This article is part of an ongoing collaboration between the Colorado School of Public Health, the Denver Museum of Nature & Science, and the Institute for Science & Policy. Watch the full recording of this session and find all of our previous COVID-19 webinars and recaps here.

The systemic inequities in the American healthcare system existed long before COVID-19 ever arrived. Throughout history, Black, Latino, Native, and Indigenous communities have borne a disproportionate burden in public health crises due to a lack of affordable and accessible treatment options. In part one of our discussion, we explored the role of structural racism; longstanding mistrust between communities and medical practitioners; and the need for authenticity in our support systems.

Recently, the Institute’s Senior Policy Advisor Kristan Uhlenbrock sat down to discuss the history of healthcare inequality, trust (and mistrust) of health practices, data from the current outbreak, and possible ways forward with Alisha Brown, MNM, Senior Vice President, The Foundation for Sustainable Urban Communities and Director of the be well Health and Wellness Initiative; Michael Cortés, MSW, MPP, PhD, Scholar in Residence and Special Community Member at the DU Graduate School of Social Work and Executive Director of the Colorado Latino Leadership, Advocacy & Research Organization (CLLARO); and Jennifer Ho, PhD, Director of the Center for Humanities & the Arts and Professor of Ethnic Studies at the University of Colorado Boulder and President of the Association of Asian American Studies.

The transcript below has been edited for clarity and flow.

KRISTAN UHLENBROCK: Good morning. Mike, could you tell us a little bit about the work that you're doing as well as how the Latino and Hispanic experience in Denver has been shaped by COVID-19?

MICHAEL CORTÉS: Good morning, everybody. It is my privilege to serve as executive director of Colorado Latino Leadership Advocacy and Research Organization (CLLARO). We're very much about helping Latinos in low income communities in Colorado work together to solve problems of their own choosing. We're very interested in education and civic engagement and so a lot of what I have to say today is driven by that vision of our organization.

This morning, I've got some facts and opinions that I'd like to share with you. Some of them might surprise you. And maybe you'll think some of what I say is wrong. If what I'm about to say is wrong, I've got a challenge for you: Just for fun, try thinking like a scientist. Make a note to yourself of something that I said that seems wrong. And after we’re finished, do some research. Look for scientific or scholarly evidence that contradicts what I said. If you can't find it, don't give up. Ask a reference librarian to help you run it down.

I don't recommend relying on opposition research based on motivated reasoning. By motivated reasoning, I mean something that looks like logical research but it only cites evidence that supports the writer’s preconceived ideas. That's not real science or scholarship. I suggest you look instead for blind peer reviewed publications and reports relying on scientific logic. Some of the most helpful ones use unbiased measurements or observations that test competing hypotheses. Then, send me an email complete with bibliographic citation of evidence based research. That's just so I can check it out too. If I say something today that's not true, I want to know.

Okay, so here's some facts and opinions. COVID-19 hurts Latinos more than others. Latinos in the United States are a little under 19% of the nation's population. But we make up 35% of all our COVID-19 cases. We think of this as a disease that puts older folks like me most at risk. But I want to focus a bit on children between the ages of five and 17 who have confirmed cases of COVID. More than half of them are Latinos. Now if you look at youth and young adults who have confirmed cases of COVID, 43% of them are Latino. And a lot of them die. You look at children and youth who die from COVID-19 and 40% of them are Latino.

So, why is this happening? I don't think the virus prefers Latinos. Latinos are a diverse multiracial multinational ethnic group. Many Latinos in the country are immigrants, of course, but most Latinos in Colorado are not. Latinos have lived in what is now Colorado since before the arrival of English speakers. The Arkansas River that runs through Pueblo, Colorado, used to be the border between Mexico and the United States, years before Colorado became a state. All land in Colorado south of that river used to be part of Mexico.

In the town of San Luis, the oldest town in our state, Spanish has always been and still is the first language spoken. Many of the families in San Luis have been there for generations. English speakers are relatively recent arrivals in our part of the world. Some Latino families in Colorado have lived in what is now the southwestern United States since the 1500s, before the pilgrims landed in Plymouth Rock. 10 years ago, one out of five Coloradans were Latino. And we've been growing. Five years from today, one out of four Coloradans will be Latino.

So why is COVID-19 giving Latinos such a hard time? The answer seems to be economics. Since the 1950s, economists who study U.S. labor markets have gathered ample evidence of what they call labor market segmentation. Throughout history since colonial times, the kinds of work that people do in the United States has been influenced in part by their race, national origin, ethnicity, and the language they speak. Those same factors have also affected people's educational opportunities, their earnings, where they can buy and rent places to live, the way they're treated by government and police and their fellow citizens, and even whether they can serve on juries or vote.

Labor market segmentation affects poor Latinos in several ways. Today, Latinos are concentrated in jobs that have the highest risk of exposure to COVID-19. Latinos are more likely to be classified by employers and government as essential workers, and are less able to work at home while others are safely quarantined or sheltering in place, Latinos employers are less likely to provide health insurance. Latino children are less likely to have access to broadband internet during the pandemic. It's harder for them to keep up with school lessons as well.

So those are the facts. And I'd like to close with some opinions. The COVID-19 pandemic is hitting Latinos harder because too many decision makers are people who tend to treat Latinos and other minorities differently from the way they treat non-Hispanic whites. Those decision makers decide who gets hired for which jobs, and how much they'll be paid and whether they'll receive health insurance and whether their children will attend good schools, and whether people who lost their jobs were behind on their rent should be evicted..

Does that sound like racism to you? If you think I'm wrong about the facts. I'm sharing with you this morning. I look forward to hearing from you. I promise to take a good look at your evidence.

KU: Thank you, Mike, and good morning, Alisha. You founded the be well health and wellness initiative I'm wondering if you could tell us a little bit about what that is and some of the ways you've been engaging with communities since COVID-19.

ALISHA BROWN: Thank you to my fellow panelists, the Institute, and the Colorado School of Public Health. I'm glad to be a part of this panel. Our initiative is part of the Foundation for Sustainable Urban Communities. It's an initiative that was really founded and guided by residents back in 2000, who really saw a challenge with equity and health way back then and saw disparities and started thinking about why is this happening and what are ways in which we can address these challenges. Why is it that African Americans and Latinos and our Asian Pacific Islanders communities are disproportionately impacted by the disparities? We really focused on six areas in Denver and Aurora to really think about what that means and why. Over this period of time, we've really worked to see what programs, policies, research, etc. has been done, and how that impacts day to day lives as far as economics, housing, transportation, and other social determinants of health.

Our goal with the be well health and wellness initiative is to provide opportunities that allow those who are most impacted to engage in the decision making processes that are impacting their communities the most and begin to serve in some of those leadership roles. We must see a reflection of those serving our communities in leadership positions, as well as in decision making opportunities. And I'm not just talking about having someone be the next city council person, but at every level of leadership, and at every level of being able to make decisions. Engaging residents in those decision making processes is important for us and that's a lot of what we focus on. Additionally, we try to look at what programs, policies, procedures and practices are literally impacting the day to day lives of our residents and to try to gain some influence within the communities that we serve. We can work in six different neighborhoods, reaching over 150,000 residents, to advance equity in our communities.

KU: Thank you, Alisha, and welcome Jennifer. I'm wondering if you could talk to our audience a little bit about the resources that you've developed to help educate people about anti-Asian racism as well as the wave of anti-Asian racism that we've seen here in the wake of COVID-19.

JENNIFER HO: Good morning to everyone. Before I begin, I want to acknowledge the land that I am currently occupying is the traditional territories of the Cheyenne, Arapahoe and Ute nations. Though I will be focusing the bulk of my remarks on anti-Asian racism in the midst of this global pandemic, anti-Asian racism shares, along with Indigenous and Black Americans, being oppressed and being subject to white supremacy and systemic racism in the United States. And so I think it's also important for us to think about this coalition.

I am a self-identified Asian American who also studies Asian Americans. But it doesn't matter whether you identify as Asian American, it matters that you identify as a human being and care about human rights. Social justice and racial justice are absolutely a human rights issues, which is one of the reasons I developed these resources that I’m going to share with you.

In January, when news of the virus was first coming out, friends of mine on Facebook who are also Asian American academics knew that there was going to be a rise in anti-Asian racism that would hit the U.S. and probably the globe. And so we started developing to develop resources because this is what happens in the United States when there is a threat to the US coming from an outside nation, particularly an Asian nation. The reaction is to scapegoat anyone that you think comes from that nation. We saw this after 9/11 with the way that various South Asian and Sikh and Hindu people were being attacked and misidentified along with Muslim Arab Americans and people from the Middle East. And we are seeing this now with COVID-19 where anyone who's perceived to be Chinese ─ whether they are in fact Chinese like myself or Chinese American, Asian American, Japanese American, etc. ─  are being subject to physical attacks, harassment, or verbal abuse.

I want to highlight why the phrase “Chinese virus” is racist. Starting in early April, I kept hearing people use that term and by people, I mean many Republican legislators, including in the White House. We've heard most recently, from the President himself, “Kung Flu.” I don't think I need to tell anybody why that one is racist, because I think that is abundantly clear. But I think there has been some confusion around “Chinese virus.” If the virus in fact originated in Wuhan, China and everything that I've read suggests that it did, why not just say that, you may wonder?  I’ll take that question at face value and think generously that people may not understand the rhetorical harm that comes by continuously linking disease to people who are Chinese or from Asia because there's a much longer history of doing this than our current pandemic suggests.

The World Health Organization has given this virus the name COVID-19. This is the name that we should use. From a basic human point of view, we want to be called the names that we choose to be called. You want to be called by your nickname in certain contexts and you want be called by your legal name in others. You don't want to be called by a name that maybe have racist connotations. So, the World Health Organization did this because they knew that there was racial stigmatization that happens when they use a geographic or ethnic label with respect to disease. People have been pointing to the 1918 flu pandemic and saying that we called it the Spanish flu. But just because you did it once upon a time over 100 years ago doesn’t mean it's okay today. The danger in saying “Chinese virus” is that you are continually saying that the virus is somehow associated inherently with being Chinese. And just as my fellow panelists pointed out, the virus itself does not have an ethnic or racial target, even though there are clear health disparities in who is being harmed most. Those health disparities are because there is systemic racism that has happened and continues to happen in the United States that causes unequal distribution of resources.

I want to address the question of allyship and racism. What is the difference between being “not racist” and being anti-racist? (I think we all understand what it means to be racist or at least most of us have a working definition of what racism is and what it means to be racist.) As a critical race scholar and as an anti-racism educator, this is the distinction I make: If you're not racist, it means that you're being a decent human being. You're not going out of your way intentionally trying to harm people by using racial slurs. You're not actively or consciously discriminating against people of a different race.

But to be anti-racist, you actually have to act, think, speak, and have behaviors that promote anti-racism and promote reduction in harm that racism causes. Now, it may seem overwhelming and intimidating to decide that you're going to be an anti racism educator or ally. It is not about the degrees you hold or that you're in a teaching position. It's about the will and the decision that you are going to educate yourself about the history of racism in the United States, and then you are going to act and speak as an educator and ally. The good news is that all of you can decide today that that's what you want to do. My

KU: Thank you, Jennifer. Mike and Alisha, do you have thoughts on the question not racist vs. anti-racism?

MC: Our organization’s primary interest is helping Latinos come together to take collective action to fight racism. Maybe we could wait a long time for everybody else to decide that they want to be anti-racist, but I think within our own communities, we really have to do what we can to increase our economic opportunities, increase our political influence, and begin to dig into some of the public policies and laws that work against us and tend to support racist outcomes. CLLARO has always determined as an organization that nobody's going to do it for us, we're gonna have to do it ourselves. And so we are very much about community organizing, we are very much about training people to be advocates, and we're very much about introducing college students, parents of children whose who attend under-resourced public schools, and neighborhood volunteers who are concerned about social determinants of health in their neighborhoods. We work with folks like that to bring people together to work on these things collectively, and basically we're fighting back.

AB: Our initiative focuses a lot on race but we also focus a lot on how we try to engage partners in understanding why it is important to not be racist but to also be an anti-racist. And so what we have done is provide opportunities for people to learn that. At the same time and in parallel, we’re working within systems to infiltrate those systems with folks that are on the ground. We’re understanding how these policies and practices that have been put in place intentionally to advance racism have impacted our communities and looking at ways to dismantle those systems.

We build the capacity of residents to be able to advocate on their own behalf, and also how we can work with allies and how people can be a true ally with us. I agree with my fellow panelists: If we continue to wait for others to change these systems for us, we see where that has put us in the past. It’s important to look at history and to think about what changed in history to get us to this place. Thinking about redlining and how that has pushed communities out in terms of housing, gentrification, etc. COVID hit these communities so hard because it exacerbated things that already existed.

We can't just sit idly by and say we're going to have a continued conversation. We have to really get on the ground and take action and that's what the world is about. It’s not driven by leadership, it is driven by people on the ground who have told us that we're tired of being the ones most impacted.

KU: We've talked a little bit about the social determinants of health and how that all comes into play. What are some of those underlying challenges that you're familiar with or have worked with that you think have been exacerbated because of the COVID-19 crisis?

JH: It’s always really always difficult to talk in broad strokes about any racial group but I will say that if anyone is perceived to be Chinese ─ generally anyone of East Asian or Southeast Asian heritage ─ they're having an additional level of stress put on them. This is why I think that racism is a public health issue. I think about this myself when I leave the house, wondering if I am going to be confronted by someone who is going to attack me verbally or perhaps physically. I know that there have been people who have been stabbed or had acid thrown in their face or been punched and kicked. Someone tried to throw someone on to a subway platform, right in front of a train. So there's real violence happening against people who are perceived to be Chinese and Asian in the United States, and that's also going to cause an emotional and psychological toll.

Now I will also say, this is relatively new. For some Asian Americans, it is relatively new to be faced with this level of violence and harassment. Asian American organizations are really coming together and thinking about how to address this and working in a coalition with Black Americans to look at the common denominator of white supremacy.

MC: Really appreciate the other folks who have mentioned history. In Colorado, as Latinos, we are affected by the fact that in 1846, the United States government, which was more back east those days, decided to invade Mexico and declare war on it. It was basically an unprovoked war of aggression because the United States was seeking more land. And when the war ended in 1848, as some of us like to say, the Latinos who lived here didn't cross the border ─ the border crossed them.

We inherited a place and a society ruled by another government with different legal traditions. People who made a living in farming and ranching were displaced from their land. The treaties that were signed to end the war were violated. We ended up with a workforce that was displaced from their way of supporting themselves, and were encouraged to become migrants and work in new industries like railroads, mining, and agriculture. Those are still dominant patterns in the workforce today, I focus on the workforce because I think a lot of what we see today could be explained in economic terms about who was employed where, back to this idea of labor market segmentation. Some have suggested that cheap labor market segmentation sounds like institutionalized racism right and I’m not gonna argue with you.

We've had a race conscious labor market going all the way back to colonial days and before the Civil War, when most of the gross domestic product of the country was produced by slave labor. That's African American history, and those things don't evaporate because someone comes in with a wonderful new federal initiative like the War on Poverty, and then all of a sudden, it’s gone. These things persist, and living in the middle of it is sometimes hard for us to see it. But history helps us think critically about what's going on around us today.

AB: The only other thing that I'll say in terms of how COVID-19 has specifically exacerbated some of the inequities are the social disparities that already existed in our communities. When you think of communities of color, a lot of our communities of color were often plagued with higher instances of chronic illness and diseases. They were plagued with lower income wages in some areas, not having the best education systems. So when I think of layering COVID-19 on top of that, it is insane that our schools have to go online and provide education for their children online. We have many of our workers who are the frontline workers that are battling this every day. We have many of our families who may already have low incomes. We have many of our families that are maybe suffering from some type of chronic illness. Our communities are losing their jobs at a faster rate in addition to the microaggressions that we face day to day. As an educated black woman, I feel like I have to acknowledge that I have significant privilege as well. We need to provide people with a voice and opportunity by really understanding those systems and making them more equitable for the population as a whole.

KU: What are some ways that folks watching can actively participate?

JH:  Talk about it. If you have a desire to be anti-racist, that's the starting place. Being anti-racist is not about an ethnicity. It's not an identity. So just because I'm Asian American does not mean I am inherently more anti-racist than a person who would identify as white.

So, if you want to be an anti-racist, that's great. There are tools for you to help dismantle systemic racism. The first thing you've got to do, like anything else that you are doing for the first time, is exercise. This is a muscle that you have to develop and like with every muscle, it's going to hurt. You’re going to make mistakes, it is going to be uncomfortable. You have to live with that sense of being uncomfortable and potentially making other people uncomfortable, but it is definitely worth it if what we have as the end goal is a more just society.

I know I'm focusing a lot on race. But I believe in intersectionality, which means I believe in the theory of overlapping oppressions. I believe that if we are going to dismantle systemic racism, along with comes poverty and sexism and homophobia, and a whole bunch of -isms. I know that sounds overwhelming right because I'm talking about a whole host of social ills. All I'm trying to say is, a lot of these things are intertwined. When you start untangling and really see this as a human rights issue, you will see that it's necessary also to think about the value of all human beings for who they are.

MC: Awareness makes it possible to do something. And so, in listening to others and becoming more aware of how pervasive racism is and how it affects everyday living people, I think is a really important first step you can do is talking to people, that you haven't really talked to about this before. There's lots of different ways to learn, but awareness is one thing.

And then, thinking about opportunities and what you can do. I'm 74 years old and doctors tell me that I shouldn't be going to mass demonstrations, so I don't go to quite as many as I used to. But there's other things that I can do. When our organization was started in 1964, the city government did not employ Latinos. Most employers did not employ Latinos for most jobs, Latinos were not allowed to live in most neighborhoods. We were actively discouraged from voting. We were not selected to sit on juries. That's the way it was in 1964, so we did what we could. And that was about community organizing and basically making things uncomfortable for other people that made them reconsider whether to let us in.

And sure enough, the next mayor of Denver appointed the first Latino to a mayor's cabinet, which had never happened before. A man named Bernie Valdez, native to the United States and not an immigrant. He learned Spanish and English during the Roosevelt administration when he got his first job in government. Today's a different story. We have other opportunities. We have begun electing people to the state legislature. I take some of the college students that participate in our program and we place them with individual legislators within the state capitol and they work on changing laws. We couldn't do that back in 1964.

Changing laws is a lot of what needs to happen to help dismantle some of the legal frameworks that historically have always supported racism and still do today. So, do what you can with what you got. Whatever is within your power to do, that is the most important ingredient.

AB: We can understand the history and the context of what we're operating with, and also understand our privilege, but then it's also about using the privilege to advocate on behalf of others and not be fearful of doing that. I know that this is a very challenging topic and people have various different views but it comes right back down to right from wrong, and knowing and understanding that everybody is human. That we all deserve access and opportunity for our family. Thinking about how we can step outside of ourselves and use the privilege to be able to operate on behalf of others and advocate on behalf of others, to advance strategies that uplift the whole instead of just me. And that takes a lot of courage

When I see these things happening, when people are being treated poorly or unfairly, when we saw George Floyd's neck pinned down, how can I use my privilege to say ‘no, this is not right.’ I have to step out and be that voice.