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Health

Black and Hispanic people get monkeypox more but get less care. Here’s what’s being done to address inequities

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CNN
 — 

The organizers of Atlanta Black Pride, an LGBTQ celebration held each Labor Day weekend, have big plans. There will be parties and performances, workshops and financial literacy classes, brunches and a boat ride. This year also brings an event that no one ever expected would be necessary: a vaccination clinic.

“We actually got a head start, and we started early, even before the festival, with monkeypox vaccinations for people that are here in Atlanta,” said Melissa Scott, one of the organizers.

The festival will also offer Covid-19 vaccines on location.

The monkeypox vaccines won’t protect people right away, because two doses are needed, but Scott said the festival is the perfect opportunity to reach a large group of people who have been disproportionately affected by the outbreak.

As of Friday, there are nearly 20,000 probable or confirmed cases of monkeypox in the US, according to the US Centers for Disease Control and Prevention.

The virus is spread through close contact and can infect anyone. But cases in this outbreak have mostly been among gay, bisexual and other men who have sex with men, and no one’s been hit harder than those who identify as Black or Latino/Hispanic.

Nearly 38% of monkeypox cases are among Black people, yet they represent only 12% of the US population. Hispanic or Latino people make up 19% of the US population but account for 29% of the cases as of August 27, according to the CDC.

Not all US cities keep or publish demographic data. But among those with the most monkeypox cases, people of color are often overrepresented among the sick and underrepresented among the vaccinated.

In Philadelphia, for example, 55% of monkeypox cases are in Black people, 16% are in people who identify as Hispanic, and 24% are in those who identify as white. Yet 56% of the shots have gone to white individuals, 24% to Black people and 12% to Hispanic people, according to the city’s website.

In Atlanta, as of mid-August, 71% of monkeypox patients identified as Black, 12% as white and 7% as Hispanic, while 44% of the vaccines have gone to white people, 46% to Black people and 8% to Hispanics.

And in Houston, Black people are overrepresented among the sick, making up 32% of all the cases, but they are only 23% of the population. Only 15% of people who have gotten the vaccine identify as Black, according to the Houston Health Department.

However, while Hispanic people account for 21% of the cases in Houston, they make up 45% of the city’s population and 32% of those who have been vaccinated. White people are 24% of the population, 17% of the cases and 39% of those who have been vaccinated against monkeypox.

In Los Angeles County, the health department says 40% of cases are among Hispanic people, yet only 32% of first vaccine doses have gone to members of that community. Hispanics make up 49% of the county’s population.

White people are the most vaccinated against monkeypox in Los Angeles. They’ve gotten 41% of the first doses, and they account for 29% of the cases. White people make up a quarter of the population of the county.

Black people are overrepresented among the cases. They make up 9% of the population in the county but 11% of the cases. Only 9% of those who got their first vaccine dose identify as Black.

It is not totally clear what’s driving the differences, but this isn’t the first disease to see such inequities, said Dr. Chyke Doubeni, chief health equity officer at Ohio State University. Unless something drastically changes, he said, we’ll see the same pattern in the next outbreak.

“I would say as a public health community, we’re very good at repeating the same mistakes multiple times,” he said. “It’s the same story, the same underlying causes. There are barriers to care and information. Systems that require people to stand in line for hours for a vaccine do not work for people with hourly jobs, for instance.”

For months, community leaders have repeatedly called on the Biden administration to step up its efforts to protect this population. On Tuesday, the administration announced that it was launching a pilot program aimed at LGBTQ communities of color.

“It’s important to acknowledge that there’s more work we must do together with our partners on the ground to get shots in arms in the highest-risk communities,” said Robert Fenton, the White House national monkeypox response team coordinator.

“Equity is a key pillar in our response, and we recognize the need to put extra resources into the field to make sure we are reaching communities most impacted by the outbreak.”

The administration will send thousands of vaccine doses to organizations that work with Black and brown communities. The initiative will also work with state and local governments to set up vaccination clinics at key LGBTQ events that attract hundreds of thousands of people, such as Atlanta Black Pride, Oakland Pride in California and Southern Decadence in New Orleans. They will send enough vials to vaccinate up to 5,000 people at each event.

Federal health officials say they also will work with local leaders to identify smaller gatherings for pop-up vaccine clinics, like house and ballroom events that are popular with younger people. They’ve set aside an additional 10,000 vials for those equity initiatives.

Pride Month events in June went by without pop-up clinics. One pilot vaccination program that the administration launched with local public health organizers at the Charlotte Pride Festival and Parade last weekend ended up administering only about a quarter of the doses allocated, but officials still called it a “great success.”

“It’s important to also respect sort of the strategy that Charlotte may have had in terms of how to get the word out,” Dr. Demetre Daskalakis, the White House’s assistant monkeypox response coordinator, said Tuesday. “And so, 500-plus vaccines is a great success – it’s not a clinic, and so really, going to Pride and getting vaccinated – any number, especially that, I think is remarkable.”

The outreach seems to be working in Fulton County, Georgia, which includes Atlanta and several large suburbs.

Black people make up 79% of monkeypox cases there but are only 42.5% of the population, according to the last census. Since the start of the outbreak, the county Board of Health said, it has initiated its own efforts to engage directly with organizations that work with Black and brown communities. Officials have set up clinics, posted QR codes in bars that link to appointment information, and extended hours at clinics so people don’t have to take time off from work to get vaccinated.

As a result, nearly 70% of the monkeypox vaccines that the county has given have gone to people of color, the board said. In comparison, only 10% of doses nationwide have gone to people who are Black, 22% went to Hispanic or Latino people, and 44% went to people who identify as white, according to the Biden administration.

“Communities of color have been hit particularly hard by monkeypox,” said Dr. Lynn Paxton, Fulton County’s district health director. “So efforts targeting health equity have been especially crucial for the Board of Health.”

The Biden administration said equity is a key priority with its monkeypox strategy.

“Our vaccine strategy is to meet people where they seek services, care or community, especially in communities of color,” Daskalakis said.

The extra efforts have been prompted by several obstacles to access to treatments, vaccines and culturally sensitive education material, public health experts say.

Sean Cahill, director of health policy research at the Fenway Institute in Boston, a health organization that works with sexual and gender minorities, says he has been frustrated by these unnecessary barriers.

For example, the monkeypox treatment Tpoxx is still considered experimental, so patients and doctors have to fill out paperwork required by the CDC to get it. For months, not one of the forms was translated into a language other than English. The CDC made the Spanish-language form available on its website in the second week of August.

“For patients who speak Spanish or Chinese or don’t speak a lot of English, it can be a real challenge for them to complete these forms,” Cahill said. It’s even harder for people who don’t have access to a computer or printer.

“There’s just some logistical issues that have been a constant challenge to help patients, and there needn’t be,” he added.

Throughout the outbreak, organizers have been critical of the Biden administration’s response to the public health crisis, especially where people of color are concerned.

“As soon as we started receiving a vaccine, we should have had a conversation with Black and brown community-based organizations to lead the way to vaccinate the most at risk,” said Daniel Driffin, an HIV patient advocate and a consultant with NMAC, a national organization that works for health equity and racial justice to end the HIV epidemic.

To get a vaccine appointment, particularly in the beginning of the US outbreak when vaccines were in much shorter supply, people essentially had to follow their local health department on Twitter to find out when they were available, Driffin said. The appointments would often fill up in minutes.

“Your health status should not be dictated by Twitter or Instagram,” Driffin said.

He added that it’s especially difficult for some people to get appointments to get tests or treatments.

“Especially here in Georgia, where many individuals, especially men, Black and brown people, may not have access to regular medical care. So where are they supposed to go?”

This is not, of course, the first health outbreak to disproportionately affect Black and brown communities.

Black people account for a higher proportion of new HIV diagnoses and cases compared with other races and ethnicities. Hispanic and Latino people are also disproportionately affected by HIV.

The CDC says racism, stigma, homophobia, poverty and limited access to health care continue to drive these disparities.

These same communities are overrepresented in the Covid-19 pandemic. People of color have a disproportionate number of cases and deaths compared with White people when accounting for age differences, according to the CDC.

The CDC has regularly said that more needs to be done to help these communities, and public health officials’ inclination to want to help is good, Doubeni said.

“But typically, they don’t say ‘Oh, we have a problem. Let me see how I can work with the community to see what is beneficial for them,’ and they especially don’t do this from the beginning,” Doubeni said.

On more than one occasion, Doubeni said, he has watched government public health officials spend months to create education materials in English. Only after those materials come out will they start working on a Spanish version.

“I think it’s all well-intentioned, but unfortunately, it doesn’t always begin with an end in mind,” he said.

He tells people that because of institutional racism, and for social and economic reasons, those who are in communities of color may have to be persistent to get the treatment they need.

“Don’t take no for an answer,” Doubeni said. “People should not be ashamed to have to seek treatment for monkeypox. It has nothing to do with them as a person per se. We can control this outbreak and keep it from running out of control. And it’s your right to get the answers you need.”

Atlanta Black Pride organizer Scott said she’s been pleased with the local public health department’s targeted outreach. One of the event’s goals has always been to strengthen the community’s health while encouraging everyone to have fun.

“We’re trying to make sure we reach the people who need it most,” she said.

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Health

Monkeypox is disproportionately affecting Black, Hispanic people, latest CDC breakdown shows

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There were 2,891 cases of monkeypox reported in the United States by July 22, about two months after the country’s first case was reported. Case report forms with additional epidemiologic and clinical information were submitted to the CDC for 41% of those cases, though not all details were complete in all of those forms.

Among the cases with available data, 94% were in men who reported recent sexual or close intimate contact with another man. More than half (54%) of cases were among Black and Hispanic people, a group that represents about a third (34%) of the general US population. And the share of cases among Black people has grown in recent weeks, according to the CDC analysis.

“Public health efforts should prioritize gay, bisexual, and other men who have sex with men, who are currently disproportionately affected, for prevention and testing, while addressing equity, minimizing stigma, and maintaining vigilance for transmission in other populations,” the authors of the report say.

Additional analysis shows that all of the patients had a rash. However, a genital rash was more commonly reported in the current outbreak than in “typical” monkeypox. It was the most common location for rash (46%), followed by arms (40%), face (38%) and legs (37%). More than a third of cases with available data reported rash in four or more regions.

Early warning signs of illness, however, are less common in the current outbreak compared with “typical” monkeypox. In about 2 in 5 cases, the illness started with the rash — but no reported prodromal symptoms such as chills, headache or malaise. About 2 in 5 cases also did not report fever.

The authors of the report emphasize that anyone with a rash consistent with monkeypox should be tested for the virus, regardless of their sexual or gender identity or the presence of other symptoms.

Among those cases for which data was available, fewer than 1 in 10 (8%) needed hospitalization due to monkeypox. No deaths were reported.

Of those for whom vaccination status was available, 14% had gotten a vaccine for smallpox, including 3% who had gotten one dose of Jynneos during this outbreak. At least one person with monkeypox had symptoms more than three weeks after their first dose of the Jynneos vaccine.

A “substantial proportion” of monkeypox cases have been reported among people with HIV, who may be at higher risk of severe illness. More analysis of this group is underway, according to the CDC.

The agency says it is “continually evaluating new evidence and tailoring response strategies as information on changing case demographics, clinical characteristics, transmission, and vaccine effectiveness become available.”

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US

New Mexico Wildfire Rips Through a Hispanic Bastion

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LAS VEGAS, N.M. — As rushing flames neared the remote mountains where his family has lived for generations, Miguel Martinez knew he had to move fast and flee with only the clothes on his back.

“I left behind 25 goats, 50 rabbits, 10 chickens and two dogs,” said Mr. Martinez, 71, who escaped his home in the village of El Oro this week for an evacuee shelter. “I have no idea if my house is standing or if my animals are alive. I need to prepare for the possibility everything was wiped out.”

More than a dozen wildfires are raging this month across the Southwest, as fire season stretches earlier than ever into spring. But the country’s largest active blaze, a megafire that has ballooned across more than 160,000 acres in northern New Mexico, has evolved with such ferocity that it threatens a multigenerational culture that has endured for centuries.

Like Mr. Martinez, many who have fled the megafire, known as the Calf Canyon/Hermits Peak fire, are descendants of Hispanic settlers who arrived in New Mexico long before the United States came into existence. They intermarried with Native Americans, honed ways to grow crops in parched lands and preserved an archaically influenced form of Spanish that can still be heard in the aisles of the local Walmart.

Speaking in a mixture of Spanish and English, Mr. Martinez, a retired musician, said his ancestors had settled so long ago in the village of Mañuelitas, where he grew up in a home built by his forebears, that he was not exactly sure when they had arrived. His wife is from the Aragón family, which long ago made nearby El Oro its home, he said.

“It was a little bit of a shock to move to El Oro, but I’m adapted now,” Mr. Martinez said, reflecting on how closely bloodlines remain tied to the land in these remote settlements surrounded by pine trees and trout-laden streams. “I just hope I have a village to go back to.”

Shaped by challenges that range from conquering armies to long economic slumps, these far-flung Hispanic villages withstood one test after another. But the worst drought in at least 1,200 years, marked by intense and unwieldy fire activity, is something new.

“These fires are burning down a way of life that’s lasted hundreds of years,” said Rob Martinez, New Mexico’s state historian and an Albuquerque native whose parents hailed from Mora and Chacon, two outposts in the fire zone. (He is not related to the retired musician from El Oro.)

Las Vegas, N.M., a town of about 13,000 that has long served as a hub for the surrounding villages and ranches, has become the nerve center for the fight against the blaze. Crews raced to the fire lines this week as ash fell from a sky shifting at times from bright blue to a surreal orange hue.

As the fire continues to spread, it already ranks as the third largest on record in New Mexico, eclipsing the acreage lost to fires in the entire state in 2021. While no lives have been lost, the fire has destroyed at least 172 homes, forced many families to evacuate and remains just 20 percent contained. As dry weather persists, authorities warn that the fire could expand in various directions in the coming days.

At least six other wildfires are currently scorching other parts of New Mexico, according to the National Interagency Fire Center, and this week President Biden approved a disaster declaration for five counties. The state’s blazes include the Cooks Peak fire, which has grown to 59,000 acres in Mora County, and the Cerro Pelado fire, a 25,000-acre blaze within 5.5 miles of Los Alamos National Laboratory, which helps to design and maintain the country’s nuclear weapons stockpile.

As flames from the Calf Canyon/Hermits Peak fire could be seen on ridges from Las Vegas in recent days, officials evacuated the nearby United World College, a boarding school founded by the industrialist Armand Hammer, and emptied out the county jail, releasing some inmates and transferring others.

Some who were forced to flee gathered in a shelter in an old middle school. Others slept in their vehicles or decamped to the homes of relatives or friends; some who had already evacuated to Las Vegas had to evacuate again when smoke filled the skies above the town.

Diana Trujillo, 63, was raised in a three-room adobe home with her seven siblings in Monte Aplanado, near Mora. She said the ancestral structure survived the fire, but the double-wide trailer next door, where she had lived with her daughter and granddaughter, burned to the ground.

“It’s a loss I can’t even put into words,” said Ms. Trujillo, the assistant manager of a senior center. “The beautiful mountain around us, all those trees, it’s all charcoaled now.”

Paula Garcia fled Mora, with a population of about 800, first for Las Vegas and then Santa Fe. She said she had helped her 82-year-old father pack up his tools before escaping herself as the fire approached their tight-knit community.

“It’s a place where people call each other primos and parientes” — cousins and relatives — Ms. Garcia, 50, said. Some of her ancestors put down stakes in the area in the 1860s, moving from other parts of northern New Mexico.

Ms. Garcia, the executive director of the New Mexico Acequia Association, a nonprofit that works to protect the state’s 700 or so acequias, or irrigation ditches, said she attributed her community’s persistence to “pure grit.”

“We’ve lived there so long because of our querencia,” said Ms. Garcia, a term she defined as “a cultural longing, a pull, that keeps us there.”

Such ties to the land have origins in Spain’s colonization of New Mexico, which began in 1598, years before the English first settled in the Virginia colony of Jamestown. The colonists and their descendants persisted in relative isolation on the Spanish Empire’s northern fringe.

New Mexico remains the nation’s most heavily Hispanic state, with nearly 48 percent of the population claiming Hispanic or Latino heritage. The small towns, villages and ranching outposts in the counties hit by the fire, where Hispanics account for about 80 percent of the population, still defy easy classification.

So many families had previously left the area, largely for economic reasons, that they view it as a kind of homeland, or old country. In contrast to other rural areas around the United States that have leaned heavily Republican in recent elections, Mr. Biden carried San Miguel County, whose seat is Las Vegas, with 68 percent of the vote.

Until the fire arrived in late April, one of the main sources of tension in Las Vegas was a recent dispute over a proposed museum exhibition about 19th-century Hispanic vigilante nightriders who had targeted Anglo land squatters after the United States took control of New Mexico.

Relations between ethnic groups have evolved since then. But unlike other parts of the United States where Hispanics are viewed as newcomers and Anglos seek to defend their culture from demographic shifts, in northern New Mexico the roles are often reversed.

“We bought our land back in 1993, but we’re still considered outsiders compared to many of our neighbors,” said Sonya Berg, 79, a retired teacher from Texas whose home in Rociada, a town of several hundred people, was destroyed by the fire.

Still, Ms. Berg said she understood why some families remained in the area for generations, explaining that their land had been so important to her husband, who died in 2019, that his gravesite is on their fire-scorched property.

“I’m sure we’ll rebuild,” she said.

Given the fire’s erratic behavior, it is not clear when evacuees will be allowed back. Wendy Mason, a New Mexico wildfire prevention official, said it was the first time, at least in recent memory, that so many large fires were raging at once in the state. Ms. Mason also cautioned that more fires could start in the coming weeks.

“We usually don’t expect much moisture until the monsoons arrive, and that’s generally not until July or August,” Ms. Mason said. Even if some rain falls, as it did in parts of the state over the weekend, it could be accompanied by lightning strikes that ignite other blazes, she warned.

“Our climate is changing, making the fire season a lot longer and more intense,” Ms. Mason said.

Still, Mr. Martinez, the state historian, emphasized that such challenges were part of the region’s history. Mora was burned to the ground, he noted, by invading American forces in 1847 during the Mexican-American War. After that episode, the community picked up the pieces and started again.

“This isn’t the first fire our families have dealt with,” he said.

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US

Texas House finalizes gnarled U.S. House map that gives GOP bounty from decade of Hispanic growth

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Updated at 2:30 a.m. Sunday

WASHINGTON — The Texas House approved a congressional election plan late Saturday that would lock in an overwhelming Republican edge for a decade — despite a slipping share of the population and the fact that Texas’ two new seats stem from growth in the Hispanic population.

The gerrymandered map allocates 24 of 38 U.S. House seats to the GOP, a generous ratio given that Republicans collected just 53% of votes in congressional races last November.

“They would like to erase African Americans and Hispanics from the state by not allowing them to have access to vote for a person of their choice,” said Rep. Yvonne Davis, a Dallas Democrat, accusing Republicans of “racism” and “racist gerrymandering.”

The state Senate had already approved the map, which has implications far beyond Texas as Republicans try to topple Speaker Nancy Pelosi in the 2022 midterms.

The map is guaranteed to invite litigation on grounds that it leaves minority clout stagnant, even though 95% of the 4 million new Texans the Census Bureau counted in 2020 are people of color, and half are Hispanic.

The Dallas-Fort Worth area gets no additional representation, despite leading the state in growth. And it remains the largest region in the country without a Hispanic-majority district, despite a Hispanic population of 1.7 million – nearly as many people as the entire state of New Mexico, and enough to fill two congressional districts.

Rep. Rafael Anchia, a Dallas Democrat who chairs the Mexican American Legislative Caucus, called that “the elephant in the room, the big glaring omission….You really have to try hard to deny Latinos in North Texas the ability to elect the candidate of their choice.”

The House approved the map just before midnight on a party line 80-61 vote, after making minor tweaks that require House and Senate negotiators to meet Sunday and finalize the plan.

The latest census found that nearly 1.1 million people moved into Dallas, Tarrant, Collin and Denton counties since 2010.

That’s more than double the growth in Travis, Williamson and Hays counties, which share one of the two new seats.

Democrats have the edge in that Austin-area district. Republicans will control a new Houston-area seat.

The demographics in both new districts favor white candidates.

Hispanic voters would control seven Texas congressional districts going forward — down from eight in the current 36-seat map.

“It is another step in our state’s shameful history to discriminate against Black, Latino and [other minority] citizens by passing a racially gerrymandered map,” said Rep. Chris Turner of Grand Prairie, chair of the House Democratic caucus. “There’s a lot of problems with this map.”

House Redistricting Chair Rep. Todd Hunter, R-Corpus Christi, defended the plan, saying it complies fully with federal law while keeping together political subdivisions and communities of interest and protecting incumbents.

“Yes there’s been a large percentage of growth,” he said.

The League of United Latin American Citizens demanded new districts in South Texas and Dallas-Fort Worth to fairly reflect growth patterns, asserting that without such districts, the map amounts to overt racial discrimination.

“This plan is a blatant partisan power grab,” said Anthony Gutierrez, executive director of Common Cause Texas. “A fairly drawn map would have given more opportunity districts to the minority communities responsible for all of our population growth.”

Growth in Texas outpaced most of the country, and no other state gained as much in this year’s reapportionment of the 435 U.S. House seats. California slipped but remains the biggest state.

The third special legislative session Gov. Greg Abbott has called this year ends Tuesday. Lawmakers worked frantically to finalize maps, and have already sent Abbott plans for the state House and Senate. The State Board of Education map is still pending.

Democrats complained that Hunter’s committee held a hearing on the Senate-approved congressional plan Wednesday with just 12 hours’ notice. More than 80 people testified. All voiced opposition.

To avoid the risk of delay beyond Tuesday, the House panel approved the Senate’s plan without changes, opting to hash out potential tweaks during a floor debate that began late Saturday afternoon and ended moments before midnight.

The GOP majority shot down one Democratic request after another, offering little rhetorical pushback as Democrats took advantage of the floor debate to air their grievances.

“You think it’s OK for Latinos to have zero representation in the United States House of Representatives in a region that has 1.7 million Latinos. Are you saying that that’s OK?” Rep. Victoria Neave, a Dallas Democrat, challenged Republicans at one point.

The new map carves up Dallas County into six congressional districts, represented by three Democrats and three Republicans.

It packs non-white people into districts represented by three Black lawmakers — Reps. Eddie Bernice Johnson and Colin Allred of Dallas and Marc Veasey of Fort Worth — which keeps them out of neighboring districts held by Republicans.

Allred’s new district is just 36% Anglo. Johnson’s is 18%, and Veasey’s is 13%.

At the same time, some minority residents are shifted into more rural districts where white Republicans dominate, diluting their clout.

Veasey’s gnarled and jagged 33rd District hangs together at one point by a sinew of territory just three-tenths of a mile wide in Grand Prairie. It’s interlocked with District 6, itself connected by a strip in Arlington just four-tenths of a mile wide.

“You can see how the lines of the districts in North Texas snake into ridiculous shapes in order to undermine the growth of minority voters across Tarrant and Dallas counties. The borders of District 33 and District 6 are particularly offensive,” said Turner.

District 6 favors GOP Rep. Jake Ellzey of Waxahachie, who took office July 30 after a special election to replace Ron Wright, the first member of Congress to die in office of COVID-19.

White voters will comprise just under half the voting-age population, with a large number of Black and Hispanic voters from Northwest Dallas County combined with rural voters as far away as Palestine and Rusk in East Texas.

GOP mapmakers used the decennial process to fortify a number of their incumbents.

Freshman Rep. Beth Van Duyne, a former mayor of Irving, won last fall by just 4,700 votes, a 2-point margin. The new map turns the 24th District from a 52-47 Joe Biden district to a 55-43 Donald Trump district.

In one egregious example of cherry-picking voters to dilute Democratic voters’ impact, the city of Denton is shifted into a district that gave Trump a 60-point margin, connecting the Democratic stronghold to the far reaches of the panhandle, 400 miles away.

Overall, the new map expands the number of one-party strongholds — making Republican seats more Republican, and Democratic seats more Democratic.

Republicans will control 23 seats by more than a 10-point margin, up from 14 seats on the current map; Democrats get 13 such seats, three more than they’ve had in recent elections.

The 5th District, held by Rep. Lance Gooden, R-Terrell, one of the most conservative members of the House, would include a quarter-million Black and Hispanic residents of Dallas County — along with enough voters from rural counties to the east to leave a 52.5% Anglo voting majority.

Hispanic advocacy groups have blasted the map as discriminatory and unconstitutional.

Since the U.S. Supreme Court gutted the Voting Rights Act in the 2013 Shelby vs. Holder ruling, states have been able to alter electoral districts without seeking approval from the Justice Department. Lawsuits after changes are adopted take years to work through courts.

The map leaves two competitive districts — one in South Texas, held by Rep. Vicente Gonzalez, D-McAllen, the other stretching from San Antonio to El Paso, held by Rep. Tony Gonzalez, R-San Antonio.

In Collin County, GOP Rep. Van Taylor of Plano gets reinforcements in the 3rd District, which after years of Democratic gains remained in the Trump column by a single percentage point.

Rep. Roger Williams, R-Austin, would likewise end up with a higher concentration of Republicans, and the 25th District sheds Austin and takes in Parker County in North Texas.

The new map pits two Democratic incumbents from Houston against each other, shifting Rep. Sheila Jackson Lee into Rep. Al Green’s district.

There’s a neighboring Democratic district with no incumbent that Republicans anticipate she would run in. But Democrats were furious, and tried unsuccessfully to tweak the map Saturday to eliminate the pairing.

Jackson Lee’s district was once represented by Barbara Jordan.

“That district has been dismantled, removing two universities, downtown and the historic Third Ward,” Turner complained.

Political writer Gromer Jeffers Jr.contributed to this report.

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Science

Ellen Ochoa, first Hispanic woman in space, on challenges, leadership

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This story is part of the Behind the Desk series, where CNBC Make It gets personal with successful business executives to find out everything from how they got to where they are to what makes them get out of bed in the morning to their daily routines.

When people ask Ellen Ochoa if she’d change anything about her life, the former NASA astronaut quickly responds: “Oh gosh, no!”

Any small change to her story, she says, could have altered her historic journey. In 1993, Ochoa became the first Hispanic woman in space. Twenty years later, after completing three more missions to space, she became the NASA Johnson Space Center’s first Hispanic director, and only its second female director.

The milestones are particularly noteworthy considering Ochoa’s background. Her paternal grandparents immigrated from the Sonora region of Mexico to Arizona, before moving to southern California. Her father worked at Sears while her mother stayed at home raising five children.

Becoming an astronaut is never easy. Ochoa’s experience was all the more challenging as a Hispanic woman in the ’90s.

“I did get some discouragement,” she tells CNBC Make It. “I can’t always say whether it was because of my Hispanic background or because I was a woman, because people don’t actually tell you.”

Today, Ochoa, 63, is retired from NASA and living in Boise, Idaho. These days, she says, she realizes her mission was always more than just going to space.

For decades, Ochoa has spoken to students across the country, especially in Hispanic communities, about getting involved in engineering and space exploration. She has been featured in children’s books, textbooks and has at least six schools named after her, many of which focus on STEM education.

Here, Ochoa talks about her journey to becoming an astronaut, how she handled workplace challenges along the way and the lessons she learned rising to the top of NASA’s management ranks.

On developing a relentless childhood work ethic: ‘As you can see, it was definitely worth it’

My dad’s parents were Mexican, and he was the youngest of 12. By the time he was born, he was born in California. I grew up in La Mesa, a suburb of San Diego.

My mother wasn’t Hispanic. She was born in Oklahoma, and moved to California when she was a teenager. My parents got divorced when I was in junior high, so she was really the one around when I was in high school.

My mother loved learning, and knew education was important to us. She had didn’t have the chance to go to college when she was younger. So the whole time, when my four brothers and sisters and I were growing up, she was taking one college class a semester. We would always hear her talk about her classes and see her do homework, along with us doing homework.

Homework always came first. Then my music — I started playing the flute when I was 10, and much later, got to play my flute in space — and other things. As you can see, it was definitely worth it.

On pursuing science and engineering: ‘I would run into people who didn’t think I should be there’

When I was going through school, it was pretty unusual for a woman to be in STEM fields. Certainly, any woman of color. In some [classes], I was the only woman. In others, maybe one of two or four. I can only remember one class with more than that.

I did get some discouragement. I can’t say whether it was because of my Hispanic background or because I was a woman, because people don’t actually tell you.

When I was at San Diego State University as an undergraduate, I started to explore STEM fields. I went to talk to a professor in the electrical engineering department. He made it very clear: He was not interested in having me in his department.

He said, “Well, we did have a woman come through here once, but it’s a really difficult course of study and I just don’t know that you’d be interested.”

Fortunately, I also talked to a professor in the physics department who was much more encouraging. That’s a pattern I saw throughout graduate school and early my career: I would run into people who didn’t think I should be there, but also other people who were really supportive.

My Ph.D. advisors at Stanford, for example, were very supportive — and that certainly made a huge difference in my career.

On deciding to become an astronaut: ‘I really needed to see’ people like Sally Ride do it first

My first year in graduate school [in 1981], the space shuttle flew for the first time. NASA started to open up who they were looking for, in terms of selecting astronauts — much more interested in a variety of people with different kinds of science and engineering degrees, with less emphasis on military pilots.

A couple of years later, Sally Ride flew. That was a huge milestone: the first American woman in space. She had been a physics major, like I had. She had gone to Stanford, where I was getting my Ph.D.

Then, two years after that, the first astronaut of Hispanic heritage, Franklin Chang Diaz, flew. A lot of things were changing. Certainly, the space world was changing. I really needed to see those kinds of comparisons for me to think about it.

When I was in graduate school, I decided that I would send my application to NASA as soon as I got my Ph.D. — so I did that. About two years later, they called me and asked me to spend a week interviewing for the astronaut program.

It was my first time at the Johnson Space Center, and my first chance to talk with astronauts in person and really find out what the job was like. I wasn’t selected, but I was encouraged to keep my application updated.

I later took a research position at NASA’s Ames Research Center, in Mountain View, Calif. About six months after that, I became the head of a research group of about 35 people there. And then six months after that, I got called to interview for the astronaut program again.

I found out about six months later that I was selected.

The five NASA astronauts assigned to fly aboard the Space Shuttle Discovery for the 1993 STS-56/Atlas-2 mission are pictured in training versions of their partial-pressure launch and entry garments. Left to right are astronauts Kenneth D. Cockrell, Steven S. Oswald, C. Michael Foale, Kenneth D. Cameron and Ellen Ochoa.

Historical | Corbis Historical | Getty Images

On fighting discrimination in the workplace: ‘These were people who didn’t know me at all’

When I joined the astronaut corps in 1990, women had already been there for 12 years. There were a couple of astronauts already with Hispanic backgrounds. But I was the first Hispanic woman.

After my first interview, I got a pilot’s license, because those skills are very transferable to the astronaut job. Still, the other astronauts really wondered about me, coming from my research background: “Well, OK, but can you perform operationally? You might be really smart and know a lot about engineering or science, but we also need people who can make decisions on the fly and operate in high-stress and high-visibility environments.”

Looking back, every time somebody told me that I couldn’t do something or it probably wasn’t suited for me, or made some comment about women or other underrepresented groups, they were really just revealing [their own] bias.

These were people who didn’t know me at all. They hadn’t seen somebody that looked like me before in their department, and just couldn’t really picture me as someone who could do the job.

On the success of her first space flight: It gave a lot of people ‘something to think about’

After just a couple of years, I was assigned to my first flight. Our crew had a press conference, maybe 10 days before the flight, and somebody asked me, “What are you most afraid of?”

And I said, “I’m most afraid of being in a car accident sometime in the next 10 days and not getting to go.”

When I got back, I got all kinds of invitations to speak at schools with high Hispanic populations. It feels really good to reach out to students who didn’t [previously] see people who looked like them accomplishing things in the science, engineering or space world.

It gave a lot [of people] something to think about, the same way that I really started thinking about space after I saw Sally Ride flying.

STS-96 Mission Specialist Ellen Ochoa holds her son, Wilson Miles-Ochoa as she steps off the bus at the Cape Canaveral Air Station Skid Strip June 7, 1999. The STS-96 crew members are preparing to return to the Johnson Space Center in Houston, Texas, after a successful 10-day mission to the International Space Station aboard Space Shuttle Discovery. (photo by NASA)

NASA | Getty Images Sport | Getty Images

On fighting for leadership and management roles: ‘I made the same mistake that a lot of women or people of color probably make’

Sometimes, when people asked, “Would you change anything?” I’d be like, “Oh gosh, no!”

When I went into management leadership positions at NASA after I was done flying as an astronaut, I made the same mistake that a lot of women or people of color probably make, which is [assuming that] if I just put my head down and work hard, opportunities will come up.

People still weren’t seeing me as somebody who was ready or even interested in the next level of leadership. If there’s a lesson, it’s that you need to explicitly have these discussions with your supervisor, or maybe even a layer or two above that.

The decisions I made ended up working out for me, but you absolutely just don’t know that at the time. I think you have to trust yourself a little bit.

Any small little thing might have taken me down a different career path. If I hadn’t talked to that physics professor, I probably wouldn’t have gotten into STEM at all, and none of this would have happened.

On managing through crisis: ‘The worst times that I had at NASA’

The worst times that I had at NASA were after we lost Shuttle Columbia [in 2003, when the spacecraft broke up while returning to Earth, killing seven astronauts].

I had just gotten into a management position, and I was representing the crew office in mission control that morning. It was the absolute worst thing that can ever happen. It was difficult personally, and for everybody that worked at NASA and their families.

We had a playbook for bad days at NASA, so we weren’t just making up things on the fly. I was one of the people that day that talked to the astronauts who were on the International Space Station, to let them know what happened. It was a long day.

We all tried to do two things: figure out how to best take care of [the astronauts’] families, and then understand what happened [so we could] get back to flight. And we had to do that as a team.

Some people were saying, “Well, we’re never going to make it safe enough, and we shouldn’t go back to flight.” Others were saying, “Well, we have to accept the risks, and we should get back flying right away.”

What we did was in the middle. We tried to understand more specifically what happened and what we needed to fix. In addition to fixing the technical issue and developing a way to inspect the shuttle on orbit, [we took] actions to address organizational causes — like the Mission Management Team going through training to improve communication.

The two and a half years after Columbia, before we got back to flight, were pretty difficult. But the fact that people had the same big goal in mind certainly made it a lot easier.

Advice for the next generation: ‘You don’t want to listen to discouragement from people that don’t know you’

It wasn’t easy along the way.

You don’t want to listen to discouragement from people that don’t know you. That’s really telling you more about them. It doesn’t say anything about you or your talents, interests or passions.

As time went by, I really grew to appreciate the power of intent and what a team working together can achieve. Missions don’t happen because of one individual. That teamwork aspect is something that I think I’ve carried with me, in every position.

As an astronaut, I was already in a visible position, one where I had the opportunity to illustrate my own knowledge, contributions and teamwork. My advice to others is to have career conversations with your supervisor — or sometimes a sponsor, if your supervisor isn’t receptive — to discuss where you’d like your career to go, and what steps you can take to help improve the odds of getting there.

At one point in my career, I just assumed that my hard work and accomplishments would make it obvious that I was ready for the next level — and [I] found out that wasn’t the case. I had to speak up about what I thought I was capable of doing, and what I wanted.

This interview has been edited for length and clarity.

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US

Latinos own and disown ‘Hispanic’ in journey to harness identity

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Ligia Cushman, who grew up in New York City’s predominantly Dominican neighborhood of Washington Heights, remembers being told “you’re not Black, you’re Dominican.” She used to identify herself as Hispanic until she moved to the Deep South.

“That is where I had to come to terms with the fact that the world, the larger spectrum of the world, doesn’t necessarily see me as Hispanic,” Cushman, 46, said.

While living in states such as Tennessee, Kentucky and North Carolina, she faced instances in which her Latino identity was questioned. She specifically recalled one instance in which a co-worker told her their team needed to hire a Hispanic woman, even though Cushman had been working for that team for five years.

“I thought it was a joke, and she literally wasn’t joking,” she said. Following those kinds of experiences, she learned about the term Afro Latina, one that embraced both her Blackness and her Dominican roots.

“Identifying in that way, is what gave me some closure. And it also helped me learn to love myself,” she said.

As Hispanic Heritage Month kicks off, Latinos grapple with the decadeslong debate on whether or not the pan-ethnic terms that exist to identify their communities truly represent their lived experiences.

The term Hispanic first emerged in the 1960s when Puerto Rican civil rights groups and others such as the National Council of La Raza, now called UnidosUS, advocated for a way to count people who could trace their roots to Spanish-speaking countries in Latin America, the Caribbean or Spain in order to identify specific needs and fight for policies that could improve their livelihoods.

In 1968, President Lyndon Johnson signed a bill to celebrate Hispanic Heritage Week and recognize the contributions, diverse cultures and extensive histories of Hispanic and Latino communities in the U.S. starting Sept. 15.

But the federal government officially adopted the term Hispanic as a descriptor for this population in the 1970s under President Richard Nixon. It became an Office of Management and Budget directive in 1977, with the purpose of including the term in the 1980 census count, according to Mark Hugo Lopez, director of race and ethnicity research at the Pew Research Center.

Hispanic Heritage Week was later extended to Hispanic Heritage Month during President Ronald Reagan’s term in 1988. Throughout the following decade, other terms such as Latino and Latinx emerged, with Latino being included alongside Hispanic in the 2000 census count.

Newer terms such as Afro Latino or Black Hispanic have also been adopted in academic spaces in recent years to highlight particular experiences of Black people who also belong to other ethnic groups.

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Alternate terms for Hispanic have become crucial for Latinos such as Alfredo Corona, who wanted to shy away from the original term.

Corona, 26, said he does “not really like to use terms like Hispanic and Latino too much,” which implicitly anchor the ethnic identity to Latin America’s colonial period when mixing occurred among Indigenous people, white Europeans, Black slaves from Africa, and Asians. Instead, he prefers to identify as Chicano, a term popularized by people of Mexican descent born in the U.S. during the 1960s, since it adds value to his indigenous roots while also acknowledging his American upbringing.

He even pays tribute to his roots through Chicano rap music. His artistic name, Aztec Speech, is an ode to the rapper known as Speech of the Atlanta-based hip-hop group Arrested Development — as well as the Aztec tribes that once lived in central Mexico, where Mesoamerican culture flourished prior Latin America’s colonial period.

“We really would call ourselves Mexicas,” Corona, who lives in the Atlanta metropolitan area, said about coming up with his rapper name before learning that Aztec was the term European colonizers used to describe Mexica tribes. “But I guess it’s too late now to change it.”

Fatima Garza also identifies as Chicana. But as a Mexican American who lives in south Texas, the 21-year-old identifies as a “fronteriza,” or borderlander. It is specifically someone who lives in the U.S.-Mexico border area and navigates both languages and cultures.

“We didn’t cross the border, the border crossed us. So, there’s this very unique experience,” Garza said. “My family has experienced this state of not being from Mexico, but not being from the United States. That’s why I find it so important to call myself a fronteriza.”

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Health

Working age Hispanic immigrants were 11 times more likely to die of Covid in California, study says

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A steady stream of research has shown vulnerable communities across the United States are impacted the most by the COVID-19 pandemic, and a new study uncovers a stunningly huge inequity among a specific group in California.

Researchers at the University of Southern California found Hispanic immigrants of working age, that is 20 to 54-year-olds — are 11.6 times more likely to die of the virus than U.S.-born men and women who are not Hispanic. Looking at Hispanics of the same age who were both U.S.-born and foreign-born, the death rate was 8.5 times that of whites.

Among Black men and women age 20 to 54, the coronavirus death rate was nearly five times that of whites.


These numbers are far higher than the ones from the Centers for Disease Control and Prevention, which indicate Hispanics in the U.S. are 2.3 times more likely to die from the virus and Blacks are 1.9 times more likely than whites.

“We all have known since the beginning of the pandemic when numbers were coming up that there were differential impacts for different groups and we saw that especially for Black and Hispanic individuals,” said Erika Garcia, an assistant professor of preventive medicine at the Keck School of Medicine of USC and the study’s lead author. “We haven’t been able to break it down by age group like this. Although we figured there would be differences, we didn’t expect it to be so large. With a ratio, the numbers disparities are much larger among these younger working age individuals, particularly you see it for both Black and Hispanic individuals.”

Garcia and her co-authors said the study is a “call for state officials and public health departments to target vaccinations and treatments to a demographic that comprises the backbone of the state’s agricultural and service industries,” according to a statement on the study from USC.

For the study published March 29 in the Annals of Epidemiology, researchers analyzed the death certificates of 10,200 people who died from COVID in California from Feb. 1 through July 31, 2020. “Death certificate data, rather than hospital system or insurance company data, allowed the researchers to capture COVID deaths among historically marginalized groups, including immigrants, who might be underrepresented in health care or insurance systems,” the statement read.

The most frequently observed characteristics among individuals were ages 65 years or above, foreign-born, male, Hispanic,and educational attainment of High School or below.

Garcia said when they took a closer look at the data by age group, the disparities were more significant among younger-aged Asian/Pacific Islanders, Blacks, Hispanics and whites.

While the study didn’t identify the reason for the disparities, Garcia said she and the other study authors hypothesized based on other research that working age Blacks and Hispanics are more likely to work in service industries that require them to leave their homes daily, often for jobs that expose them to high numbers of other people. Hispanics are also more likely to work in agriculture jobs.

“Within each of those groups, there are differences in risks, and risk factors may be different between black and Hispanic and men and women,” she said. “A lot of it has to do with living conditions, and if there are multiple people living in a home. People who have to leave the home for work are at a higher risk and working conditions and having to take public transportation also play into it. The risk factor for COVID is higher if you have to come into contact with more people.”

Jon Jacobo, the health committee chair for the San Francisco-based Latino Task Force, wasn’t entirely surprised by the study results though he said he was stunned by the disparity between working age Hispanics and whites.

“The number did pop out as something a lot higher than what I had anticipated,” Jacobo said, “We know the national average is 2.3 times higher. It falls right in line with the pain we’ve been seeing on the front lines.”

Jacobo said the study highlights the pain experienced by Hispanics in agriculture jobs in the Central Valley that has been hammered by the pandemic. The Task Force is assisting with the COVID effort in Planada, a small farming community of 4,500 people west of Merced.

“We’ve talked to people here who have tested positive in their farm jobs, and then they have to drive two hours and pay $200 to $300 for a test to prove they’re negative before they return to work,” he said. “Those have been some of the stories that have been shared with us and have been painful for us to listen to. You think of the disparities and inequities and access to resources among these farm workers who support all the food that comes into our homes and to the tables.”

He also noted that Hispanics have been hit harder not due to individual choices but due to systems and policies that have long been in place.

“It’s not that we don’t know how to wear masks,” he said. “It’s not that we don’t follow CDC guidance. And it’s not that we don’t think this is real because in fact we know that it’s real more than anyone because our community has been hit so hard. It’s the legacies of racist policies that were enacted with this country’s founding and continue to be perpetuated today.”

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