Why Massachusetts Immigrant Communities are at Higher Risk From COVID-19: A Tale of Three Cities
By Aurora Koren, Capacity Building Intern, Summer 2021
The issue of COVID-19 needs no introduction. It has killed millions, disrupted everyone’s lives, thrown economic and political systems into disarray, and revealed deep inequalities within our society--and immigrant communities often bear the brunt of such inequalities. In addition to the variety of pre-existing conditions which may make certain individuals or populations more susceptible to Covid-19, there are also several social factors that raise the risks of Covid-19 infection. According to The Lancet, these factors include poverty, being a member of a certain race or ethnicity, close living quarters, and exposure to certain environmental toxins. We will begin by exploring these factors as they apply to immigrant communities in Massachusetts. In addition to looking at Massachusetts as a whole, we will look at three very different cities--Cambridge, Malden, and Lawrence--whose major commonality is their large immigrant populations.
Cambridge, Lawrence, and Malden’s Immigrant Communities To those who know the Boston area, Cambridge, Lawrence, and Malden could not be more different. Cambridge, the home of Harvard and MIT, is world-renowned as a hub of education and research. Lawrence, originally designed as a mill town during the industrial revolution, has struggled to reinvent itself in the decades since factory jobs left. And Malden is a small city northwest of Boston, often operating as a bedroom community for its larger neighbor. What they all have in common are large immigrant populations: Cambridge’s population is 29% foreign born, Malden’s is 44%, and Lawrence’s is 36%; additionally, all three are in Massachusetts’ top ten in terms of raw numbers of immigrants. These three communities contain highly diverse immigrant populations, demonstrating the heterogeneous experience of being an immigrant in Massachusetts: for example, a majority of immigrants in Cambridge and Malden originate from Asia, while most immigrants in Lawrence come from Latin America. Additionally, the three cities come from very different places on the financial scale: Cambridge, with its high number of scientists and professors, is one of the wealthiest cities in Massachusetts, while Lawrence is the poorest--Malden is poorer than the state average, but still financially better off than Lawrence. The distinction between these three communities represents the distinctions between Massachusetts immigrant communities as a whole. As a result, the lessons learned about COVID-19 in these cities can be utilized to study the impact on Massachusetts’ overall immigrant population.
COVID-19’s Relationship with Societal Inequalities COVID-19 has never been the great equalizer. The pandemic has disproportionately impacted already marginalized and struggling populations, with studies published in The Lancet and The Journal of Public Health noting that poorer populations are placed at higher risk of COVID-19 infection. This is shown throughout Massachusetts cities: the city of Lawrence, with a population of 80,000, has had 18,000 cases--meaning that 22.5% of the city’s population has been infected with the virus--while Cambridge, with a population of 116,000, has only had 5,000 cases, or less than a third of Lawrence’s. Lawrence is the poorest city in Massachusetts, with the median household income only about half of the state’s as a whole, while the median Cambridge household makes about $20,000 more than the state median. The case of Lawrence vs Cambridge demonstrates the sharp impact of poverty on Covid rates, while immigrant status is linked to higher rates of poverty. As Graph 1 shows, within the state of Massachusetts, the poverty rate among foreign-born residents is 3% higher than native-born residents, while the discrepancies in poverty rates among foreign-born and native residents of Cambridge and Malden are double that. This demonstrates that even within wealthy or middle income communities such as Cambridge and Malden, immigrants are generally poorer, and, thus, at a higher risk of contracting COVID-19. Interestingly, poverty rates for foreign-born Lawrence residents are slightly lower than that of native-born residents, although both demographics have quite high poverty rates.
One reason poverty is closely associated with COVID-19 infection rates is that, as a study published in The Journal of Public Health notes, “economically disadvantaged people are more likely to live in overcrowded accommodation.” And life in an overcrowded accommodation means less room to socially distance or quarantine if a household member is infected. Statistics from all three cities and from Massachusetts as a whole show immigrants living in far more cramped conditions than their native-born neighbors: as Graph 3 shows, 1% of native-born Massachusetts residents live in a home with more than one occupant per room, but 6% of foreign-born residents do so. Data from all three cities shows similar disparities between native and foreign-born residents, while also showing the link between poverty and crowded living conditions; Malden has slightly higher rates of poverty compared to the state as a whole and also reports more crowded living conditions, while Lawrence residents are the poorest and most cramped out of all three cities.
Another potential issue associated with COVID-19 infection and undocumented immigrants in particular is fear of detection and subsequent legal consequences--and fear of detection can have dire consequences for those infected with COVID-19 and those close to them.
As Health Affairs notes “there are reports of foreign-born noncitizens avoiding care (including testing and advice regarding COVID-19-like symptoms) for fear of being deported or risking their future legal resident status based on new federal ‘public charge regulations. Massachusetts has an undocumented population of approximately 215,000 according to Migration Policy Institute, with a majority of these immigrants originating from Central and South America. This means that, in addition to potentially avoiding care and testing due to fear of detection, many of these undocumented immigrants may suffer from issues related to their race or ethnicity, a topic which will be discussed in the next section.
Race, Ethnicity, Systemic Racism and COVID-19 Risk In addition to poverty, one oft-cited social factor associated with higher rates of COVID-19 infection is being a member of certain races or ethnicities, and, as a result, suffering from systemic issues which negatively impact these social groups. These include, as the journal Health Affairs describes, “long-standing historical inequities and structural racism, which have led to adverse outcomes including residential segregation and differences in access to health care.” Many cities throughout the US, including some cities in Massachusetts, report higher rates of COVID-19 infection within African American communities, although statewide statistics from UMass Boston’s Gaston Institute show that 6% of Covid-19 cases have infected African American Massachusetts residents, despite them making up 8% of the state’s population (however, one should note that race was not observed for ~25% of statewide COVID-19 cases, so these numbers may not reflect the reality of the pandemic’s impact on certain populations in Massachusetts). As the Gaston Institute notes, the hardest hit ethnicity in Massachusetts seems to be Hispanic/Latin American residents, as they make up at least 21% of COVID-19 cases, despite making up only 12% of the state’s overall population. Of our three cities, Lawrence has by far the largest Hispanic/Latino population--the city’s overall population is 80% Hispanic/Latino, compared to 9.5% of Cambridge’s population and 8.5% of Malden’s population--indicating that much of Lawrence’s population is at an elevated risk due to social and systemic factors correlated with ethnicity. Despite Cambridge and Malden’s comparatively lower Hispanic populations, the foreign-born populations of all three cities skew more Hispanic, placing many immigrants in a higher risk category. While Lawrence and Malden do not report race and ethnicity for their COVID-19 cases, Cambridge’s data shows that Hispanic/Latino residents compose 16% of COVID-19 cases, despite making up 9.5% of the city’s population. Cambridge is also one of the Massachusetts cities which shows higher case rates for African American residents, as they make up 15% of COVID-19 cases in the city (although this may be a lower estimate, as not all cases report race of the patient), despite making up 13% of the city’s population. This indicates that, much like COVID-19 rates among Hispanic Cambridge residents, African American Cambridge residents are disproportionately likely to have become infected with COVID-19. Similarly to Cambridge’s Hispanic/Latino community, a higher percentage of foreign-born Cambridge residents are African American (15%) than native-born (9%). This means that, in addition to being an issue of minority health disparities, Massachusetts COVID-19 rates among minority racial and ethnic groups is an issue of immigrant health disparities.
Other studies have further contributed to the data of COVID and race in Massachusetts, while also examining the potential explanations for the discrepancies of COVID infection along racial lines. For example, a study in Health Affairs notes that “there is growing concern, for example, that lower-income and Black and Latino persons may be at greater risk for exposure to COVID-19 because they are more likely to be essential workers and also tend to live in densely populated areas and multigenerational households.” A study in The American Journal of Industrial Medicine found that, even among already elevated risk occupations (such as health care support and food preparation), African American and Hispanic workers tended to have higher COVID death rates than their white coworkers. This indicates that, even within occupations that put all their workers at increased risk of COVID, African American and Hispanic workers are at a higher risk. This indicates that the immigrant populations of these cities are at higher risk than native-born due to their racial and ethnic demographics, largely due to systemic issues faced by these racial and ethnic groups.
COVID-19’s Economic Impacts on Immigrant Communities While the primary impacts of the COVID-19 pandemic--rampant illness and death--are the most obvious, as most are keenly aware, the impact of Covid-19 has extended outside the realm of health and into the realms of economy, education, and virtually every other facet of society. Perhaps not surprisingly, considering the previously discussed issue of poverty within immigrant communities, immigrants face daunting economic challenges.
Discussions about systemic racism often note that poverty rates often fall along racial lines, and in Massachusetts (and in much of the country) immigrants tend to be non-white: 62% of Massachusetts’ foreign-born population is non-white, compared to just 18% of the native-born population, and this links issues experienced by immigrant communities to those experienced by minority communities. A study by the Harvard University School of Public Health found that 72% of Hispanic/Latinos, 60% of African Americans, and 37% of Asians (compared to 36% of white Americans) reported serious financial difficulties during the pandemic. As shown in Graph 5, the majority of Hispanic/Latin American, African Americans, and Asians in Massachusetts are foreign-born, indicating that, based on racial data, immigrants in Massachusetts are more likely to suffer financial struggles. Additionally, while it may seem that Asian Americans are doing comparatively well, financially speaking, based on their lower rates of financial difficulties, an article in the Scientific American notes a flaw in the study’s methodology which may lead to faulty data on Asian Americans: surveys were only conducted in English or Spanish, leaving out Asian Americans with little or no English proficiency. As a result, the number of Asian Americans--particularly those who do not speak English and are already vulnerable--suffering financial troubles as a result of the pandemic are probably much higher.
Those who are undocumented and non-resident immigrants - many of whom are also immigrants of color - face additional financial and economic hurdles as a result of the pandemic. Despite what some media outlets have reported, undocumented immigrants do not qualify for stimulus checks under the Biden administration’s program--just like they did not under the Trump administration. Indeed, the one key change between administrations in regards to undocumented immigrants and stimulus checks is the Biden administration’s allowing of families with mixed immigration status (where one or more family member is a legal immigrant or citizen and others are undocumented) to receive stimulus money, a move which allowed 5.1 million more Americans to receive the benefits. Additionally, documented, but non-residential immigrants are not eligible for stimulus checks, according to Forbes. This includes groups such as foreign government employees, students and trainees, and athletes. As a state world-renowned for its institutions of higher education, the lack of stimulus checks for foreign students is an especially pressing issue within Massachusetts.
Remote Learning and Immigrant Communities While issues of poverty and economic struggles linked to COVID-19 are daunting, the impacts of the pandemic have extended beyond the realm of economics: the educational system has been significantly altered. As anyone with a child between the ages of three and eighteen will tell you, Covid-19 has heavily impacted the education system, with remote schooling proving a daunting challenge for parents and students alike. A study by the Rand Corporation listed several factors that increase the challenge of remote learning, including poverty, having a larger family, and having a parent with a lower level of education. These factors, as well as certain social and emotional issues, make remote schooling more difficult for many immigrant children and families.
The Rand Corporation study found that families struggling financially during the pandemic were more likely to report struggles with various aspects of remote learning, such as lack of space to complete school work, lack of access to electronic devices, and less support from school staff. As was discussed in the previous section on the link between poverty, immigrant status, and COVID-19 rates, the poverty rate for foreign-born Massachusetts residents is 3% higher than that of native-born residents; in two of the focus cities, Malden and Cambridge, the gap is even wider. This indicates that immigrant families, who were more likely to be struggling financially even before the pandemic, are more likely to struggle with remote learning. It also means that for many older students, they must work to support their families through the crushing economic fallout of covid--this means that school is often put on the backburner. Indeed, even before the pandemic, English language learners were more likely to suffer from chronic absenteeism, according to the Economic Policy Institute, and the pandemic has only made the issue worse. Poverty is related to another important factor: parents’ own levels of education. While level of education is by no means an indicator of one’s intelligence, it can make helping one’s own child with school work more difficult. As Graph 2 shows, across Massachusetts and our three cities, the rate of foreign-born residents without a high school diploma is higher than native-born residents without a high school diploma. Perhaps not surprisingly, this is also linked with poverty. Lawrence’s rate of residents without a high school degree, both native and foreign-born, for example, is much higher than that of the much-wealthier Cambridge.
Another factor noted by the Rand Corporation as making remote learning more difficult is having a larger family. Graph 4 shows that in Massachusetts as a whole, and in the three focus cities, foreign-born residents tend to have larger households than native-born residents, and for many families, this means more children needing to learn remotely. This brings with it a variety of logistical and financial challenges, including having adequate devices and a large enough internet bandwidth to accommodate multiple children attending school, having enough space for each child to work, and the parent having the time and language skills to help their children as needed when issues almost inevitably arise.
While many of the issues that can impact remote learning--poverty, parent’s level of education, family size--can be defined quantitatively, there are other factors that make remote learning a challenge for immigrant children. An NPR interview with a school guidance counselor who works with children fleeing violence in Latin America notes that, without physically seeing the child, signs of anguish, trauma, and suffering may go unnoticed and unseen. For some students, the trauma of the pandemic may reopen old traumas, making it more necessary than ever for them to have consistent mental and emotional support--but remote schooling makes this a challenge. She also notes that many of her students must care for younger siblings as their parents are essential workers, and many also grapple with economic struggles. School, which may once have been a respite from stresses at home, is no longer an option.
Conclusion So what do these issues say about the connection between immigrant communities in Massachusetts, COVID-19, and its impacts? Massachusetts’ immigrant population is--across the board--at increased risk of infection from COVID-19. This is due to increased rates of poverty, higher rates of crowding within households, and increased number of Hispanic/Latin Americans and other people of color within immigrant populations. Massachusetts’ immigrants in certain cities--such as Lawrence--are at an even more significant risk from Covid, due to even higher rates of poverty and crowding within these communities. Additionally, Massachusetts immigrant communities have a variety of factors that make remote schooling and economic recovery more difficult.
Yet, merely knowing that immigrant communities in Massachusetts are disproportionately impacted by the pandemic is only a piece of the puzzle. It raises the question of what can we--Massachusetts state residents, municipal, state, and federal government, and nonprofit service providers that work with immigrant communities--can do to combat these issues. The root of many of many of the COVID-19 issues that impact immigrants in Massachusetts--such as infection rates, financial struggles, and educational challenges--is inequality. These inequalities can be seen in discrepancies between immigrant and native-born poverty rates, educational achievement, and other demographic measures. If Massachusetts is to learn from the COVID-19 pandemic and aim to become resilient to future challenges, it is essential that our state and municipal governments focus on making Massachusetts a more equitable place for immigrants.
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