San Francisco Chronicle - (Sunday)
Fund small health groups to gain trust of vulnerable
After I touched down in New Orleans to visit family last month, an older Black Uber driver who picked me up from the airport told me that four of his family members had died from COVID-19. He got vaccinated in July, but said he wasn’t sure that would protect him from getting sick.
I told the man about my brother, sister-in-law and mom, who works as an emergency room doctor, all contracting the virus last year. They were lucky to survive their bouts with COVID. The same can’t be said for the parents and siblings of other Black folks I know.
With the rapid spread of the delta variant, I’m
terrified by how familiar this all feels. We’re entering another critical phase in this pandemic where what happens in our most vulnerable and undervaccinated communities will have exponential consequences in the months ahead.
But here’s the problem: Small organizations with the most credibility in Black and brown communities also struggle the most for public health funding to expand their efforts.
This isn’t a new plight. Studies have shown that nonprofit organizations led by people of color are rarely awarded grants. Because of this, they often operate with smaller staffs and budgets. In 2019, the Association of Black Foundation Executives published a survey of 66 Blackled philanthropic groups. Only 23% had enough reserve money to last at least three months. This is a dangerous line to walk during times of crisis.
“What people have been seeing over the last year is these small organizations that don’t have contracts, either because they were too small or didn’t have the infrastructure to apply, have still been on the ground doing real work,” said Dr. Kim Rhoads, an associate professor of epidemiology and biostatistics at UCSF. “But they need funds to be able to continue doing it.”
Rhoads is the founder of Umoja Health Partners, which unites community organizations to combat COVID-19 in Black communities in the Bay Area. She said complicated requests for proposals or qualifications, known as RFPs and RFQs, often discourage small groups without the extra time or staffing to navigate the arduous application process. If it isn’t the time-consuming paper or digital submissions, Rhoads said it’s the public health system’s bureaucratic interpretation of equity that unintentionally works against smaller, minority-led organizations. Groups doing important work in hard-hit communities often don’t have prestigious names funders recognize, she explained.
“It’s always under the guise of equity where we have to make this RFQ process open in such a way so it’s fair. It’s never fair,” Rhoads said. “Often when public health is moving quickly, they’ll look to give contracts to familiar partners instead of finding new ones.”
This is one of the reasons Rhoads didn’t apply for Alameda County’s $12 million initiative to fund communityled coalitions in the fight against COVID-19. Umoja has a recognizable name now. So she thought keeping her hat out of the financing ring could increase the chances for other groups with minority leadership to get the money.
We’re still waiting to see the results. While these hyper-local vaccine distribution efforts were supposed to be up and running by Aug. 1, the Alameda County Board of Supervisors still hasn’t approved a final list of contract recipients or set a date to do so, a county administrative specialist told me Wednesday.
Minority-led organizations don’t have the luxury of waiting.
Dr. Kim Rhoads hands out vaccine flyers at a June pop-up event in Oakland. She says small, minority-run health groups responding to COVID-19 need easier paths to funding.
“These small organizations that don’t have contracts, either because they were too small or didn’t have the infrastructure to apply (for grants), have still been on the ground doing real work. But they need funds to be able to continue doing it.”
Dr. Kim Rhoads, associate professor of epidemiolog y and biostatistics at UCSF Neither do the people they serve. Especially in Alameda County, where residents who are Black, Pacific Islander or of multiple races experience much higher COVID death rates than residents of other races and ethnicities.
While Black vaccination rates have improved in recent months, they remain lower than those of Asian American, Latino and white people in Alameda, San Francisco and Contra Costa counties, according to California Department of Public Health data. To make matters worse, a nationwide survey by Tufts University researchers recently found that 18% of Black people surveyed say they’re “very unlikely” to get vaccinated, which is more than other minority groups surveyed and only behind white respondents.
I personally know more unvaccinated Black folks than I know vaccinated ones. That’s a deadly recipe with the delta variant surging, say health officials.
“I’m telling people that delta does not care about you, your plan or any of the rest of it,” said Dr. Ayanna Bennett of the San Francisco Department of Public Health. “The pandemic was a storm,
and now there’s a tidal wave. If you haven’t been listening to the weather, you’re about to get hit really hard.”
My mom said she’s sharing a similar warning to patients in her Louisiana emergency rooms.
“If you haven’t been vaccinated, this is coming for you,” she told me. “You may have dodged it the first time. Now it’s deadlier, and you probably won’t be as lucky.”
It’s physicians like my mom, Bennett and Rhoads who are best positioned to dispel vaccine myths and deliver that urgent warning. If local governments want to preserve Black and brown life, they need to cut the red tape and position credible messengers to meet this frighteningly familiar moment.
Above: “Church, San Francisco, 1949” shows a cluttered vista. Right: “Construction of Houses, Baker Street and Anzavista Avenue, San Francisco, 1949” shows far-off City Hall. in regular people,” Garcia said last week. “He rarely shows us the iconic city.”
There are the obvious orientation points, be it City Hall’s dome or the steep drama of the Pacific Telephone building, 26 stories of terra cotta that for decades was the only tower south of Market Street. A photo of two workers repairing a street at the summit of Potrero Hill shows the gap-toothed skyline off in the distance, though they’re ignoring it for the job at hand.
We feel that disconnect in our own way, because the sights that anchor us also cast us adrift. The Potrero vista includes Coit Tower — was this big city ever so snug? City Hall is glimpsed through the building scaffold near the lone house in a subdivision-to-be in
“San Francisco Photographs by Minor White”: Noon. to 5:30 p.m., Wednesdays-Saturdays, through January. $10. The California Historical Society, 678 Mission St., San Francisco. www.calhist.org
Anza Vista Heights. The Pacific Telephone building stands in stark detachment a few blocks from what then were the industrial flatlands of Harrison Street.
That 1952 image may be my favorite in the show, with its smart framing and vivid forms that include a smooth metal water tower that appears more assertive than the 435-foot edifice on New Montgomery Street. At a deeper level, the cumulative force of the imagery evokes a sensation familiar to anyone who inhabits a place for any length of time. Sometimes
“Pacific Telephone building from Harrison Street, San Francisco, 1952” shows the landmark terra cotta edifice.
you’re in control, confidently navigating every nook and cranny, every rhythm and trait. Then come the moments or days when the landscape bears no relation to the person you imagine yourself still to be.
On a good day you savor the glow. On the bad ones, you’re oppressed by the gloom.
Certainly that’s true of the San Francisco of today, a terrain scarred by the pandemic at every conceivable scale.
Many blocks seem ghostly, especially in the high-rise canyons where workers starting to return to offices wear masks as they walk past shuttered storefronts and restaurants that may never return. Within these voids, the scarred people stranded on our streets are more visible than ever. Even where there’s a buzz, as on parklet-lined streets, the high spirits can seem forced.
Minor’s work conveys this pendulum swing without drawing grand lessons — as if to shrug,
We see new construction and cleared building lots, but “his photographs neither lament the ruins nor applaud the forward march of progress,” Garcia points out in her notes.
They also tacitly display how generations and traditions overlap. Two photos include horse-drawn supply carts within their frames, one of them a Financial District image where young female workers briskly cross the street on the way to their morning coffee.
And then there’s Juhl’s Pet Supply in the Fillmore, captured in a 1949 photograph that layers one incongruity atop another. When the sign in the window uses jaunty typefaces to announce “HORSEMEAT
for Animal Consumption only,” but the word on the building above the window is “Salads” in a midcentury font, you know the times they are changing.
Though modest in scale, “San Francisco Photographs by Minor White” deserves to be seen. Icons and high-profile trends come and go. The collage of urban life is far more complex. It’s a lesson White grasped, and one we would do well to heed.