Health Equity Metric is Racist

by Corva Corvax

A Logical Opinion

Governor Newsom released a new "equity metric" last week that adds to the requirements necessary before a county can move to a less restrictive tier. The census tracts in the lowest quartile of the Healthy Place Index (HPI) must now meet a threshold close to that of the county as a whole. The HPI is defined by the California Department of Public Health as "a composite measure of socioeconomic opportunity applied to census tracts that includes 25 individual indicators across economic, social, education, transportation, housing, environmental and neighborhood sectors."

We assume race is one of the criteria since that appears to be the main concern of the new metric.

The data point bringing on the new demand for counties is that while 24 percent of Californians live in the state's lowest quartile HPI census tracts, they account for 40 percent of COVID-19 cases.

In order to address this inequity, which must certainly be an issue of racism, state officials devised a new metric to force local officials to focus resources on this lowest HPI quartile. According to the CDPH, counties should invest in expanded laboratory capacity for testing in these neighborhoods, conduct more contract tracing there, give isolation support, and spend money on education regarding the disease.

Will any of that help? Do COVID-19 tests slow down the spread of the disease? How, exactly, does that work? And are people living in the lowest HPI quartile unaware of the news and information available to those living in other quartiles?

There are many possible reasons more residents in the lowest HPI quartiles are contracting COVID-19. More of these residents may work in essential industries that require in-person contacts. More of them may live in large households with consequent higher risk of infection from others in the same household. It is also possible that less of them follow safety guidelines, for reasons known only to them.

What is not possible is that it could be the fault - or responsibility - of people in one group for the behavior of people in any other group, particularly when they have not one drop of control over that behavior.

For Governor Newsom to take on the job of helping certain communities lower their infection rate is to belittle them, to assume they have inferior intelligence or self-control, and to take away their agency. He is setting up himself and other government officials as the overseers of the plantation, taking care of the helpless subservients.

Since it is unlikely the County of Los Angeles is going to be able to move to a less restrictive tier any time in the near future, the demand that officials here reduce the number of cases in low HPI quartile neighborhoods is largely an empty gesture. In this case, it is a patronizing one.


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