Democratic Western Massachusetts State Senator Adam Hinds chaired the first hearing for a new committee on re-imagining Massachusetts after the COVID-19 pandemic Tuesday.
The “Reimagining Committee,” chaired by Hinds, is designed to explore the inequities highlighted by COVID-19 in areas like the economy, transportation, race, and more.
Dr. Jarvis Chen, Lecturer on Social and Behavioral Sciences at Harvard, gave a presentation on the national health system’s shortcomings brought to the fore by the pandemic.
“You can't ensure health equity if you don't measure health equity," he told the committee. "And this is particularly salient because early on in the COVID pandemic, it was very difficult to get data on racial ethnic patterns in terms of cases and deaths, and it took several months for the data to become available.”
From state to state across the country, data on race and ethnicity were reported differently.
“As of March 7th, The Atlantic's COVID racial data tracker showed that 75% of Massachusetts cases have data on race ethnicity, whereas 99% of deaths do," said Chen. "Massachusetts doesn't report race ethnicity data by tests, although it does for hospitalizations. And just as an aside, this too, is an example of our data infrastructure because it took a private media organization, The Atlantic, to put together a COVID racial data tracker to track what the different states were doing because that wasn't being coordinated or tracked at the federal level.”
Chen noted that the disparity in reporting on race and ethnicity in the pandemic continues to this day.
“11% of the information on individuals with at least one vaccine dose administered are missing race, ethnicity data, even though the CDC reporting form for vaccinations that everyone has to fill out, has race ethnicity as one of the first elements on the form," he said. "And so this just speaks to the importance of actually collecting the data, particularly on historically disadvantaged groups or groups that have been subject to historical structural racism. If we think that disparities exist, we need to look at them in order to document them.”
But just collecting that information isn’t enough to understand the extent of inequity in the health care system.
“A lot of the news coverage of this last year showed that, for example, non-Hispanic Black communities had twice the rate of COVID-19 mortality compared to their non-Hispanic white counterparts," said Chen. "But that doesn't take into account the fact that nonwhite populations tend to have a younger age distribution compared to white populations in the United States. And also we know that COVID-19 mortality risk is much greater at older ages. So when you actually age adjust these, you get a very different picture, showing that actually, the disparity – this was in July of last year – for non-Hispanic blacks compared to non-Hispanic whites was actually 3.6 times rather than just two times and carries across for other racial ethnic groups as well.”
Chen described the disparities in COVID-19 experiences between racial and ethnic groups as extraordinary.
“The rate for non-Hispanic Black folks between 35 and 44 years old being nine times that of non-Hispanic whites is truly dramatic," he said. "And as we know from last year, the patterns for American Indian and Alaskan natives are even more distressing. So this really reflects that the differences in mortality are very specific to age. They very likely reflect differences in occupation, particularly in these ages, where people are working in terms of who's able to work from home, versus who is working an essential job, who is able to practice social distancing within those contexts. And certainly housing makes a very big difference here as well, in terms of who's able to isolate or quarantine.”
People with less than a high school education experienced five times the COVID-19 mortality rates of those with higher levels of education, with nonwhite racial and ethnic groups making up a larger portion of that population.
Chen noted that contemporary segregation was highlighted by the pandemic, with data showing zip codes with greater communities of color experiencing the highest mortality rates from COVID-19.
He said the most recent spike in mortality rates has hit Hispanic Massachusetts residents between the ages of 55 and 64 the hardest.
“This is the group that wasn't yet eligible for vaccination," said Chen. "And it's also the group again, where those Hispanic, Latinx in this age group are those working in essential jobs, those unable to practice social distancing, those living in multi-generational housing, and so that's reflected in these mortality rates.”
Chen concluded by calling for investment in robust public health data collection and the centering of equity in health care.
“What we saw last year in our sort of federal public health system was a little bit like being caught with our pants down, having to invent these systems that we had assumed were going to be there in useable ways," he said. "And then we realized in the moment that we actually have to reinvent them.”
Another presenter at the hearing chaired by Democratic Berkshire, Hampshire, Franklin and Hampden district state Senator Adam Hinds was Lee Rainie, Director of Internet and Technology research at the Pew Research Center. He shared findings from a poll conducted among over 900 members of the tech community about the emerging trends of a post-pandemic world.
“Their basic argument is that technology trends that were already underway at the start of the coronavirus outbreak were sharply accelerated last year,” said Rainie.
Almost half of those polled said that life would be mostly worse for people by 2025 than it was before the pandemic.
“They wrote about changes that could reconfigure fundamental realities, such as people's physical presence with others, and humans’ conceptions of trust and truth," Rainie told the committee. "Several wondered if people and institutions can cope effectively with such far reaching changes, given that they're required to function, in the words of biologist E.O. Wilson, with Paleolithic emotions, medieval institutions and God-like technology.”
Those questions weren’t limited to the metaphysical sphere alone.
“Of particular concern to these expert respondents, the optimists as well as the pessimists, is that the expanding role of digital technology in people's lives will worsen social and economic inequality," continued Rainie. "They worry that those who are highly connected and the tech savvy will pull further ahead of those who have less access to digital tools, less training or aptitude for exploiting them.”
Rainie said the potential for technological advances to replace workers with machines has produced growing fear among the poll respondents.
“These experts have a related concern about how post pandemic trends and technology adoption will enhance the power of big technology firms, as they exploit their market advantages and processes such as artificial intelligence in ways that could stifle marketplace competition, and further erode the privacy and autonomy of their users," he said. "In effect, the experts embracing this view believe individuals will have less capacity to act in ways that will improve their circumstances in the future.”
However, the poll didn’t strictly elicit dystopian visions of the future from the tech community.
“They believe that reforms aimed at racial justice and social equity can be enacted because they have been spurred by large scale citizen activism," said Rainie. "These experts argue that the reset brought about by the pandemic will allow people to reconfigure major systems such as education, health care workplaces, and ease in the shape of urban, suburban and rural spaces. They assert that advances in technologies such as AI, smart cities, data analytics and virtual reality could make public facing systems safer, more humane, more productive – starting with the emergency responses in crises themselves.”
Rainie said respondents reflected on how the increasing role of technology in our lives exacerbates the best and worst of humanity.
“On the one hand, they noted that today's crises are enhancing digital interconnectedness," he said. "And that can engender empathy and better awareness of the ills facing humanity, and actually the capacity for more forceful collective action. On the other side, they believe that individuals, cities and nation states will become more insular and competitive as they retreat to survival strategies in the pandemic and its aftermath. Xenophobia, bigotry and closed communities will also likely increase.”
Rainie’s key takeaway promoted to the committee: the future remains in the hands of present-day actors.
“One of the main reasons we do these expert canvass things about the future of digital technology is our sense that the issues we explore are not yet settled," he told lawmakers. "There is a time to change the shape of the future. We hope that current technology creators and policymakers who are called upon to assess their work can examine the kinds of answers we get in our questions about the future and act in ways to mitigate the potential harms that could lie ahead and maybe nudge technology development towards beneficial outcomes.”
