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Advocates Worry Contact Tracing Leaves Black, Latinx Communities Behind

A sign in Spanish outside a Mexican grocery store in Logansport, Indiana encourages social distancing and mask wearing. (Justin Hicks/IPB News)
A sign in Spanish outside a Mexican grocery store in Logansport, Indiana encourages social distancing and mask wearing. (Justin Hicks/IPB News)

At a news conference on Aug. 26, Indiana State Health Commissioner Dr. Kris Box said it’s crucial for Hoosiers to participate incontact tracing.  

“So If you get a text or a phone call from the state department of health about an important public health matter, please answer the text, answer the call,” she said.  

But some community health leaders say for many, answering that call is easier said than done. That’s especially true for those more at risk of contracting the virus, like Black and Latinx Hoosiers. These communities have been harder hit by the virus, and have ahistory of mistrustof government. 

An example of the text an Indiana contact tracer will send after a person tests positive for COVID-19.
Credit Photo courtesy of the Indiana State Department of Health
An example of the text an Indiana contact tracer will send after a person tests positive for COVID-19.

“Contact tracing taken out of context is, ‘I’m being traced, I'm being tracked,’" says Tony Gillespie, vice president of public policy and engagement for the Indiana Minority Health Coalition. “Especially in racial and ethnic minority communities and Hispanic and Latino communities, that's a real concern.”  

Since the pandemic started, groups in the coalition have discussed the importance oflocally led testingand contact tracing efforts. Yet Gillespie says the state did not seek input from community health groups before it developed a contact tracing plan. 

"That's community-based activity,” he says. “And so you can’t really do community-based activity without community.” 

But that’s happened across the country, according to Amanda Merck ofSalud America, a national organization that works to raise awareness of Latinx health issues. As statesbuilt uptheir contact tracing workforce, they didn’t always seek tracers from marginalized communities, she says.   

“A lot of the concern is there's problems when the public health workforce doesn't reflect the communities it's intended to serve,” Merck says.  

In April, Indiana hired a Virginia-based company, Maximus,to develop a call center. It now has 680 contact tracers. After a person tests positive for COVID-19, contact tracerstry to reach themby text and then with a phone call.   

Margarita Hart, executive director of Esperanza Ministries and the Indiana Community Health Workers Association.
Credit Photo courtesy of Margarita Hart
Margarita Hart, executive director of Esperanza Ministries and the Indiana Community Health Workers Association.

But undocumented immigrants would not answer a text or call from an unknown number, according to Margarita Hart, executive director of Esperanza Ministries and the Indiana Community Health Workers Association. She works with undocumented immigrants in the Indianapolis area. 

"It doesn't work, the way that it's set up,” she says. “And I'm not saying that it's set up wrong. I'm just saying that it's just not culturally appropriate. “ 

The state says it’s working to better publicize the number a contact tracer’s text and call will come from, and that the contact tracing center uses translators for Hoosiers who don’t speak English.

But in practice, community health workers like Hart say if the person who answers the phone doesn’t speak English, the contact tracer asks to speak to someone who does. Most often, that’s a child.  

“They have to then get their third grader or fourth grader to interpret because that's the only person at home,” Hart says.  

Even if the contact tracer speaks Spanish, Gabriela Lemus says that’s not enough for her clients. She’s the Latino community health worker for Health Visions Midwest, a health education organization in Fort Wayne.   

“They know the language, but they don't know your culture,” Lemus says.   

Lemus says her clients don’t always tell contact tracers who they were with or what large gatherings they’ve attended. They may be embarrassed about ignoring public health guidelines. And though the state says contact tracers don’t ask about immigration status, Lemus says her clients want to protect their family, friends and neighbors, some of whom may be undocumented.    

"So they're not giving the true information and they're not giving the correct information to those people to get their tracing right,” she says. 

Gabriela Lemus, Latino community health worker for Health Visions Midwest.
Credit Photo courtesy of Gabriela Lemus
Gabriela Lemus, Latino community health worker for Health Visions Midwest.

Contact tracers tell those who test positive to stay home for the CDC-recommended 14 days. But Lemus says her clients in that situation have questions and need resources. And they don't feel comfortable asking a stranger for help, even if that stranger speaks Spanish.   

“They will tell or share more information with a trusted person that they know in the community,” Lemus says. “They already feel comfortable talking to us.” 

In August, the state reported more than 76% of people reached by a contact tracer completed an interview.Most states don’t publicly report data on contact tracing, so it’s hard to know how Indiana compares to the rest of the Midwest or the nation. 

Meanwhile, Indiana’s contact tracing workforce is growing. Including contact tracers at local health departments, there are more than 1,200 statewide.

But some researchers say thousands more are needed. According toGeorge Washington University’s contact tracing workforce estimator, Indiana should have more than 5,500 contact tracers.  

This story was produced by Side Effects Public Media, a news collaborative covering public health.

Contact reporter Lauren Bavis at lbavis@wfyi.orgor follow her on Twitter @lauren_bavis

Copyright 2020 Side Effects Public Media

Lauren a reporter and editor based at WFYI in Indianapolis. She maintains Side Effects' website, social media accounts (which you can follow on Facebook and Twitter) and newsletter (which you should sign up to get weekly). Lauren graduated from Towson University and moved to Indiana in 2012, where she began her career as a newspaper reporter. She reported on health and social services for the Bloomington Herald-Times. Her work has been recognized by the Indiana chapters of the Society of Professional Journalists and Associated Press Media Editors, as well as the Hoosier State Press Association.