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A new effort from two centers at the Brown School aims to encourage people from traditionally undercounted communities to complete the 2020 U.S. Census.

As of April 3, the 2020 Census household self-response rate for St. Louis City was at 34%, well below the 51.7% and 43.2% self-response rates for St. Louis County and Missouri.

HomeGrown STL— a university-community partnership that aims to eliminate the disparities facing black boys and young men in the region— is challenging Black fraternities, sororities and social organizations to document a count of every Black male household among their members by April 30, 2020. The 2020 Census Challenge will use community partnerships, social media, virtual stickers and friendly competitions toward a goal of 100 percent participation.

“We are especially focused on making sure that black males ages 18-29 are counted in their households,” said Sean Joe, principal director of HomeGrown StL, the associate dean for faculty and research, and the Benjamin E. Youngdahl Professor of Social Development at the Brown School. The effort is also being led by Gena McClendon, PhD, voter engagement director at the School’s Center for Social Development.

The Kathryn M. Buder Center for American Indian Studies is also working hard to make sure American Indian and Alaska Native people are included in the census count. Through a grant from the St. Louis Regional Census Fund, the team is working to provide information as well as to help Native Americans be counted more accurately.

“The census is an opportunity for us to stand up and be counted,” said Kellie Thompson, Director of the Buder Center. “We need to make sure our communities get the funding they need to improve roads, schools, hospitals, and more.”

Cynthia Williams, assistant dean for community partnerships at the Brown School, said the census effort was important because governments allocate funding and other resources to communities based on the census. “Public resources on the local, state and federal levels will be determined based on the 2020 Census for the next 10 years,” she said. It is critically important that every man, woman and child be counted, particularly in low-income households and communities of color.”

For additional information, see https://raceandopportunitylab.wustl.edu or visit the Buder Center’s 2020 Census page.

Over the past three weeks, I’ve been obsessively checking my inbox and refreshing my Canvas messages, waiting as my professors, supervisors and Brown School faculty have gradually shared information about the adaptations to our new learning environment. I’ve been coordinating significant changes to 10 classes while transitioning two jobs and one practicum to a remote schedule. The logistics of it all are overwhelming.

After a week of virtual learning, I’ve had to adapt to a go-with-the-flow mindset. I came into the week with strong opinions about who had made the “right” and “wrong” choices. Going into the second week, it’s pretty clear that there is no one right way to handle this crisis. All of my professors have planned shorter classes, and a few have moved to pre-recorded video lectures. They have largely acknowledged that students have other things going on right now and adapted their classes accordingly. The best any of us can do is recognize that there won’t be a semblance of business-as-usual. We need external support to ensure staying physically and mentally healthy can be our top priority at this time.

I’m lucky to be in an academic position where I can use the new pass/fail option for my classes. I’ve been wavering between taking pass/fail and taking letter grades. I’ve found myself thinking that taking the pass/fail option is taking the easy way out. If there were ever a time to take the easy way out, this would be it. Avoiding that harsh voice and giving ourselves some lenience around academics right now is going to be essential to making it through this epidemic.

Focusing has been hard—I have an anxiety disorder, and that means that concentrating on schoolwork can be hard even when there isn’t a global pandemic going on. I am definitely dealing with information overload around COVID-19. Like many of my peers, I live far away from my family and friends. It has been hard to focus on assignments that have limited application outside of the classroom. Schoolwork is hardly relevant when I am worried that peers, family, and friends will fall ill, or that we will be laid off, or that we won’t find a job after graduation.

As someone who hates Skype/FaceTime/Zoom as a mode of communication, I was not looking forward to switching to 15+ person Zoom calls for a classroom environment. It seemed nearly impossible to participate in class discussions in this new format, and I was particularly worried about the 15-minute, two-person Zoom presentation I had to give in a Transdisciplinary Problem Solving class this week. The most surprising thing this week was how much easier it is to give a virtual presentation than an in-person presentation. I couldn’t see if people were paying attention or looking bored. The nerves I would normally have in this scenario went away completely. It’s a very thin silver lining, but it’s there, nonetheless.

I thought I would need increased flexibility, prerecorded lectures, and alternative assignments. And I have needed that flexibility, but I’ve found myself also really needing structure. Working exclusively from home gives me the chance to walk my dog five times a day, but it also means that I can really easily put tasks off indefinitely. I’m finding myself rushing to meet a deadline I’ve known about for weeks. I’m remembering how important a to-do list is, especially for allowing myself the time to prioritize tasks that normally don’t feel productive enough to engage in, like finishing a needlepoint I started in 2017 or mindlessly playing the Sims. I’ve spent a lot of the last three weeks reconsidering what is going to be important for me during this quarantine, and I’m taking that into the coming weeks. I’m hoping that doing so will help me weather this uncertain time.

Lands, from Denver, is an MSW/MPH student in her second year at the Brown School.

Many countries reacted slowly and inadequately to the spread of COVID-19. Some critics have said this is due to initial reports of the disease, which indicated that it mainly affected older populations. Some, including the Texas lieutenant governor on Fox News, have even suggested that older Americans should be willing to sacrifice their health or lives for the good of the economy and the good of others.

“Older adults are not some kind of expendable commodity,” said Nancy Morrow-Howell, the Betty Bofinger Brown Distinguished Professor of Social Policy at the Brown School at Washington University in St. Louis and an international leader in gerontology.

While it is true that older adults have been disproportionately affected by the coronavirus, a number of younger patients have become ill or died as a result of COVID-19. According to the Centers for Disease Control and Prevention, young adults under the age of 44 comprise 20% of COVID-19 hospitalizations in the United States.

“I feel saddened when I hear it suggested that this disease ‘only’ impacts old people,” said Morrow-Howell, director of the university’s Friedman Center for Aging. “The older population is very heterogeneous and most people over the age of 65 are fit and functional — engaged individuals who contribute greatly to their families and to society.”

She said it’s important to prevent “otherizing” older people during this epidemic and to avoid age stereotypes.“We are seeing that it is not age per se, but the fact that older age is associated with a number of risk factors that complicate the disease, including chronic health conditions, compromised immune systems and living in residential facilities,” Morrow-Howell said. “Chronological age is not an indicator in and of itself. It has more to do with overall health.”

“I think it’s vital that we connect individual action, like social distancing and washing hands, to the common good,” Morrow-Howell said. “We also need to be descriptive about the risks, beyond old age. There are lots of people at increased ‘risk:’ children out of school who don’t have regular meals; restaurant workers without a paycheck; health care professionals on the front lines; people living alone who are experiencing isolation and anxiety; people with underlying health conditions. What can we do to ensure that all of us are as safe and well as we can be?”

Looking ahead to an eventual recovery from the virus, there are a number of issues that will need to be monitored in the older population, she said. We will have to deal with:

“We need to remember that all of us are in this together — old and young alike,” Morrow-Howell said. “We need to come out of this with more intergenerational solidarity.”

For more information on how older adults are impacted by coronavirus bias, view Morrow-Howell’s Open Classroom webinar The Coronavirus: What Age Has to Do with it, and read an article on ageism and coronavirus published on the Harvey A. Friedman Center for Aging website.

As the coronavirus spreads across the United States, larger cities, like New York and Seattle, are dealing with increasing numbers of infections and deaths daily.

However, less populated rural areas are not immune from the disease, say two public health experts at Washington University in St. Louis and controlling it in rural America presents a unique set of challenges.

“On the positive side, social distancing is easier in rural settings due to low population density,” said Ross Brownson, the Steven H. and Susan U. Lipstein Distinguished Professor at the Brown School and a leading expert on chronic disease prevention.

“Lower proximity to international airports likely reduces risk from travel-related transmission and there are outdoor spaces for individuals to walk and spend time in nature,” he said.

On the challenging side, rural populations are at higher risk due to their sociodemographics and health, Brownson said.

“Rural Americans are older on average, with more chronic conditions like heart disease, diabetes, obesity,” he said.

“In addition, the digital divide is greater, with less access to high-speed internet that generally will become more important when people are spending time ‘safe at home,’” he said. “And in general, people in rural areas experience more issues with access to quality medical care and good health insurance.”

Rural communities have faced slow economic growth in recent years, and are now losing more jobs as the layoffs resulting from the COVID-19 pandemic are hitting rural areas again.  In addition, rural communities have higher numbers of residents without health insurance and access to quality health insurance from employers than their urban counterparts, said Tim McBride, the Bernard Becker Professor at the Brown School and a noted health economist.

“In general, while rural people often have decent access to primary care, there is often less access to specialists and a lower supply of hospitals,” McBride said.

“Recent closures of rural hospitals and nursing homes across the country will create challenges as rural people need access to hospitals near them,” he said. “Rural people, who generally have lower incomes and higher poverty rates, may face higher out-of-pocket costs for prevention and treatment of COVID-19, given that the health insurance they tend to hold requires higher copayments.”

In addition, Brownson said, rural residents have greater travel distances to health care and live in areas where it is probably less likely for local government to impose social distancing and other control measures.

As the coronavirus continues to spread across the nation, a number of false conclusions and rumors have spread with it. Three epidemiologists in public health at Washington University in St. Louis separate truth from myth.

The following information is from Alexis Duncan and Kim Johnson, associate professors, and Christine Ekenga, an assistant professor, all in the Brown School.

The numbers of cases in my area are low, so I don’t have to worry. This is false. When testing is limited, the number of reported cases is likely a fraction of the actual number of infected people who can transmit the disease, making it important for everyone to comply with social distancing measures.

Males are more likely than females to have more serious complications from COVID-19. So far, this is true. Evidence from six countries indicates that the ratio of males to females who have died of COVID-19 ranges from 1.1 to 1.9.

The virus will go away with warmer weather. This is currently unclear. If COVID-19 behaves like other corona viruses, there may be a seasonal pattern with lower transmission in the summer. An excellent analysis of this question is provided by Marc Lipsitch of Harvard’s T.H. Chan School of Public Health.

Children are only carriers for COVID-19 — they don’t get sick. Although adults appear to be at higher risk for COVID-19, infants and children can get sick from COVID-19. Symptoms in children are generally mild, but children with underlying medical conditions can develop severe illness. It is important to keep in mind that children who have been infected with COVID-19 can pass on the illness to others, even if they themselves only have mild symptoms or are asymptomatic.

I am young and healthy, so I don’t need to be concerned about COVID-19. It is true that overall younger people have been less likely to sustain severe symptoms and die from COVID-19 compared with older people; however, younger people are not immune to severe illness and death from COVID-19. In a study of COVID-19 cases in the U.S. from Feb. 19 to March 16, 20% of all hospitalized cases and 12% of hospitalized cases in ICUs were aged 20-44 years old, with an estimated case-fatality rate of .1 to .2%.

Coronavirus is “just the flu.” Symptoms of COVID-19 and influenza may be similar, but COVID-19 spreads more easily, causes more severe illness and is deadlier than either the seasonal flu or the 2008-09 swine flu (H1N1). At this point in time, there may have been more seasonal influenza cases and deaths worldwide this winter than from COVID-19; however, COVID-19 cases and deaths have been increasing at an exponential rate and will likely surpass the number of influenza cases and deaths before long unless we can curb the spread of the virus.

A couple of weeks of social distancing can stop the spread. While social (or physical) distancing measures may slow the spread of the virus, they won’t alleviate the stress on our health care systems if they are ended too soon. Premature termination of these measures could also lead to a resurgence of cases when people resume their daily activities.

Blacks are immune to coronavirus. Early reports of low rates from African countries led to this false rumor. Unfortunately, recent data suggest that coronavirus is spreading in Africa. Here in the U.S., we have limited data as the Centers for Disease Control and Prevention has yet to publish a demographic breakdown of coronavirus testing, cases and deaths. We do know that coronavirus disproportionately affects people who have comorbidities and, given the well-documented racial disparities in both access to and quality of care in the U.S., there is reason to believe that African-Americans may be an at-risk population for poor outcomes.

Public health can defeat the coronavirus. There is still time to reduce and stop the transmission of coronavirus and save lives, but we need to act soon. A coordinated expansion of testing will allow epidemiologists to track the spread of the virus, and increased production of personal protective equipment will provide much-needed protection for health care and other essential workers. While we learn more everyday about this novel coronavirus, prevention remains a fundamental principle of public health. People of all ages can reduce their risk of exposure to the virus by practicing good hygiene and social distancing.

Access to evidence, partnerships, and funding restrictions were the commonly cited barriers to the use of evidence-based decision making in public health departments, according to research from the Brown School at Washington University in St. Louis. Training and communication by leadership were important steps toward more effective use of evidence.

Researchers conducted qualitative interviews with 27 chronic disease prevention and health promotion program staff in four states who were members of the National Association of Chronic Disease Directors. 

All practitioners said their work unit leadership encouraged and expected staff to use evidence-based processes. They saw the provision of training and technical assistance as key to workforce development and effective communication of leaders’  expectations. Access to evidence and limited funding were among the impediments to evidence-based public health.

“The results of this study highlight practitioners’ perspectives on promoting evidence-based public health in their departments,” wrote the study’s lead author Stephanie Mazzucca, research assistant professor at the Brown School. “Findings can inform the development and refinement of resources to improve the use of evidence-based practices A-and organizational and leadership capacity of state health departments.”

The paper was published February 25 in Implementation Science Communications.