The news of her brother’s death wasn’t unexpected. But mid-March 2020 would prove to be an extremely unusual time for Margaret, an African American woman in her 70s living in Wichita, and for her family to bury a loved one.
The novel coronavirus was beginning to reach Kansas. Just hours after Kansas Gov. Laura Kelly issued an emergency declaration in response to the COVID-19 pandemic, Kansas recorded its first death linked to the disease.
In about a week, Margaret would learn just how close to home the pandemic would hit, when she became Sedgwick County’s first confirmed case of COVID-19. The Journal is withholding her real name at her request to protect her privacy but has verified details of her account through hospital discharge papers and interviews with friends and family members.
As a veteran, she would eventually recover following a stay at the Robert J. Dole VA Medical Center. But her story corresponds with a now all-too-familiar narrative concerning the disproportionate impact that COVID-19 has had on people of color, especially early in the pandemic. Nationwide, people of color have been more likely than white Americans to contract COVID-19, and more than 73,000 have died from it, about 15% of all COVID-19 deaths where race is known.
Last spring, as more and more Wichitans like Margaret got sick from the virus, Sedgwick County’s trajectory looked similar to the nation’s. In April, the infection rate for Black county residents was about 61 people per 100,000, compared with white residents, who were being infected at a rate of roughly 30 per 100,000.
The disproportionate impact spurred stakeholders in Wichita’s African American community to mobilize through Wichita’s Black Alliance. One of the first points of emphasis was pushing county leaders to use some of the $99.6 million that Sedgwick County had received for coronavirus relief to help its Black community and low-income residents.
To make their case, Black leaders gathered for a demonstration outside the courthouse in early May to demand better communication, testing, and support for Black-owned businesses. That week, a letter had been sent to all area elected officials co-signed by the Wichita Branch NAACP, Greater Ministerial League, Wichita African American Council of Elders, Wichita Urban Professionals and Wichita State University’s African American Faculty and Staff Association. Kansas state Sen. Oletha Faust-Goudeau; state Reps. Gail Finney and K.C. Ohaebosim, all Wichita Democrats; and City Council member Brandon Johnson also signed.
They asked the county to ramp up COVID-19 testing, education and mask availability, while improving data and demographic metrics and providing support for parents and minority- owned businesses.
Then on May 12, The Wichita Eagle published a letter by the Black Alliance.
Johnson said the letter was written to make sure that the county Board of Health knew how the Black community was being impacted and what the Alliance wanted the county to address.
“We wanted to speak in one voice to make sure every governing body, including the one I’m a part of, understood that we were serious, this is a need, and we are concerned about the potential threat that this virus poses to us,” he said.
The effort prompted county officials to initiate one of its earliest relief expenditures: expanding communication outreach to the Black and Hispanic communities, eventually earmarking $150,000 for campaigns last year.
With that money, the county hired professionals from minority-owned communication firms, including Claudio Amaro of AB&C Bilingual Resources and Christina Long of CML Collective, to help ensure that information would be geared toward Black and Latino residents and appear in places where they were readers and listeners.
“It’s important here that the messaging goes out to the entire community,” said County Manager Tom Stolz, one of the key figures helping to oversee the disbursement of pandemic-relief aid. “And so we’re trying to hit those culturally sensitive areas, and we hired people within the culture to help us do that.”
Then in November, the Black Alliance and the Wichita African American Council of Elders received a $532,500 CARES Act grant through Sedgwick County to provide information technology support, food assistance and mental health support to the Black community. The funding also provided the support necessary to launch an outreach education campaign called #FACTSNOTFEAR, designed specifically for the Black community.
It had taken months of work, planning and collaboration by the Alliance and the Elders to get to that point. Multiple rounds of requests for COVID-19 CARES Act funding made their way through the advisory councils that allotted the money.
Despite holding to purpose, Black leaders didn’t get everything they requested for the Black community and minority-owned businesses. The county put $5 million into a bucket for business grants of up to $5,000, and although none was earmarked for minority-owned firms, leaders encouraged them to apply.
Access to testing improved, in a large part because HealthCore Clinic took the lead through initiatives such as mobile testing. But fear, Johnson says, still proved to be a barrier for many.
Combating that fear came down to communicating thoughtfully with the Black community. Doing that became one of the clearest outcomes of the push by Black leaders to raise the heat on the county and community to better battle COVID-19.
From flyers to geo fencing
Because of a history in this country of anti-Black violence and inequality, communicating effectively with African Americans about the pandemic posed special challenges.
Local officials needed to craft messages specifically for Black residents about limiting exposure to and the spread of the virus, said Djuan Wash, communication director for the Alliance and a drafter of the letter headlined “Wichita’s Black Alliance: Coronavirus is no laughing matter” in The Eagle.
“Historically Black communities have a deep-seated mistrust of medicine and doctors, and that is obvious and for good reason,” Wash said. “You know when you have such things as the Tuskegee … experiment, you know, experiments that they did in St. Louis with the military, you know all of these sorts of things Black people have in the back of our minds when we’re asked to go take this – this test that we don’t really know about.”
And it was also important that those communications be inclusive. Sedgwick County is about 80% white (about 68% are white alone, not Hispanic or Latino), and crafting communications about the pandemic only for the majority population would be an easy shortcut to take. But if African Americans and other communities of color didn’t see themselves represented in the campaign, they wouldn’t respond well to it.
“In a place like Sedgwick County and really all over, you see white faces in the marketing, you hear white voices in the marketing,” Wash said.
The county’s communication team approached Long early on to help ensure that the messaging it put forward would be relevant, representative and distributed in the best ways possible.
Even before her contract was finalized in May, the county was putting the pieces in place to help make people aware of COVID-19 and its impact in the area.
“They had already identified and created an online report system and communication resources that anyone who had access to the Sedgwick County website and was visiting could download and use for their own, either professional or personal communication effort,” Long said.
An initial $50,000 investment in communications was followed up with an additional $100,000 effort that emphasized the basics of staying safe during the pandemic — handwashing, social distancing and hygiene, said Akeam Ashford, Sedgwick County’s director of strategic communications.
The push came with an eye on meeting the audience where they were by encouraging them to find ways to keep themselves and those around them safe even if they couldn’t abide some of the recommendations.
“We kind of saw that you had those who were staunchly against wearing a mask,” Ashford said. “From the direction of (Sedgwick County Health Officer) Dr. (Garold) Minns and other physicians, they started to see the numbers start to go up and so they really wanted to push the message of those three factors which, in the very beginning of this pandemic, were kind of the key points.”
Traditional marketing strategies such as flyers and posters, along with social media messaging and engagements with television stations, newspapers and radio stations certainly played a role. But technology also provided opportunities to employ more sophisticated and better targeted approaches.
One important addition proved to be geo fencing, a marketing strategy that allows for segmentation of what types of ads appear on mobile devices, based on the geographic location.
Long says geo fencing offered the ability “to use a combination of traditional methods, with digital and electronic communications and also newer trendier technologies, just to make sure, again, the county’s messages about healthy behaviors and what to do about testing and where to get tests were out there.”
Long’s deep connections and understanding of the community also made her and her team tremendous resources in advancing the county’s efforts, Ashford said.
“Her ideas and her insight really helped us to reach the folks that we are trying to reach,” Ashford said. “That kind of consultant to communications, I’ll be honest, it makes my job really easy.”
Sedgwick County’s efforts to prioritize communication to minority communities were noteworthy, he said.
“Most places, most organizations don’t think about communicating to minority groups, and I think just pulling in Christina, pulling in Claudia for our (Spanish) speaking folks, and then translating into Spanish and in Vietnamese, that says volumes about Sedgwick County government,” he said. “I think the future is bright. I think this is a learning opportunity. "It was a hard lesson to learn in a lot of ways, but I think it sets us up for the future to better communicate in the next event.”
‘People they trust’
Ti’Juana Hardwell, owner and editor of Mamarazzi Entertainment, also played a key role in the #FACTSNOTFEAR campaign.
“I honestly feel Ti’Juana Hardwell is working herself in a tizzy to make sure that these niche messages are out, and she is doing a phenomenal job," Long said. "That is also another indication and demonstration of how the county and the community are getting it right … in the face of a pandemic,” Long says.
Using grant money that the Alliance and the Elders had applied for, a communications plan was fashioned to fill information gaps.
“We knew how important it was to make sure that people who looked like them are helping to get the pertinent information out to them,” Hardwell said.
One of the campaign’s innovations was a community alert system that allowed organizers to communicate directly with residents via text message. The alert system was sponsored by the Elders and the Kansas African American Affairs Commission and supported by the Kansas Health Foundation, which also funds the Kansas Leadership Center, publisher of The Journal.
“The community alert system allows anyone to be able to text the word ‘alerts’ to 484848,” Hardwell said. “And they will begin to receive information as we receive it.”
The communications push didn’t just help empower residents to keep themselves safe. It also helped connect them to resources that would help them weather the pandemic’s economic impact.
Hardwell says a lot of African American business owners especially were not aware that they they were qualified for CARES Act funding — one consideration that arose when the alert system went live.
“This whole idea about having a community alert system, text messages that come right to their phone, (is) so that they are able to get that information and not just a timely manner, but from people who they trust,” Hardwell said.
One point of pride for Hardwell and her team was the inclusion of Black business owners in their planning and distribution efforts.
“With that money that we received, we actually did a lot of business with African American business owners. That was a way of us being able to make sure that that money went back” to people who could most benefit from it, she says.
The lessons learned during the outbreak will likely be applicable to the next phase of battling the pandemic: encouraging vaccinations. The Alliance and the Elders hosted virtual town halls and vaccine health forums in November, December and January to discuss vaccine facts and fears.
All of the communication tactics used to inform minority groups about how to reduce the COVID infection rate could also play a role in persuading skeptical individuals to get vaccinated and, in turn, increase the chances of herd immunity.
“It’s really important to know that when it comes to … these vaccinations that are getting ready to happen, African Americans have a long history of not trusting medical professionals, and also not trusting news that is disseminated," Hardwell said.
"It’s just a long history."
The challenge of reining in a disparity
Gauging the success of the communications campaign in helping to stem the pandemic can be difficult and complicated.
What the numbers don’t show presently, though, is the stark racial disparity evident early in the pandemic. White residents of Sedgwick County now appear slightly more likely to test positive for COVID-19 than Black residents. But it’s tough to say for sure whether Sedgwick County has avoided the racial and ethnic disparities in COVID-19 deaths nationally because of the large number of deaths in which racial data is unclear or has not been provided.
According to Sedgwick County Health Department records, African American individuals accounted for 35 of the county’s 600 deaths as of early May. However, 126 deaths have been catalogued as “other races,” and no racial demographic information was recorded for 32 deaths.
In terms of ethnicity, Hispanics and Latinos accounted for 30 deaths, while 452 deaths involved people who were not Hispanic or Latino. No ethnicity was recorded for another 124 deaths.
The county’s death rates rank well below the national average per 100,000 for every racial and ethnic demographic grouping, except “other,” which is three times the national average at 301 deaths per 100,000 Sedgwick County residents.
Kaylee Hervey, epidemiology program manager at the Sedgwick County Health Department, said cases get categorized as “unknown” if the health department fails to reach an individual or a person refuses to answer questions. All coronavirus deaths recorded in Sedgwick County are tied to confirmed cases, in which a positive test for COVID-19 preceded the death.
Labs or the providers that order tests are asked to provide demographic information to the county, but in dozens of deaths, the health department has been able to obtain racial information no more specific than “other.”
In a perfect world, Hervey says, county officials would be able to know the demographic specifics of every case, but the scale and scope of the COVID-19 pandemic has complicated data collection efforts. More details could emerge over time if the state decides to allocate the resources necessary for a deeper investigation of death certificates. But for now, the data only provide an outline of what’s occurred. “You just have to know there are some nuances to that data that could skew your assumptions,” Hervey said.
The uncertainties surrounding the data frustrate analyses of whether Sedgwick County’s communications resulted in a reduced number of cases and fewer deaths. But cause and effect is often complicated in matters of public health, and advocates for the county’s efforts say they are better judged by the fact that officials made conscious interventions to address an emerging problem.
Long says that the metrics generated by Sedgwick County’s campaign provide at least one barometer of success.
“Reach numbers across digital platforms and across social media continue to show that more and more people are engaging, commenting and interacting with communications,” Long said.
Being able to count on the county as collaborators has made a huge difference. Long complimented Ashford’s teamwork, saying that he not only aided in messaging through animated videos and graphics but helped to facilitate town hall meetings where health professionals could share information.
One of the things to keep in mind, Long said, is that with something like COVID it is important to remain agile, because the goal is always changing and moving.
Still, organizers wished they could have done more. Ashford said that if they’d had more money, he would have liked to see more direct engagement, in-person town halls in some of the very large spaces in the county that could safely accommodate such a gathering and the use of national influencers.
Long said she would have liked to increase the volume across platforms.
“More budget means more frequency, more exposure,” she said. “So I would have loved to have been able to have a budget that would allow even more.”
Long said that she thinks blaming the county for racial disparity in early days of the pandemic would be misplaced.
“In terms of the racial disparity factors, we have to understand that time frame and what was going on in the country when COVID just broke out.”
She applauded the county for having the foresight and initiative to bring in outside assistance to be able to deepen their breadth of knowledge and to make sure that all types of residents were appropriately communicated with.
“However, the county is just one entity in this whole situation with COVID,” Long said. “We had a federal level voice that was causing confusion when it comes to COVID. Then we have funding — various pots of funding that the state was communicating about, the county was trying to figure out how to communicate about, the city was communicating about.”
She said the county went above and beyond what they were required to do in allocating money for a campaign targeted at African Americans.
“This was a great demonstration of what happens when you truly put resources and people to power in order to empower those who are typically left behind,” she said.