- [Voiceover] Funding for this program is provided in part by the Minnesota Arts and Cultural Heritage Fund and the citizens of Minnesota.

- At the time of this recording, there have been over 33 million diagnosed cases and 600,000 deaths in the United States from COVID-19.

We know that the pandemic has been devastating to families across the country, disproportionately affecting communities of color and low-income communities.

According to the CDC, Asian American communities are slightly more likely to be diagnosed with COVID or hospitalized than white communities, but those rates vary greatly by ethnicity within the larger Asian community.

A report published by the Coalition of Asian American Leaders and the Hmong Public Health Association shows that 49%, is almost half of deaths in the Asian community or from the Hmong community.

And Hmong Americans are significantly more likely to die than white Americans in Minnesota.

With us to discuss this COVID disparity, are Bo Thao-Urabe and Chao Yang.

Bo is the executive and network director of the Coalition of Asian American Leaders based in St. Paul, Minnesota.

Bo immigrated to the United States as a refugee child after the secret war in Laos.

Throughout her career, she served as senior director at Asian American's Pacific Islanders and philanthropy, co-founded the Asian Pacific Institute on gender based violence, Hmong American Women Achieving Together, Sisterhood Laos, RedGreen Rivers, Building our Future: A Global Campaign and Building more Philanthropy with Purpose, the MPP giving circle.

And as founder of the Hmong Public Health Association, Ma Chao is a catalyst of change and a leader with an intense focus on impact.

She has over 12 years of experience in progressive public health and human services.

Ma Chao is also a podcast editor of the Public Health Review and she's pursuing her executive master's in public health at the University of Minnesota.

So I've rattled off so many numbers and statistics in our introduction to the discussion today.

But we know that those numbers really represent real individuals, they represent bereaved families, they represent communities, your community, that's reeling from this past year and all this happened and you, of course, being leaders within the community, helping to address all that's been happening.

So I really just wanted to open up and ask each of you to share how you've been personally impacted by the pandemic this year.

And I'll start with you Bo.

- Sure.

Thanks for having us Nicole.

I appreciate the opportunity to just share a little bit more about what's happening in the community.

You know, obviously I run this organization that whose purpose is really to both elevate the issues of the community and to support the community.

And so I feel like in this time we've really paid attention to those things that make the community vulnerable and have tried to elevate them such so that the systems could be responsive, but in a very personal way.

Of course it has impacted me in many ways and I find it interesting that in so many spaces that I go to, I could talk to people who have not been touched, right?

Who might've been inconvenienced but not touched by what's happened in this COVID pandemic.

And I personally have been touched because my mother contracted COVID and died from COVID.

And so, you know, so that's a very personal thing, but also I know many friends and community members who also have had, you know, the same types of stories, right?

And so I think, you know, this time has been especially hard both in terms of trying to run an organization that is consistently challenged by, you know, just our systemic unpreparedness of trying to really listen to both communities, but also often being pushed to validate the experiences in terms of numbers or information that oftentimes the community does not have itself, right?

I mean, the community knows it's experience, but in terms of systemic data or all of those things, that's been the responsibility of the system.

And so I feel like very much during this time, I have been not only touched personally, but have been trying to really ensure that systems were doing their jobs in terms of taking those lived experiences and trying to map it out in a systemic way so that there could be investments and attention, and that resources could be appropriately designated to the community.

And so, it has been quite frustrating, to say the least because not as it just a personal story, it's about a community that I think oftentimes has been rendered invisible because of a refusal to really create the systems in place, right?

And things like that.

And then I also think that the truth is that we exist in the context of many communities who are also suffering.

And then oftentimes what systemic leaders do is create this race to the bottom race, right?

For all of us.

And so Asian Americans when, as you said, when you sort of just look at the aggregate, it feels like it's a community that doesn't need attention and doesn't require a more nuanced understanding.

And I think that's been the most frustrating part of the work in this past year because we had these concerns and had surveyed the community, had paid attention to some of the early testings in particular when testing was done in neighborhoods with high Asian American community members that we know have all other vulnerability factors had lived that up and there was just not a systemic response.

So, I can't even begin to tell you what all of that feels like, right?

It's personally painful when you have a loss, but then it is like running against, you know, a brick wall.

One systems won't respond.

So I'm gonna end there because I have a lot more to say but I certainly want Chao to share her experience in the last year as well.

- So, I think as a public health professional and, you know, an engaged community member, you know, we started to get a good idea of how severely our community, specifically the Asian American community in Ramsey county was being impacted by COVID-19.

Over half of our Asian community in Ramsey county are Hmong Americans.

And through their stories and their experiences shared with frontline staff, we understood that our community members were dying.

And yet stories weren't enough to change the decision making at higher levels.

And it was not enough to resource a variety of people and organizations to reach our most marginalized within our cultural community.

And essentially we operate in a system where data or evidence is used to make decisions.

And most of the data available particularly in Minnesota is aggregated.

And what that means is that all cultural groups that are racially categorize as Asians were lumped together.

And so as a result of that, when this data isn't available, we don't know how state and local public health leaders are actually using ethics specific population health information to inform the pandemic response.

With the publication of this COVID mortality death rate report that we wrote in partnership with the Coalition of Asian American Leaders, this has changed.

This has changed how we're working with the Minnesota department of health and local public health.

And so from March of 2020 through December of 2020, our public health association members were made up of frontline public health staff, researchers, epidemiologists, just wanna give a shout out to the Hmong Public Health Association because not one single person within our group can do it alone.

It is truly a group community collective effort.

And so we as a collective tried to get information about how our cultural community was being affected without much success.

And as an end result, I happened to be working on a policy brief and ran my idea by Dr. JP Leider, one of my professors at the University of Minnesota because I am an executive MPH student as well.

And so we were able to ask questions to get the information from vital death records system that gave us these death counts for our report.

And so instead of getting the information from public health, we had to go and find it and disseminate it and analyze it using our own networks and resources which is really unfortunate.

But this is something that the Minnesota department of health has, you know, has recommitted to doing better.

And so we're really looking forward to that.

I think on a personal level, you know, towards, oh, well actually on a personal level my stepbrother died of COVID just last month, towards the end of May.

And so we're in the thick of planning his funeral.

And so, you know, I'm directly affected.

I don't know very many Hmong people who haven't been personally affected most.

Everyone I know knows someone that has died from COVID.

And so there are, you know, the emotional, financial, social ramifications of losing as many community members as we did.

- You know, both of you have spoken at length about information, sort of this need for information to go out there so that you can do the work and address the issue and then sort of the information that needs to be shared and needs to be, you know, yeah.

Given to community in order to improve these outcomes in some way.

And so, I wanted to shift over to the, I guess the other side of this is the ways in which you, your organizations and the work that you've done has worked to empower the community members to sort of be there, you know, to leverage the resilience that's already in the community, the cultural things in the community already, to be able to protect against the things that have been sort of been leaning upon the community because of the COVID pandemic.

And so, just ways in which you've done that through a public health lens or just through just a community organizing lens as well.

- Chao why don't you start?

I feel like I took the first two questions.

- Oh, no.

Oh, okay.

This is fine.

The Hmong Public Health Association is a group I founded and is a collective of, you know, public health leaders across the US primarily in places with large Hmong populations including Minnesota, Wisconsin and California.

And so we have remained dedicated to providing a supportive space for Hmong Public Health professionals and students in the US.

And so during the pandemic and even now, you know, the Hmong Public Health Association work together in tandem with Ramsey county to put on a COVID-19 town hall to hear from our community members.

It was attended by over a 100 community members.

And as a result of some of that work, the Hmong Public Health Association leads got together and wrote together an accountability letter and sent it to county manager Ryan O'Connor to ask about what was happening at the county level, essentially asking about how resources are being allocated to our community in regards to recovery efforts.

And if you look at our, you know, Facebook, you know, our public Facebook site, we did, you know, put up those letters so that the public, our Hmong community members and our membership could see his response.

We also, you know, did the same thing.

We met with mayor Melvin Carter and his team and also send a followup letter asking for accountability.

We have not received a response.

And then we worked closely with the Minnesota Department of Health and commissioner Jim Malcolm was very gracious and helpful and we are now meeting with them on an ongoing basis to think about how data desegregation and community engagement will be incorporated into ongoing efforts.

But it's a start and we know that no one can do it alone.

And so a lot of this...

It sounds really great on the front end, but it's a lot of work.

And this is a lot of work I do outside of my day-to-day role.

This is like my community, just community volunteerism at work here.

And so it really just exemplifies the deep commitment that our public health professionals and the Hmong community have to serving our community.

And so I think that's where I'll stop and Bo you can, you know, fill in wherever needed.

- Yeah, so the Coalition of Asian American Leaders, we're not a direct service provider.

We're an aggregator of community expertise, experiences and, you know, a convener and a facilitator to try to influence and create systemic decisions that are better for our communities.

And so our work very much in this time has been to listen to the experiences of the community to try to elevate that and then to leave no stones unturned in terms of trying to make sure that investments come to the community, that there are ways in which we can impact the process in which these things are, these decisions are being made.

And so of course our partnership with Hmong Public Health Association is a part of that because we're not the experts, right?

But we rely on the experts in our communities.

But we also think that community experience is valid data, right?

And so when data systems are not robust and nuanced enough, we have to listen to communities.

And so that's been our job, was to be constant in terms of talking about that.

And so our time has been spent on trying to both answer the frustrations that communities feel and to try to make that into a productive energy that then can work with systems.

And I think that that means that we've convened folks.

We have participated on behalf of the community, but our hope is always that we have experts in our communities who can speak about these things, right?

And then that the lived experiences of those who are most impacted should drive the solutions.

And to be frank I think that there was a lot of fear of talking about COVID in the community because even though, as Chao said, none of us almost have been untouched by COVID deaths because the response was so poor that people almost felt like, well, what's the use, right?

Like, why should I tell my story because it doesn't change anything anyway, right?

So we tried to make sure that communities could still be hopeful because these are communities who know resilience, they are resilient.

They don't have to be taught to be resilient.

But what we hope is that we are able to bring and lift up those lived experiences as well as that energy to be able to create a different path.

And so as Chao said we're getting some response, but, you know, it's also after the fact, right?

So part of it is, we want communities to be on the front end of designing solutions and not just be the implementers of solutions that others people have created for the community.

And that is the experience that we have now.

So, what we're trying to do is to now really redirect the energy of systems to say, don't design solutions for communities without communities.

Now rethink about how else we might do this so that both we support the families who've already experienced loss, but that there is still so many unknowns about COVID infections.

And when you have a community like this, that has had such high both death and infection rates, there is more to do, right?

As we look at the science of how COVID impacts those who have been impacted or infected, but also as we plan for future boosters or things like that that there's not a confusion between COVID and the flu and, you know, the seasons are coming back up, right?

So I just hope that we move away from constantly being in the mood of reaction to being proactive where we can be.

And that is where we're looking for partnerships, right?

That we get to be a part of designing those solutions instead of just reacting to them.

- Okay.

Thank you both.

We're at time here and to close off I know you both in, so many of your remarks in the last half hour have noted and highlighted what the vision for, you know, moving forward looks like and what should be done now and Bo, you know, you talking just now about the proactiveness that's needed.

You know, I think there's this sort of sense, you know, there's sort of a temporal thing like the pandemic is over, the pandemic is ending.

And you all you've spoken both about, you know, this is still happening, you know, we're still working on these issues.

These issues are systemic, these issues are deep.

And I guess as we're closing, if you could just briefly each of you, yeah.

I guess talk a little bit about what your vision for continuing to address, not just COVID disparities within the community, but just continuing forward looks like as everyone's sort of attention seems to be shifting, I guess the mainstream attention seems to be shifting to let's reopen, the pandemic is over, you know, and what that looks like.

- You know, I really just wanna close out with, you know, like the acts that we're continuing to push for.

I mean, this is the call to the public to say, hey, we need to continue to scale up the collection and use of desegregated data because it's not just about, it's not about the data, it's about what the data implies, right?

And this is a start to answering a broader call to close disparate health outcomes and move towards health equity.

And another piece is ensure that our, we need to ensure that these recovery efforts and solutions meet the needs of Asian communities and our cultural groups like the Hmong American culture group by really focusing on having a deeper cultural understanding of who we are and consider who isn't at the table.

I think one of the big themes that we are seeing right now is the mental health toll that the pandemic has taken on our elderly who have been socially isolated, you know, the mental health toll on families that have lost multiple members of their immediate family and the grief and the guilt that remains.

It's not something that, you know, goes away overnight.

And I think last of all, please, you know, if you are a decision-maker, please direct resources to community based groups and organizations like the Coalition of Asian American Leaders, the Hmong Public Health Association in a way that does not foster unhealthy competition, but really builds on strong collaborations, coalitions and partnerships that leverage everyone's unique assets and networks and have specific measures that tie in the work to population health outcomes.

You know, something that we saw was like, well, you know, it's a competition and no organization does everything well, and that's why collaboration is needed.

And so those are the things I really wanna lift up and amplify and so I'll pass it to Bo now.

- Thanks Chao.

Yeah, I mean, I would just reinforce that sense that we don't need to build resilient communities because communities are resilient.

They've had to survive a lot, but we need resilience systems.

And so things like data system or cultural and linguistic, you know, culturally and linguistically competent systems.

I also wanna say that there are so many community members who are employed in these systems but they're so underutilized, right?

And the number of people who called me to just say, they felt like they had to be secretive about what they were learning, what was done or not done is a huge disappointment because that was their first level of knowledge within these systems that underutilization of the expertise of folks who come from the community is not just about diversity because we want the workforce to look like a rainbow, is because they come from communities that could have been more informative and instructive in the shaping of solutions.

So I wanna always push, you know, systems to tap into their folks and not just to tokenize them, to pay them for it, but to also then have them connect to communities 'cause we don't wanna put the burden on the employees themselves.

I also think that the real investments is that in COVID, this was a new disease that none of us had experienced.

And I felt like we were trying to use old systems to, or old strategies to figure out how to prevent it when actually we needed to get more resources out to communities to try to figure out how to prevent it and address it and that just didn't happen, that there was too many barriers put up for communities to be able to access those resources.

And if we want to be able to continue to think about how we would deal with new viruses that might come, we have to look at these experiences to say, are we better prepared the next time, right?

Or are we gonna be experiencing the same things?

And so I just wanna say get the investments out to communities and take an experimental mindset and pay attention to what works and what doesn't work rather than trying to figure out what is the right solution and then letting communities suffer so much before realizing that you made bad choices, right?

Or bad decisions that were not relevant or responsive.

So, that's all and of course we're grateful for those who have listened and who want to be in partnership to really think forward together.

- Thank you both so much for your time, for all that you do and all that you're doing.

It's part of our series of conversations where we're talking about the impacts of COVID on a number of different communities.

So I thank you again for all of your insight in this particular topic.

Thank you all for joining us today.

I'm Nicole Nfonoyim-Hara for our KSMQ public television, thank you for watching.

- [Voiceover] Funding for this program is provided in part by the Minnesota Arts and Cultural Heritage Fund and the citizens of Minnesota.