“Care” and COVID-19: A Call for Black Feminist Data Analytics, Part II

This piece is the second in a series of reflections on data analytics and COVID-19.

Data is a central actor in the COVID-19 pandemic. From the beginning, the public has been inundated with data. Whether it is the number of people who are getting sick, dying, or being tested, our collective attention, for good reason, is called to examine data trackers and graphs that tell us one story about the impact of the coronavirus in the United States. Yet, even as data helps experts and us make informed life-saving decisions, it can obscure as much as it reveals. In the case of race and the pandemic, one of the stories behind COVID-19 data is the experiences of Black women and “care.”

“Care” as a Risk Factor for COVID-19

Historically Black women in the United States have served as caretakers under the system of slavery. White landowners stole their labor and forced Black women to care for children and families that were not their own. Despite the formal end of slavery, many Black women continued to work as domestics in white homes and performed much of the same labor. White constructions of Black womanhood has largely centered around care through ideologically driven and dehumanizing stereotypes, better known as “controlling images” via the visages of the mammy, matriarch, and the welfare mother. Black women’s self-care and well-being have largely been absent in the broad contours of American society.

Despite the passage of time, Black women continue to perform a disproportionate amount of care in the labor force. We see this most visibly in the direct care industry in healthcare settings. According to the Paraprofessional Healthcare Institute (PHI), from 2005 to 2015, Black/African American workers made up approximately 30 percent of personal care aides, home health aides, and nursing assistants, otherwise known as the direct care workforce. Black women and other women of color overwhelmingly represent a large segment of this labor pool. Described as holding the most dangerous jobs in the United States during the coronavirus pandemic, they provide essential hands-on care for patients such as bathing, dressing, and feeding.

The Guardian’s Lost on the Frontline” interactive public-facing database of U.S. healthcare workers’ deaths from the coronavirus offers a snapshot of how Black women’s participation in direct care work disproportionately puts them in mortal danger of contracting and dying from COVID-19. Approximately 42% of the Black women healthcare workers profiled in the database were involved in direct care work. The remaining 56% were spread out over other types of work involving less sustained patient contact.

“Care” on the Homefront

Black women are also shouldering the burden of caregiving in their homes and communities.

Almost half of Black households with children are headed by single women, and so must face issues of child care and virtual schooling on their own. Black women report spending three times as many hours per week caring for elderly or sick relatives as do White women.

The disproportionate number of Black women participating in direct care work intersects with a large measure of homes headed by single Black women and women caring for extended members of their family. The life of Candace Allen of Bessemer, Alabama embodies the complexity of care during the pandemic. As a licensed practical nurse she worked excessively long shifts and spent much of her time outside of work providing care for her elderly mother and grandchildren. Already suffering from some health conditions, Allen, age 52, contracted COVID-19 in mid-April and died a month later on May 18, 2020.

Lost on the frontline: Hundreds of US healthcare workers have died fighting Covid-19. We count them and investigate why. https://www.theguardian.com/us-news/ng-interactive/2020/aug/11/lost-on-the-frontline-covid-19-coronavirus-us-healthcare-workers-deaths-database

The essential work of direct care and the stress of caretaking responsibilities at home means that many Black women face a greater likelihood, relative to their white counterparts, of contracting and dying from COVID-19. However, it would be remiss to argue that care on its own is the problem. Rather, it is the way that care is deeply embedded in long-standing structural racism that makes it peculiarly thorny for Black women. Unlike the white feminist construction of “care ethics” or an“ethics of care” where the care is situated in power relations that are largely defined by gender, Black women experience the underbelly of care through race, gender, and class throughout American society.

Black Feminist “Ethics of Care”

Patricia Hill Collins’s discussion of an “ethics of caring,” in Black Feminist Thought, which focuses on expressiveness, emotion, and empathy can deepen our thinking about care from Black women’s standpoint. Collins suggests that these qualities, all shared with white feminist ethics of caring, alone lack transformative power. Rather it is the situated nature of care in Black communities which gives it meaning and power. Black feminist thought shifts meanings about care from being located in white spaces where it is largely resigned to being defined as labor to ones in which Black communities both determine and are the recipients of Black women’s care. However, Black communities also validate it and sanction its affective and intellectual power. Collins’s writes:

White women may have access to women’s experiences that encourage emotion and expressiveness, but few White-controlled U.S. social institutions except the family validate this way of knowing. In contrast, Black women have long had the support of the Black Church, an institution with deep roots in the African past and a philosophy that accepts and encourages expressiveness and an ethic of caring.

While one may argue that the Black Church plays a smaller role in contemporary Black communities, Collins’s larger point is that Black socio-political communities that exceed the familial unit often endorse and substantiate Black women’s care.

Collins goes on to note that Black women’s care might be understood in the tradition of call-and-response in African culture. Call-and-response is tied to the group or communal nature of life where a speaker calls to a collection of people who respond in an affirmative and uniform voice. Improvisation, which generates new meanings, is often embedded in call-and-response. In the context of an ethics of care, care is offered or provided but lacks meaning without the response from the community which appraises its value and rewrites its significance within Black life.

“Care” and Black Feminist Data Analytics: Call-and-Response

Black feminist data analytics begins with “care.” Data is relational…it requires human attention, consideration, and protection…care…to transform it into meaningful information.

But what does it mean to analyze health data, particularly on race, through data analytics that are grounded in a Black feminist approach to care? This is where call-and-response is key. Like ethics of caring in Black feminism, care for data in Black feminist data analytics not only occurs within a context of communal life, it also requires a response and input from the community. Depending on the questions and objectives of the data analysis, these communities can be stakeholders, scholarly experts, and the general public,

In some sense, call-and-response through Black feminist ethics of caring in data analytics mirrors community-based participatory research where there’s a commitment to sharing power and engaging community partners. However, Black feminist data analytics’ praxis of care goes beyond simply sharing power. Instead, data analysis derives its power and meaning from the community through call-and-response. Effective data analysis is not only cut off when the community is unable to demonstrate its capacity to generate knowledge, it also loses its transformative potential.

Care in Black feminist data analytics depends and thrives upon community response and input (call-and-response), which work together to ensure that data will be life-changing.

“Care” and Black Feminist Data Analytics: Ethic of Risk

Black feminist data analytics also discloses an “ethic of risk” in data, a sense that caring for data is a precarious prospect that equally holds the possibility of liberation and oppression at once. Black women’s complicated history as caretakers of white society for much of their presence in modern history requires that they accept that care, no matter how well it’s done, will not guarantee freedom from subjugation. When this conceptual framework is applied to data, it demands that we scrutinize all data, even counterdata, and considers it to be potentially harmful even when it holds a range of possibilities for resilience and resistance.

If we return to Candace Allen’s story from the “Lost on the Frontline” database, we might begin to see how it acts as a critical lens into the volatile relationship between care and data. Even as Allen’s profile is carefully designed to elicit critical empathy and raise awareness about healthcare workers’ vulnerability to COVID-19, the disclosure of her health data, information about her pre-existing conditions, violates her right to medical confidentiality. She did not and was unable to consent to the publication of this information. One might ask why it matters now that Allen is deceased?

Early media coverage and the U.S. government initially attributed Black Americans’ relatively high death rates from COVID-19 to comorbidities and personal responsibility. However, many Black doctors and scholars on Black life pointed out that pre-existing conditions and other risk factors are actually manifestations of long-standing structural anti-Black racism in the United States. Still, historian of race and medicine, Rana A. Hogarth points out that discussions about the relationship between race and comorbidities often result in the judgment of sick people. She states:

Historically, blaming the marginalized in society served the purpose of explaining disease in a way that conformed to a specific worldview.

We can see this tendency in the way everyday Americans talk about the coronavirus. According to Vox reporter, Emily Stewart, who surveyed white anti-maskers, many people:

…claimed not to know anyone who had contracted Covid-19 or died of it, and when I told them I did, the responses were the same: How old were they? Did they have preexisting conditions?

The mask debate is complex. As much as it’s about science, health, and risk, it’s also about empathy. If someone doesn’t personally know anyone who died from Covid-19, does it mean those lives don’t matter?

The fact of the matter is that many white people have little relationship with Black individuals and communities. Due to historical and contemporary anti-Black racism, they often lack empathy and care for Black Americans’ painful experiences in the pandemic. Thus, the exposure of data, albeit with good intentions, about Allen’s medical conditions reinscribes the very systemic inequality and racism that placed her in the crosshairs of the converging meanings around care for Black women and made her vulnerable to COVID-19.

Black women’s experiences in the coronavirus pandemic reveal how care should be instrumental in the way we manage and analyze data. Black Feminist data analytics offers a method for applying processes of care that decenter the data scientist and privilege community knowledge through call-and-response. Just as importantly, analyzing data from Black feminist theory and praxis highlights an ethic of risk, which reveals an unstable relationship between data, care, and justice.

Look for the next essay in this series to learn more about Black feminist data analytics and the value they hold for analyzing COVID-19 racial data.

ABOUT THE AUTHOR:

Kim Gallon is the Director and Founder of COVID Black. Learn more about COVID Black by clicking here.

Redefining Health Data…Connecting Black Communities to their Data.