As COVID-19 cases continue to rise locally and nationally, the pandemic is hitting people of color the hardest. In Central Texas, hospitalization rates have remained the highest among Hispanics. Texas had a state office fully devoted to tackling healthcare disparity issues some believe could be helping save lives right now, but lawmakers shut it down three years ago. Now, there is a renewed push to revive it.
AUSTIN (KXAN) – It’s a rare, quiet moment in the middle of a jam-packed November morning of seeing patients. Dr. Guadalupe “Pete” Zamora took off his face shield and mask and escaped to his office at his medical practice in east Austin – an area of the city that’s been a COVID-19 hot spot.
Still dressed in blue scrubs and a Dallas Cowboys bandana tied around his head, Zamora sat down at his desk and jumped on a Zoom call to walk us through what he’s seen the last few months, weeks and days.
“I guarantee you of the three [patients] I tested today, all will be positive,” Zamora said. “It’s coming back, and we’ll be in stage four soon.”
Zamora treats mostly Black and Hispanic patients, and has had about 220 people test positive for COVID-19 since the pandemic first flared up in mid-March.
“We’ve lost two. They were both older folks,” Zamora said with sadness in his voice but also a hint of relief that he hasn’t had more deadly cases.
The virus is hitting the populations he serves the hardest. In Travis County, hospitalization rates have been higher among Hispanics than any other race, according to the Austin Public Health COVID-19 dashboard.
Nationally, cases are more than twice as high for Hispanics and Black people when compared to white people, and deaths among Black people are twice as high as deaths among white people, according to the U.S. Centers for Disease Control.
Zamora said the state’s cases highlight the need for a state office — like the now-shuttered Office of Health Statistics and Engagement — that focuses on racial disparities in health care. Early in the pandemic, that office could’ve helped cities like Austin pinpoint areas where people were more likely to get sick and create a plan to address it.
“You could make the case by going into those communities and seeing, like, what is it that’s driving the spread? What is it that’s driving deaths?” said Lauren Lluveras, a former employee of the minority health statistics office.
History of the Office of Minority Health Statistics and Engagement
The Office of Minority Health Statistics and Engagement was created in 2010 and was originally called the Center for Elimination of Disproportionality and Disparities. Its first big project and discovery: Child Protective Services was more likely to remove children from Black parents than from white parents.
The office’s name was later changed to the Office of Minority Health Statistics and Engagement, and the work expanded to looking into disparities across the state’s health agencies.
The office received about $2 million a year from the state, and Lluveras was one of about two dozen employees.
“I had never before then knew that you could predict health outcomes by somebody’s zip code, predict somebody’s likelihood that their child was going to be removed based on their race and ethnicity,” Lluveras said. “It was really eye-opening, and I just really fell in love with the work they were doing there.”
She was a regional specialist assigned to about 30 counties in Central Texas. Lluveras recalls visiting the small town of Marlin, near Temple, after a section of town with more people of color had its water shut off. She talked to members of the community and shop owners and tried to convince them to speak at a City Council meeting.
Lluveras also recalled a trip to Waco where she met families with low-weight, pre-term newborns, and connected them back to the McLennan County Health District.
Defunding the state office
During the 2017 legislative session, lawmakers defunded the minority health statistics office due to what State Rep. Garnet Coleman, D-Houston, said was political infighting among lawmakers during the state budget process.
Coleman said he believes the move was a way to “go after” former State Rep. Dawnna Dukes, D-Austin, who was highly supportive of the state office. She was a member of the House Appropriations Committee at the time, and faced multiple felony indictments related to abuse of public office. All the charges against Dukes were later dropped, and she lost a bid for reelection in 2018.
Lluveras, who had to find another job, said she went to the Capitol to fight for the office, but the Senate Finance Committee ultimately zeroed out the office’s budget.
The Senate Finance Committee’s chairwoman, Jane Nelson, R-Flower Mound, did not respond to KXAN’s requests for comment about the situation. Her staff said they were under the impression the Texas Health and Human Services Commission would continue to collect and analyze racial data, and the agency was directed to team up with a university to continue the work.
The Legislative Budget Board said that never happened, and the office shut down in September 2018.
“None of its functions transferred anywhere, and we just left all of these people hanging,” Lluveras said.
Coleman, who serves a predominantly Black district in Houston, said the people who ultimately suffered the most were Texas minorities. He believes if the office were still intact, the state would’ve responded to COVID-19 racial disparities faster.
“We would’ve known where people have diabetes, who had heart disease and hypertension because we would’ve been keeping those statistics and then we could act before people were infected with COVID-19,” Coleman said. “And tell them specifically in those areas that you have to be more vigilant — that came very late in this pandemic.”
Former CPS official Joyce James, who was appointed to lead the office in 2010, told the Texas Observer the state might have been better prepared for the virus had the office continued its work.
What’s happened in its absence
In April, about a month into the pandemic, KXAN reported on groups calling for a closer look statewide at how the disease was affecting people of color.
At that time, Texas Department of State Health Services was tracking race and ethnicity data for COVID-19 cases, but it was incomplete. Nearly a fifth of the cases were listed as “unknown,” and DSHS said it had only received case report forms for about 2,000 of the 10,230 cases reported by local jurisdictions.
After requests from lawmakers, HHSC said it launched a study in the last month to better understand how and why COVID-19 is having a greater impact on vulnerable populations. It hopes to release that information next month.
HHSC also said even without state funding for the minority health office, they’ve tackled a project addressing obesity among minorities in Beaumont, Laredo and Port Arthur, have worked to increase breastfeeding rates among Black women, and improved pregnancy-related outcomes in Hidalgo and Smith counties.
‘Thorn in my side’
Travis County Associate Judge Aurora Martinez Jones had just launched a big project with the minority health office when it shut down.
“I’m so glad to hear this coming up,” Martinez Jones said. “It has been a thorn in my side ever since they did away with it.”
She had seen the legislative report put out by the Texas Department of Family and Protective Services showing Black children in Travis County were nearly eight times more likely to be removed from their families than white children.
As a Black woman who handles child welfare cases, Martinez Jones embarked on a mission to find out why the discrepancy existed, and to come up with a solution to change it. Jones formed the Child Welfare Race Equity Collaborative, which was made up of several organizations. The minority health statistics office was one of most powerful players at the table when they held their first meeting in May 2018.
Little did Martinez Jones know, it would be the first and last meeting with the state office.
“I think that a vast majority of Texans didn’t realize this was happening,” Martinez Jones said. “It was devastating for us to move the work forward.”
With the minority health statistics office gone, Jones had to regroup. She called on county agencies to help. The latest data that came out last month shows the rate of removals for Black children has been cut in half, which means they’re still about four times as likely to be removed from their home by child protective services than white children.
“Quite honestly, that’s still not good enough,” Martinez Jones said. “And, we’ve got a lot more work to do.”
Push to revive it
In a Tweet last month, State Rep. Donna Howard, D-Austin, said she will be working to reinstate the minority health statistics office.
Coleman, who is a diabetic, said he plans to file a bill in the upcoming 2021 legislative session to bring it back, and restore its full funding.
“I think it’s imperative as long as we have issues that kill people, health issues that take people’s lives in a disproportionate way to others,” Coleman said. “It has to be done and I think that those of us of color, we know that this is very important.”
Texas Democratic Sen. Borris Miles filed a bill last week that would bring back the office of minority statistics and engagement in a smaller capacity. Senate Bill 75 proposes putting the office within the Department of Family and Protective Services to address the disparities of minority children in the child welfare system. The bill, which does not mention racial inequities in health care in its scope of work, calls for the use of existing resources and directs DFPS to consult with a university to assist them.
Sen. Miles said he wants the office to have even more power than before and would support a full restoration of the office, but he drafted the bill “pragmatically” given the tighter budget facing the state next year due to COVID.
“I didn’t want to let money stand in the way,” said Miles, who went on to say in an emailed response:
“Had this office been open we would have been able to immediately recognize the disproportionality in which black and brown folks were being affected by COVID. Many of the questions and answers we needed could have been gathered during this pandemic. There was no need to ever defund the Office of Minority Health and Engagement except to hide the harsh truths that the offices revealed. It was only $2 million in a $107 billion dollar budget. But COVID has revealed the many disparities in our society, including in health and human services. This bill is the first step in restoring an office that could identify and provide solutions to those problems.”
Photojournalist Richie Bowes, Senior Investigative Producer and Digital Reporter David Barer, Producer Phill Robb and Digital Executive Producer Kate Winkle contributed to this report.