spain, and who are 100% or so European in origin. Plus, you have self-described "Hispanos," Americans in the Southwest descended from Mexicans who lived in the territories conquered by the US in 1848. Their origins are overwhelmingly Spanish, and they generally don't consider themselves Latinos, but would likely identify themselves as "Hispanic." So between Spanish immigrants and their descendants and Hispanos add a percentage point or two, and you get that the average self-identified Hispanic American is "about 3/4" European by descent. If someone is aware of alternative estimates published in scientific journals, please let me know.

Professor Bernstein is asking the wrong questions and ignoring the bigger issue about ensuring the effectiveness of the vaccine in wider subsets of the population to improve its efficacy, in fact, for Caucasians. I am not an expert in product liability or torts like Professor Bernstein, but I can safely claim a better understanding of environmental health and epigenetics than Professor Berstein. I have also conducted a Google query of how racial and ethnic differences impact vaccine uptake. The reason why a larger subset of the population is needed is because in the past vaccines, such as as the flu vaccine, were more effective in some groups versus others. Those variations in uptake have not been fully investigated. To make sure the vaccines work well across broader groups of Caucasians, it is essential to test the vaccine across diverse racial and ethnic groups. That would mean the delay occurs not only so that diverse racial and ethnic groups have access, but that Caucasians also have a vaccine that is MORE effective for them. Please don't fault diversity for trying to give white people a better vaccine. Don't make diversity the excuse as to why one encountered a delay or received less vaccines - by one week. The entire year, week after week, day after day has been death and devastation. The same way science was avoided in responding to the pandemic, science should also not be ignored in recovering from the pandemic.

The Actual Medical Literature

In 2015,  Peng-jun Lu, MD, PhD, Alissa O-Halloran, MSPH,  Walter W. Williams, MD, MPH, Megan C. Lindley, MPH, Susan Farrall, MPH, and Carolyn B. Bridges, MD, published findings of their study on Racial and ethnic disparities in vaccination coverage among adult populations in the American Journal of Preventative Medicine.  They analyzed a 2012 National Health Interview Survey (NHIS)  of adult vaccination by race/ethnicity for six commonly recommended vaccines, including influenza, Tetanus, pneumococcal, human papilloma virus, and zoster vaccines. They used a "multivariable logistic regression analysis ... to identify factors independently associated with all adult vaccinations." They concluded:

Racial and ethnic differences in vaccination levels narrow when adjusting for socioeconomic factors analyzed in this survey, but are not eliminated, suggesting that other factors that associated with vaccination disparities were not measured by the NHIS and could also contribute to the differences in coverage. Additional efforts including systems changes to ensure routine assessment and recommendations for needed vaccination among adults for all racial/ethnic groups are essential for improving vaccine coverage.

Another reason to develop a broader subset of diverse test groups for the vaccine test sample is because of the overrepresentation of people of color among frontline workers, both healthcare personnel and essential workers. These are the people who will have highest contact rates with the subset of the population, which is out and about, so it would make sense to inoculate them and make sure such inoculation is effective. 

In The Impact of Vaccine Concerns on Racial/Ethic Disparities in Influenza Vaccine Uptake Among Health Care Workers, Rohit P. Ojha, DrPH, Sericea Stallings-Smith, DrPH, Patricia M. Flynn, MD, Elisabeth E. Adderson, MD, Tabatha N. Offutt-Powell, DrPH, and Aditya H. Gaur, MD, published their research in the American Journal of Public Health. Below is graph displaying their results. 

 

AJPH.2015.302736f1
Overall and race/ethnicity-specific influenza vaccine uptake by level of concern about influenza vaccines among health care workers: St. Jude Children’s Research Hospital, Memphis, TN, 2012–2013 influenza season.

 

 

The researchers concluded the difficulty in analyzing a small subset of the population of health care workers (HCW), because the group is isolated and cannot provide "an inadequate sociocultural perspective for understanding barriers to vaccination." The normative response to these findings would be not to ignore the racial and ethnic disparities in vaccine uptake, but to understand the causes and investigate them further. Dr. Ojha and his colleagues found that "Multilevel perspectives such as the socioecological model of health promotion recognize that individuals cluster in social networks and that social networks cluster in communities." They noted: 

Our results suggest that despite high vaccination coverage overall, uptake was still lower for non-Hispanic Black than White HCWs. More importantly, our findings suggest that greater concerns about the safety, effectiveness, and necessity of the influenza vaccine among non-Hispanic Black HCWs mediated this racial/ethnic disparity.
Then the question becomes, " Is it fair to prioritize racial minorities?" This question is where lawyers can weigh in, but only after reviewing some level of scientific and medical literature. In October 2020, Harold Schmidt, PhD, Lawrence O. Gostin, JD, and Michelle A. Williams, addressed this as a viewpoint in the Journal of American Medical Association (JAMA). They considered if it was lawful and ethnical to prioritize racial minorities for the COVid-19 vaccines. They write:

The United States is experiencing an intense reckoning with structural racism, both because of the disparate health effects of COVID-19 on racial minorities and protests over police violence. Vaccine allocation strategies should not exacerbate racial divisions yet must consider socioeconomic and racial disadvantage. Protected litigation challenging vaccine allocation plans could disrupt the implementation of a COVID-19 vaccination plan. Before implementation, ACIP should model the performance of the [Social Vulnerability Index (SVI)] against racially neutral standards such as the [Area Deprivation Index (ADI)], in capturing vulnerable groups while minimizing legal and ethical risks.

 

Policy makers should also model how many more vaccines worse-off racial minorities should receive. [ National Academies of Sciences, Engineering, and Medicine] suggests that 10% of all vaccines be reserved for the worst-off SVI quartile in each state. In addition, states should make “special efforts” to deliver vaccines to these areas. The more intense the priority that might be given to racial minorities, the deeper the legal scrutiny will be. In addition, a seemingly arbitrary arithmetic cutoff point can invite further legal concern. An equally pragmatic yet more meaningful approach would consider COVID-19’s effects to date (for example, in terms of deaths an ADI region incurred) on worse-off racial minorities. Grounding priority decisions in objective data help justify allocation formulas both for the general public and for the judiciary.

 

Public health agencies will have considerable discretion in rationing scarce COVID-19 vaccines. They could become agents of change toward improving social and racial justice. Or they can become complicit in allocation strategies that, once again, disproportionately favor the better-off, White majority. Racially neutral approaches must be implemented to advance social and racial justice in the United States.

Google may be evil, but it can still be your friend.

January 3, 2021 | Permalink | Comments (0)