Original reporting from the
MANCHESTER, NH — For the first time, state officials released data showing the ethnic breakdown of confirmed COVID-19 patients, confirming what many feared — that minorities make up an outsized portion of the cases.
While the majority (81 percent) of the cases were found in white patients, which is notably less than the 90 percent of the state’s demographic makeup white people represent, the percentage of cases among black, Latinx and “other” races exceeded their share of the population, according to a weekly summary report released by the state Department of Health and Human Services Wednesday.
People who identified as black or African American make up 5.4 percent of the cases, while only 1.4 percent of the state population, and Latinx patients accounted for 6.1 percent of cases, while they are 3.9 percent of the population, according to Census Bureau estimates from July 2018.
Only patients who identify as Asian seemed to be affected proportionate to the group’s size, with just over 3 percent.
In New Hampshire, the largest concentrations of communities of color are found in its largest cities, Manchester and Nashua. Phil Sletten, senior policy analyst for the New Hampshire Fiscal Policy Institute, said that while the two cities only make up 15 percent of the state’s population, they are home to roughly half of the black and Latinx populations in New Hampshire.
As of Wednesday, there were 326 confirmed COVID-19 cases in Manchester, and 145 in Nashua, according to DHHS, which is some of the highest numbers in the state.
“Relative to both population density and income levels, individuals and communities identifying as something other than non-Hispanic white are at statistical disadvantages,” Sletten said.
Communities of color have been hit harder by COVID-19 across the country for the same reasons; socioeconomic disparities and systemic racism.
Sletten said Latinx, black and Asian residents have higher rates of poverty than their white counterparts in the Granite State, they may have less access to resources and healthcare and some who live in crowded housing situations are at a higher risk of contracting the virus.
“If one person gets it then it can very easily travel throughout the family,” said state Sen. Melanie Levesque of Brookline.
Levesque, who represents Nashua, said she spoke with a representative of the Latinx community in the Gate City who told her he is particularly concerned that there are some multi-generational households living in small spaces. She also said some undocumented immigrants may be fearful to seek help either due to lack of insurance or they’re afraid of being detained by immigration enforcement.
At first, state officials were not actively collecting racial demographic data as part of its COVID-19 tracking. Several hospitals responded to requests for information by saying they either did not have the information or could not share it without risking a violation of HIPAA privacy rules.
“I think the situation is constantly evolving,” Levesque said. “I don’t want to say they dropped the ball, but I think they’re learning as they go along that we need to track these statistics because we’re seeing throughout the country that that is a concern.”
Speaking to area businesses at a virtual Greater Manchester Chamber of Commerce event last Friday, Manchester Public Health Director Anna Thomas said the state will be doing more tracking of race information now, but it initially lacked confidence in the data.
“It’s not anything we’ve been tracking in Manchester as of yet because it’s been so new. We’re talking weeks into this and this has primarily been looking at cases of age,” Thomas said.
Thomas said communities of color face additional barriers to care and resources because they don’t have the same experience with the healthcare system as whites do to begin with. She said that’s often the result of socioeconomic variables, institutional structures that work against minorities and poor people, and racism.
Bobbie Bagley, the director of the Nashua Division of Public Health and Community Services, said she has been tracking racial data from the start.
“I am a person of color and having that data is always important to me,” Bagley said.
In fact, one of the very first contact investigations her department performed in the city was for a family of color, she said.
Initially, statewide testing prioritized people with symptoms, frontline healthcare workers and first responders. Since some groups like firefighters, police officers and nurses are usually not very diverse, Bagley said, the tests didn’t capture a good sample size of minorities early on.
And the state couldn’t easily release that data when the numbers were too low, since the public could potentially deduce the identity of patients, violating their privacy.
“You can count on your hand sometimes how many minorities live in a town,” Bagley said.
Now that testing has broadened to include more categories of qualifying people, Bagley is hopeful they’ll soon get a clearer picture of how COVID-19 is affecting communities of color.
“As we broaden the opportunity for testing, you’re going to … be able to screen more minorities,” Bagley said. “In a place like New Hampshire, where you don’t have a large minority population, it’s hard to get that kind of data.”
The picture is still incomplete, however, as the state only has race data for 80 percent of the total cases; the state has race information on 1,158 people out of 1,447.
One of the challenges with collecting information from minorities is there is often mistrust of the government because of historical structural racism, Bagley said. But she said the Nashua health department has a diverse and multi-lingual staff in an effort to overcome those kinds of barriers.
Other health departments in other parts of the country may not be so diverse, or they may lack sufficient capacity, Bagley said. Her cousin who lives in Virginia, for example, is still waiting to hear from her health department.
And systemic racism is not resigned to history, Bagley said.
“You still have a lot of discriminatory practices, you still have a lot of racism,” she said. “We get treated differently.”
Levesque said the picture in Nashua likely differs from Manchester’s in some ways.
“The story of Nashua, I think, is going to be very different than Manchester, because the people of color (in Nashua) are not as focused in one area,” she said.
There are more people of color, including suburban homeowners, who are spread out across the Nashua area, Levesque said, while Manchester’s communities of color are likely more concentrated in more urban areas, she said.
Levesque said the data released by the state did not shed any new light on the geographic dispersal of the infected minorities, and she still hopes to see that mapped out.
Bagley also said she has some lingering questions, such as the racial breakdown in smaller outbreak clusters like nursing homes, and how many minorities are represented in the care staff in those facilities. She also wants to know how many minorities are healthcare professionals working in Massachusetts, what proportion of the community spread is happening within minority families, and how many of the cases contracted from international travel are representative of minorities.
“This would be a good way of taking a deeper drive into what we’re seeing in the data,” she said.
Overall, healthcare workers make up more than a third of total cases in the state.
These articles are being shared by partners in The Granite State News Collaborative. For more information visit collaborativenh.org.