Embracing A Person-Centered Life
The New Green Book for Traveling Black Americans in America 2024
Introduction
In the mid-20th century, “The Negro Motorist Green Book,” often simply referred to as “The Green Book,” served as an essential guide for African Americans traveling across the United States. Published from 1936 to 1966, it provided a directory of safe places where Black Americans could find lodging, restaurants, and other services without the risk of discrimination or violence. In today’s America, while overt segregation is legally abolished, the quest for safe and welcoming communities for Black Americans remains relevant. This essay explores the concept of safe communities in contemporary America, highlighting key factors that contribute to safety and well-being for Black Americans.
Historical Context of Safety for Black Americans
The history of safety for Black Americans is deeply intertwined with the broader narrative of racial discrimination and civil rights struggles. From the era of slavery to Jim Crow laws, and into the Civil Rights Movement, African Americans have continuously sought environments where they can live without fear of racial violence and discrimination. The original Green Book emerged as a response to this need, offering a semblance of security in a hostile landscape.
Defining a Safe Community
A safe community for Black Americans today can be defined by several critical components:
- Low Crime Rates: Areas with low levels of violent and property crimes are generally considered safer.
- Inclusive and Supportive Social Environment: Communities that actively promote diversity, equity, and inclusion create a welcoming atmosphere.
- Quality Education: Access to quality educational institutions is essential for the advancement and safety of future generations.
- Economic Opportunities: Availability of jobs and economic stability reduces the risks associated with poverty.
- Healthcare Access: Proximity to and quality of healthcare facilities ensure that residents can maintain their health and well-being.
- Effective Policing: Policing that is fair, community-oriented, and free of racial bias enhances the feeling of safety.
- Political Representation: Representation in local government ensures that the needs and concerns of Black residents are addressed.
Analysis of Safe Communities
To identify and analyze safe communities for Black Americans, we consider a range of factors from various sources, including crime statistics, educational outcomes, economic indicators, and social climate.
1. Crime Rates and Safety
Crime rates are a fundamental measure of community safety. While no community is entirely free of crime, many have significantly lower rates of violent and property crimes. For instance, cities like Plano, Texas, and Irvine, California, consistently rank among the safest cities in America. These cities boast low crime rates, well-resourced police departments, and strong community engagement.
2. Inclusive and Supportive Social Environment
Communities that foster inclusivity and support diversity are particularly important for Black Americans. Cities such as Atlanta, Georgia, and Washington, D.C., not only have substantial Black populations but also celebrate Black culture and history. These cities host numerous cultural institutions, events, and businesses that reflect and support the Black community.
3. Quality Education
Access to quality education is a cornerstone of a safe and thriving community. Suburbs of major metropolitan areas often provide high-quality public schools. For example, Montgomery County in Maryland is renowned for its excellent school system, which serves a diverse student body and provides ample resources for academic and extracurricular success.
4. Economic Opportunities
Economic stability and job opportunities are critical for community safety. Cities with robust job markets, such as Austin, Texas, and Raleigh, North Carolina, attract professionals from various fields, including technology, healthcare, and education. These cities provide a wealth of opportunities for Black professionals and entrepreneurs.
5. Healthcare Access
Access to healthcare is another essential component of a safe community. Cities with reputable healthcare systems, like Boston, Massachusetts, and Minneapolis, Minnesota, offer residents access to top-tier medical facilities and services. These cities also often have community health programs tailored to address the specific needs of Black residents.
6. Effective Policing
Effective and fair policing is vital for ensuring community safety. Initiatives such as community policing and police accountability measures are important. For example, cities like Camden, New Jersey, have restructured their police departments to focus on community engagement and de-escalation, resulting in improved relations between the police and the community.
7. Political Representation
Political representation is key to addressing the unique needs of Black communities. Cities with strong Black political leadership, such as Chicago, Illinois, and Baltimore, Maryland, are better positioned to implement policies that promote equity and safety. Representation ensures that the voices of Black residents are heard and their concerns are addressed.
Case Studies of Safe Communities
Atlanta, Georgia
Atlanta is often heralded as a mecca for Black professionals, entrepreneurs, and artists. It boasts a rich cultural heritage and a thriving Black community. The city is home to numerous Historically Black Colleges and Universities (HBCUs), such as Spelman College and Morehouse College, which provide educational opportunities and foster a strong sense of community. Atlanta’s economy is diverse, with opportunities in entertainment, technology, and healthcare. The city’s political leadership is also predominantly Black, which helps ensure that policies reflect the needs of the Black community.
Washington, D.C.
Washington, D.C., offers a unique blend of historical significance and modern opportunities. The city has a substantial Black population and a vibrant cultural scene, with institutions like the Smithsonian National Museum of African American History and Culture. The public school system, while challenged in some areas, includes high-performing charter schools and magnet programs. Additionally, the presence of federal agencies and numerous non-profits provides ample employment opportunities. The city’s political landscape, with a significant number of Black leaders, ensures that issues pertinent to the Black community are addressed.
Raleigh, North Carolina
Raleigh is part of the Research Triangle, known for its high-tech research and development centers. The city offers a strong job market, particularly in technology and education. With institutions like North Carolina State University, Raleigh provides excellent educational opportunities. The city’s healthcare facilities are top-notch, with Duke University Hospital and UNC Hospitals nearby. Raleigh’s commitment to community policing and inclusive policies also contributes to its reputation as a safe and welcoming city for Black residents.
Challenges and Considerations
While these cities offer many advantages, it’s important to acknowledge ongoing challenges. Issues such as gentrification can displace long-standing Black communities, and systemic racism can still manifest in various forms. Additionally, the benefits of these safe communities may not be evenly distributed, and there may be disparities within cities themselves.
Conclusion
The search for safe communities for Black Americans in contemporary America echoes the historical necessity that gave rise to “The Green Book.” While much has changed since the mid-20th century, the need for safe, welcoming, and inclusive environments remains. Cities like Atlanta, Washington, D.C., and Raleigh exemplify the qualities that make communities safe and supportive for Black Americans today. By focusing on crime rates, inclusivity, education, economic opportunities, healthcare access, effective policing, and political representation, we can identify and cultivate communities that honor the spirit of the original Green Book, ensuring safety and prosperity for Black Americans
Bonnie Jean Smith July 2024
Dave A. Chokshi, MD Racial Inequities in COVID-19 Hospitalizations During the Omicron Wave in NYC
Executive summary
The mission of the NYC Department of Health and Mental Hygiene is to protect and promote the health
of all New Yorkers. During the COVID-19 pandemic, we have been particularly focused on understanding
and addressing racial inequities that have led to particularly high rates of death and suffering in certain
groups, such as Black New Yorkers. This builds on our broader approach to dismantling structural racism
(the system of structures, institutions and policies that work together to advantage White people and
disadvantage people of color) and the ways it leads to poor health.1
We recently put out a report on the omicron surge.
2 As part of this work, we identified a concerning
trend: During the omicron surge, the COVID-19 hospitalization rate was more than two times greater
among Black New Yorkers compared to White New Yorkers. Understanding why the dramatic inequities
experienced by Black New Yorkers throughout the COVID-19 pandemic became worse during this most
recent surge requires a deeper analysis and cannot be explained by simple factors. This white paper
traces the cascade of factors that ultimately result in these inequities and lays out a roadmap for action.
While we focus here specifically on anti-Black structural racism, we acknowledge that many other
intersectional forms of oppression — for example, ageism, sexism, homophobia, xenophobia and
transphobia — compound the inequities we describe here. Additionally, we acknowledge that there
have been substantial misclassifications of ethnicity, particularly among Hispanic and Latino/a
populations, which may obscure some of the differences.3 We felt it was essential to explore the high
rate of hospitalization of Black New Yorkers in greater depth and in close proximity to the omicron wave.
Key analyses and observations
• Anti-Black structural racism drives health inequities (differences in health outcomes among groups
that are rooted in social and structural injustices that are avoidable and unfair) through a cascade of
factors (Figure 1) and has manifestations warranting dedicated analysis and response. We explore
the ways in which structural racism may have contributed to a COVID-19 hospitalization rate more
than two times greater among Black New Yorkers compared to White New Yorkers (Figure 7).
• We must first consider the factors that have led to increased rates of Sars-CoV-2 Infection, such as
access to safe community and work environments. Since the start of the pandemic, Black and
Latino/a New Yorkers, and those in high poverty neighborhoods have been less able to work from
home (Figure 2). This has led to increased COVID-19 exposure among these groups but does not fully
explain the worsening inequities seen during omicron.
• We must next consider the factors that have led to increased rates of COVID-19 progression once
infected. COVID-19 vaccines play a central role in preventing infection and particularly in preventing
serious illness. We observed delays in primary series vaccination among Black New Yorkers (Figure 3)
and lower rates of booster doses among eligible Black New Yorkers by winter 2021 when the
omicron surge began (Figure 4).
2
• In addition, we observed longer delays to diagnosis among Black New Yorkers and residents of the
least privileged census tracts even before the omicron surge (Figure 6). These extended times from
COVID-19 symptom onset to diagnosis are driven in part by structural barriers such as decreased
access to COVID-19 testing or time off work to seek testing, and likely contribute to delays in seeking
and accessing care.
• We must next consider the factors that have led to increased rates of hospitalization. Inequities in
access to effective outpatient COVID-19 treatment can lead to missed opportunities to prevent
severe COVID-19 infection and hospitalization. Before omicron, national data showed that Black
Americans were less likely than White Americans to receive life-saving COVID-19 treatments such as
monoclonal antibodies (Figure 6).
• In NYC during the omicron surge, COVID-19 hospitalizations were disproportionately higher among
Black New Yorkers (Figure 7) and in neighborhoods with a high percentage of Black residents (Figure
8).
• Finally, we must consider the factors that can lead to increased rates of morbidity and mortality.
Even before the pandemic, anti-Black structural racism led to a four-year lower life expectancy
among Black New Yorkers (Figure 9). This trend is due to a host of social, structural, and downstream
factors. These in turn lead to higher rates of chronic disease from diabetes to cardiovascular disease
and cancer, decreased access to health care and under-resourced safety net hospitals, and other
inequities. These same factors put Black New Yorkers at greater risk of severe COVID-19 illness and
unfair outcomes once experiencing severe infection.
• The Health Department prioritizes racial equity data analyses such as these to identify and address
the issues creating health inequities. Low data quality on the race, ethnicity, and economic status of
New Yorkers and missingness of data hampers our ability to describe and understand the specific
elements of structural racism that need to be addressed to eliminate racial inequities, particularly in
the health care setting.
While the drivers of health inequities are complex and rooted in centuries of structural racism and
disinvestment, the Health Department is committed to identifying solutions to protect and promote
health today while also building long-term strategies to address structural factors. This work must be
done in collaboration with the health care community, community-based organizations, and our partner
city agencies.
To date, the City’s targeted Vaccine Equity Strategy,
4 which prioritized marginalized communities,
helped close the racial gap in COVID-19 vaccination rates in combination with New York City’s vaccine
policies (Figure 10). While more work is needed, this demonstrates the success and importance of
community- and equity-based approaches.
We call on our partners to take additional concrete actions under a shared vision of reducing racial
health inequities in the COVID-19 pandemic and beyond. These actions encompass investment in
priority neighborhoods; improved access to care, including vaccination and COVID-19 treatments; and
community engagement with cultural humility.
3
- Anti-Black structural racism drives COVID-19 inequities.
To effectively address these worsening racial health inequities, we must investigate and dismantle the
structural racism which leads to harmful policies, programs and systems that impact health. Structural
racism, specifically anti-Black racism, can be defined as “racial bias across institutions and society” and
has taken an extraordinary toll on the health of Black New Yorkers over the past several centuries and
decades, and during the last two years of the COVID-19 pandemic.5 In recognition of this, on October 18,
2021, the NYC Board of Health passed a resolution declaring racism a public health crisis and laid out a
plan of action that the NYC Health Department is now proactively operationalizing.6
Building off the work of the Health Department’s Race to Justice Initiative, we propose using the
framework of a “COVID-19 prevention cascade” to map out the drivers of racial inequities and provide a
roadmap for tackling COVID-19 racial health inequities in our city and beyond.
Figure 1. Structural racism cascade of injustice leads to increased COVID-19 hospitalizations among Black
people.
4 - Since the start of the pandemic, Black and Latino New
Yorkers, and those in high poverty neighborhoods have
been less likely to work from home.
Starting at the most upstream point in the COVID-19
cascade model requires looking at risk factors for
COVID-19 exposure. Early in the pandemic the Health
Department led efforts to quantify risk of COVID-19
exposure by race, ethnicity and income level.7 Black and
Latino New Yorkers, and those in high-poverty
neighborhoods, were more likely to experience financial
hardship and not have access to work-from-home
arrangements. Residence in multi-generational homes
without adequate space for quarantine and isolation also
contributed to inequities in exposure.
8
These structural factors led to greater exposure to the virus and higher rates of infection in these
communities and neighborhoods. We emphasize, however, that we do not yet have data on exposures
related to omicron. Additionally, exposures will not fully explain why the Black hospitalization inequity
increased more than all other races/ethnicities during the omicron wave. The highest case rates during
Omicron were seen among Latino New Yorkers who also saw higher rates of hospitalization although not
at the rates experienced by Black New Yorkers, suggesting that additional factors were at play.
Figure 2. Demographics of adults exclusively working from home and using public transportation.
5 - Inequities in COVID-19 primary vaccination series and
additional doses may have made Black New Yorkers more
vulnerable to COVID-19 during the omicron surge.
In addition to higher risk of exposure, Black New Yorkers
were also more susceptible to omicron due to inequities in
vaccination coverage during the winter surge. Throughout
the NYC vaccination campaign we have observed delays in
primary series vaccination among Black New Yorkers
(Figure 3). We also observed lower rates of additional or
booster doses among Black New Yorkers by winter 2021
(Figure 4) in part because fewer had completed their
primary vaccination to be eligible for an additional dose.
Figure 3. NYC rates of primary COVID-19 vaccine series coverage by race/ethnicity by time of omicron
wave (December 2021).
6
Figure 4. NYC rates of additional dose COVID-19 vaccine coverage by race/ethnicity by time of omicron
wave (December 2021). - Longer delays in diagnosis of COVID-19 infection have been observed among residents of the least
privileged census tracts and among Black New Yorkers.
Appropriate isolation and early treatment of COVID-19 infection to avoid progression require timely
diagnosis and access to care. While specific data are not available for the omicron wave, we observed
extended diagnostic delays among Black New Yorkers and residents of the least privileged census tracts
for patients whose symptoms began during October 1, 2020 to October 31, 2021 (figure 5). For 1 out of
4 Black New Yorkers and residents of the least privileged census tracts, it took 5 or more days to get
diagnosed. In comparison, 1 out of 4 other New Yorkers took 4 or more days to get diagnosed. These
extended times from COVID-19 symptom onset to diagnosis are driven in part by structural barriers such
as decreased access to COVID-19 testing or time off work to seek testing. Diagnostic delays likely
contribute to delays in seeking and accessing treatment, from primary care to help manage symptoms in
the community to antiviral therapies to prevent progression of disease. In NYC, our Test and Trace
initiative has aimed to decrease these inequitable delays in diagnosis by increasing COVID-19 testing
resources in low-income neighborhoods.
9
7
Figure 5. Days from onset of COVID-19 symptoms to diagnosis by ICE score and by race/ethnicity among
patients with symptom onset dates during October 1, 2020 to October 31, 2021.
Note: ICE (Index of Concentration at the Extremes) quintiles are ordered from least privileged (1) to most
privileged (5).
8 - Nationally, Black Americans are less likely to receive
monoclonal antibodies to treat COVID-19 than White
Americans.
Inequities in access to effective outpatient COVID-19
treatment can lead to missed opportunities to prevent
severe COVID-19 infection and hospitalization. The Centers
for Disease Control and Prevention (CDC) reported that
Black Americans have been 22% less likely than White
Americans to receive monoclonal antibody treatment for
COVID-19 (Figure 6)10 which pre-omicron was shown to
decrease risk of hospitalization by up to 85%.11 Notable
disparities were seen between Hispanic and non-Hispanic
populations as well.
Improved and equitable access to monoclonal antibodies and antiviral agents, such as Paxlovid, must be
ensured to disrupt racial inequities in COVID-19 hospitalization. This vision has guided New York City’s
approach to equitable Paxlovid access through a centralized system that removes barriers to care.12
Figure 6. National racial inequities in monoclonal antibody treatment.
9 - During the omicron wave, the COVID-19 hospitalization rate was more than two times greater
among Black New Yorkers compared to White New Yorkers.
The age standardized hospitalization rate due to COVID-19 was more than two times greater among
Black New Yorkers than among White New Yorkers during the omicron wave in December 2021 and
January 2022 in New York City (Figure 7). This inequity is worse than inequities seen in prior waves. As a
later step in the cascade of COVID-19 exposure, infection and illness, this finding represents the impact
of multiple points of failure in our system to adequately safeguard the health of Black New Yorkers. It
mirrors extensive national evidence documenting racial inequities in COVID-19 outcomes affecting Black
persons across the United States.
13
Figure 7. Weekly age-standardized COVID-19 hospitalization rate in New York City by race/ethnicity,
week ending March 7, 2020 to February 5, 2022.
14
10 - During the omicron wave COVID-19 hospitalizations were disproportionately higher in
neighborhoods with a high percentage of Black residents.
The geographic distribution of cases supports the Health Department’s place-based approach to
COVID-19 response, focusing efforts and resources on the communities and neighborhoods most
impacted by the pandemic and at risk of further unfair and disproportionate harm. Our work is guided
by the City’s Taskforce for Racial Inclusion and Equity (TRIE) initiative* — a data-driven approach to
prioritize the neighborhoods hardest hit by COVID-19 and facing the greatest resource and structural
inequities. The Health Department has prioritized interventions serving these TRIE neighborhoods,
which make up 50% of NYC.
15
Figure 8. Percentage of Black residents by modified ZCTA in New York City (left) and rate of COVID-19
hospitalizations per 100,000 residents by modified ZCTA for admissions occurring during December 11,
2021 through February 4, 2022 (right).
Surveying the Destruction of African American Schoolhouses in the South, 1864–1876 CAMPBELL F. SCRIBNER
Voluntary and Involuntary in America ~
Voluntary minorities are groups that come to America due to targeted systemic atrocities: being pulled from their homes and villages murdered, marginalized and severely oppressed, treated as though they are not human within their own countries. No Justice No Peace ~
Imagine the weight of African Americans and American Indians, Involuntary Minorites living with these same atrocities in America with no place to flee to be treated humanely.
United States of America’s Apartheid: “A little yeast works through the whole batch of dough.” New Living Translation This false teaching is like a little yeast that spreads …
“Poverty is not an accident. Like slavery apartheid it is man made and can be removed by human actions.” – Nelson Mandela
HONEST CONVERSATIONS…
t was started by a very wise man in human history that the health of our vision is maintained through, keeping our lens clear helping the way we envision the world around us filters our self-awareness and can expand our perspectives outside of our comfort zones.
How do you see things? How do you read things? In the midst of quarantines, telework, physically isolated from both friends and co-workers, we are also living through a time of social unrest. For many people, this time in history has brought new insights into the human interaction across cultures and life experiences. “We live life on levels and arrive in stages”- a.r.bernard.
We have our Lens (eyes) checked when we know our vision is changing for the worse if that happens we get the corrected lens because we cannot see clearly the world around us.
We need to regularly check the way we envision others in our world the same way we would check our eyesight.
This is done through “Honest Conversations”. The ability to disagree respectfully and to hear another opinion which might enlighten what we thought we knew.
Tip Sheet for Parents: Your New Normal
Tip Sheet for Parents: Your New Normal
Now that we are at home our natural family rhythms have abruptly changed and we are all in uncharted territory. We can take this time to reconnect with family where before with our necessary responsibilities outside of our home we had to triage the supports given to family members, especially in large families.
What is next?
It is time to make new natural family rhythms.
Since we are all home together everyone will have new responsibilities with new clear routines that will help everyone.
This is a great time to cultivate family togetherness whether your family structure is:
• Traditional [ two parents]
• Single parent
• Extended Family
• Foster Family
• Stepfamily
• Grandparent Family
Regardless of your family structure, you have always provided Love, support, and values for every member of your family.
During this time, we can slow down to smell the roses, and yes, as with roses, sometimes we will have to address thorny situations. But with this new normal we can learn from and understand each other growing into stronger families than we were before.
Maintain your new routines:
• Have one of your children write up a visual schedule everyone can see and use.
• Foster connections from a distance using letter writing, phone, internet face time etc.
• Offer opportunities for expression – go outside in your yard and look for bugs; look at the stars at night and try to find the constellation’s; raining outside? Learn about cloud formations together; do an indoor family experiment (there are lots of free resources online)
• Share family history stories and ask your children what they think about what you have shared.
• Have family exercise time even if it is just walking around your block or dancing to music.
Make your new normal an awesome adventure! Bonnie Jean Smith 3/16/2020
How Big is the Fly? 