Arab Americans, deemed 'white' in government records, are suffering an unseen COVID-19 crisis

Undertaker Goulade Farrah is haunted by his clients, whose grief for loved ones who lost to COVID-19 keeps playing on his mind.
The hospital told us he was fine and the next thing we know is that he is working on a ventilator.
They said go home and let us know when their oxygen level is that number but when we went back it was too late.
We're devastated, we couldn't even be with him when he died.
Approximately 90% of the deaths Farrah committed at Olive Tree, the Stanton, Calif. Morgue, about 42 km south of Los Angeles, are now COVID-related. Many are Arab-Americans.
Across the country, Arab Americans and their advocates fear alarming rates of COVID-19 infection and death in their communities - but there is little data to support these concerns, as most are classified as "white" by the federal government.
The nation's 3.7 million Arab-Americans are unable to identify themselves as such on census records and other forms of government. As a result, official health data can be difficult to obtain as experts and community leaders are forced to rely on patchwork data, often self-compiled.
The problem was exacerbated by COVID-19, raising concerns for a community already exposed to numerous risk factors for the virus, including large numbers of immigrants and refugees, poverty, multi-generational households, and high rates of high blood pressure, diabetes and heart disease .
"We are told we know when in reality we are being deprived of correct and accurate statistical data," said Hasibe Rashid of the Planning Department in New York City during a web panel this week on the social and economic impact of the virus the city's Arabs immigrant and refugee populations. “We are expected to adapt to something we disagree with, and worse, to something that society does not see us. We don't live the life of a white privilege. "
Without a racial or ethnic identifier, coronavirus infection rates in the community are "extremely unreported," said Madiha Tariq, assistant director of the Community Health and Research Center for ACCESS, a Dearborn, Michigan-based welfare agency that serves a predominantly Arab-American population in Michigan serves several surrounding counties. "This has created a false sense of security among community members who believe this is not a disease that affects them."
Hasan Shanawani, a pulmonologist in Ann Arbor, Michigan, and president of American Muslim Health Professionals, an Islamic-oriented nonprofit focused on public health, said the unrecognized status of Arab Americans has left them and their health problems forgotten .
"They all just check the 'white' box and get mainstream," he said.
A growing but invisible population
Raed Al-Naser, an intensive care doctor at Sharp Grossmont Hospital in La Mesa, Calif., East San Diego, noted that during the first waves of the pandemic, a disproportionate number of Arab-Americans came to the site's intensive care unit early for complications treated with COVID last year.
As president of the chapter of the National Arab American Medical Association in San Diego, he spoke to colleagues in other Arab-American enclaves around the country who confirmed they were seeing the same thing.
By the summer, Al-Naser was writing editorials in local publications in hopes of drawing attention to the subject. From March to December, he sifted through hospital records and found that 11% of people admitted to Sharp Grossmont with COVID-related illnesses were Arabs - about twice as many as would normally be admitted for that population.
"Nobody noticed the effects of this disease in the community," he said. "When it comes to ethnic minority Arab Americans, they are always visible when the news is bad, but invisible when it is their health."
"COVID-19 has made this reality more visible and undeniable," added Al-Naser. "And the health gaps deepen if we don't realize that these communities are not being served."
More than 500,000 Americans have died from COVID-19. Federal data shows that blacks are nearly twice as likely to die from the virus compared to non-Hispanic whites, while death rates for Hispanics and Native Americans fluctuate nearly two and a half times compared. There is no official data on Arab Americans classified in the white category.
In New York City, where immigrant and refugee families often double up to afford the city's expensive housing, a survey by the city's Arab-American Family Support Center found that overcrowding is worsening with job losses from the pandemic has and lets the virus leak rampant.
"COVID-19 is spreading like wildfire because they can't isolate," said Rawaa Nancy Albilal, the agency's president and CEO. "And many of them live or work in jobs that put them at the highest possible risk."
The front workers feel it too. In Olive Tree, which serves the southern California area, Farrah's voice trembled as he remembered an Arab-American doctor who retired in the early days of the pandemic to fall victim to the effects of the virus.
"It was awful," said Farrah, who made the doctor's arrangements. "He just wanted to help."
Last month, the community's funeral director and attorney monitored the cases of two other Arab-American ambulance doctors who had died of COVID and unsettled doctors who knew the couple had asked Farrah for help drawing up their will.
"You got the best treatment," said Farrah, "but nothing can stop this virus." It's all COVID. It has now become normal. "
Arab Americans have high risk factors for COVID-19
The country's Arab-American population has at least doubled since 2000 as mostly Muslim immigrants and refugees arrived, due to multiple wars and instability in the Middle East. They come from hotly contested places like Syria, Iraq, Yemen and Palestine and have joined a large number of more established, mostly Christian-Arab Americans with roots in Lebanon and Egypt, as well as Arab Chaldeans, an ethnic-religious group from Northern Iraq.
A customer leaves a Lebanese restaurant in Anaheim's Little Arabia neighborhood, just a few miles from Disneyland in Orange County. Southern California has the greatest concentration of Arab Americans.
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Up to 300,000 Arab-Americans live in Southern California, the largest concentration in the country. However, Michigan has the highest population, especially Detroit and nearby areas like Dearborn, where they make up half of the city's roughly 100,000 residents. As of this week, Dearborn and nearby Dearborn Heights, where at least a quarter of the population are Arabs, accounted for a fifth of Wayne County's 64,000 COVID cases outside of Detroit.
Among newcomers, young people in the United States often have a life of poverty, lower levels of education, and jobs as taxi drivers or as workers in restaurants, markets, or dry cleaning services to whom they have exposed health inequalities.
"They are important workers," said Al-Naser of the National Arab American Medical Association. “They work in jobs where they cannot socially distance themselves and have cultural factors that put them at high risk - large, multi-generational families living in the same house and nowhere to go when someone gets sick. " Because of this, we are seeing significant spread of the virus in these communities. "
At the same time, many Arab Americans have avoided being screened for the virus, either without knowledge of the services available or because they were so concerned about their families' care that they did not want to get a positive test result.
"The social and economic implications are costly for these communities," said Al-Naser. "When people are sick, they can't go to work, and when one person supports the family, it's very stressful. That's why a lot of people don't even want to be tested. That makes the whole problem worse."
Los Angeles health workers administer COVID-19 vaccinations on Feb.24.
Many Arab Americans do not want to be classified as "white"
Organizations like the American-Arab Anti-Discrimination Committee and the Arab American Institute have been fighting since the 1980s to change the census’s longstanding census ranking of Arab Americans as whites. As 2020 approached, confidence grew that the federal office would finally add a so-called MENA option for people with a Middle Eastern or North African background to its questionnaire.
Checking the "white" box creates a certain dissonance for Arab Americans, whose experience - especially after 9/11 - does not always offer the privileges of being white.
"After 9/11, we got pulled off planes left and right," said Shanawani of the American Muslim Health Professionals. About a quarter of US Muslims are Arab-Americans, he said.
Shanawani said he was also stopped at an airport, "not because of my appearance, but because of my name."
It's about more than identity: Without a racial or ethnic identity, Arab Americans are also missing out on funding culture- and language-specific social and health services available to other marginalized groups - services that proponents say are vital to addressing problems that they are clearly facing the community.
"We don't have access to funding that other churches have because we don't know the number of churches," said Samer Khalaf, national president of the American-Arab Anti-Discrimination Committee.
The community's sparse health data comes largely from local academic studies in Arab-American areas like Dearborn, Southern California, and New York City.
Hassan Jaber is a member of a Racial and Ethnic Census Advisory Board based in Dearborn, Michigan. Arab Americans who want to be counted in the US census have made political advances but still face political and public obstacles. Proponents had hoped a proposed Middle East / North Africa category would be included in the 2020 census, but the federal office suggested the option for consideration in 2030.
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Getting whitewashed by the picture hurts in other ways. Rima Meroueh, director of the Dearborn-based National Network for Arab-American Communities, said when Michigan officials recently put together a commission to oversee the state's restructuring efforts, they relied on census figures - that is, Arab Americans, a significant segment of the population -. were not specifically considered for inclusion, classified in the white category.
A 2015 study by the Census Bureau found that people from regions of the Middle East and North Africa who had previously identified themselves as white fell from 85% to 20% when offered the MENA option.
In 2018, Trump administration officials filed the MENA option, saying that further investigation was needed to determine whether the category should be viewed as ethnicity rather than race. This means that the municipality's next chance to be recognized by the federal government will not occur until 2030.
A push to educate and vaccinate Arab Americans
Proponents say the lack of reliable community data has robbed them of an important weapon as they struggle to convince some Arab Americans that they are at risk of COVID-19.
"Not only endangered, but also endangered," said Meroueh of the National Network for Arab-American Communities. “Do we have a higher rate of underlying diseases such as high blood pressure and diabetes? Yes, we know that because we work in the church. But until we can collect this data, all that remains is anecdotal evidence. "
The lack of data is critical to countering skepticism, misinformation and pandemic fatigue, issues that also plague the general population, experts said.
However, given the risk factors of the Arab-American community - including cultural and linguistic barriers and, for many, distrust of government agencies based on experiences here and elsewhere - it is greater. Some feel stung by a record of slander and xenophobia after 9/11, while others fall victim to rumors spread on communication networks linked to their home countries or Arabic-language sources on social media platforms such as Facebook, WhatsApp or YouTube are.
Syrian refugee Hamzeh Jouriyeh, 12, studies a map of the United States in the office of the International Organization for Migration in Amman, Jordan. Jouriyeh, his three siblings, and parents went to San Diego, California as part of a year-long resettlement program for 10,000 Syrian refugees to the United States.
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"Arab Americans have been slandered by so much rhetoric that this group is unlikely to trust information obtained from a government agency," Meroueh said. "It's very difficult to access these populations. Trying to work against this tide is a really big job."
San Diego visual artist Doris Bittar, who runs a home literacy program for Syrian refugees, recalled a family she worked with in nearby El Cajon, where up to a quarter of the city's 100,000 residents have Middle Eastern roots to have.
Not so long ago, family members were preparing to go to a community event with Bittar and her husband. "We had masks on and they didn't," she said. “I felt uncomfortable. Nobody was socially distant. "
The family assured her that they had spoken to relatives in Damascus, Syria, who had contracted the virus and survived, and even offered cures.
"It was like, grind some cloves and mix them with honey and swallow it whole before you taste it," Bittar recalled. Instead of carpooling, Bittar and her husband asked the family to follow them in a separate car.
"Lo and behold," she said, "ten days later everyone had COVID."
Proponents say that due to the largely social culture, some in the community also struggle to distance themselves socially.
"Arab communities are very communal," said Jeanine Erikat, community organizer at San Diego's Partnership for the Advancement of New Americans. “You have meetings with your cousins ​​and neighbors and the entire community. It's a common thing. How to stay connected. "
Caskets of Muslims who have died from the coronavirus are being prepared for burial at a busy funeral home in Brooklyn on the first day of Ramadan on April 24, 2020 in New York.
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Such situations can go insane for those dealing with people who have suffered worst from the virus.
"It really annoys me that people don't take it seriously in some sectors," said Janet Slinkard, office manager at the Olive Tree Mortuary in Orange County, where funeral services have been delayed by at least a month. “We were flooded. We have other funeral directors calling to see if we can stand their overflow. "
Proponents fear that the same factors that cast doubt on the virus are now generating skepticism about COVID-19 vaccines. And without clear data on Arab Americans, many fear officials will not know if Arab Americans are receiving adequate numbers of the vaccine.
In Dearborn, Meroueh said that despite two siblings of chemists working on viral vaccine research, she still had to escort her Lebanese mother to a local clinic to make sure she got her first shot at a neighbor who had sketchy information in The neighborhood brought out by her strongly Arab American filled her with last-minute doubts.
And in San Diego County, public health professor Wael Al-Delaimy said a small, unpublished survey of Syrian refugees conducted by his students at the University of California in San Diego found a worrying two-thirds of those polled that did not want to be vaccinated. Poll results, released in December, showed that barely 24% of blacks and 34% of Latinos planned to get the vaccine, compared with 53% of whites.
Al-Delaimy was concerned about the "wild conspiracy theories" spreading on Arab social media and created YouTube videos to encourage people to vaccinate.
"This problem is not going to go away," Al-Delaimy said, noting the arrival of new strains of the virus and the waves of spread that followed as some members of the Arab-American community continued to socialize without adequate protection. "And it's getting worse."
This article originally appeared in the US TODAY: COVID-19 Cases: Arab Americans Hit Hard, But Didn't Count in Data
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