Our Body Politic

The Black Maternal Death Crisis, the Real Reason Black Women Die from Covid-19 More Than White Men

Episode Notes

This week Farai Chideya talks with Representative Lauren Underwood about how the federal government can tackle the Black maternal health crisis. Dr. Rachel Hardeman of the Center for Antiracism Research for Health Equity explains why she focuses on the impact of racism on health. Farai shares the latest findings that Black women are over three times more likely to die of Covid-19 than white men or Asian men in two U.S. states. And we learn about Dr. Justina Ford, a Black doctor in the 1900s who served patients of color in Denver. On Sippin’ the Political Tea, Farai and Errin Haines of the 19th welcome journalist Fernanda Santos to talk about the state of things at the U.S.-Mexico border, and the possibilities of immigration reform under the Biden-Harris administration.


1:03 Representative Lauren Underwood on the Black maternal health crisis

12:00 Doctor Rachel Hardeman on how racism impacts health outcomes

20:45 Covid Update: new study on Black women’s high mortality rates, plus Covid risks for pregnant people

23:52 Sylvia Lambe shares the story of Dr Justina Ford, a Black doctor who delivered 7,000 babies at her home in Denver

30:21 Sippin’ the Political Tea: the state of migrants at the Mexican border, and immigration reform from the Biden-Harris administration

Episode Transcription

Farai Chideya: Thanks for listening and sharing Our Body Politic. As you know, we’re only a few months into this show, and we’re shaping it with lots of input from listeners like you. So I want to ask you a small favor: after you listen today, please head over to Apple Podcasts on your phone, tablet, laptop--or anywhere you listen--and leave us a review. We read those because your ideas matter to us. Thanks so much. 

This is Our Body Politic. I’m the creator, and host, Farai Chideya. Today I’m talking to people working to end the maternal mortality crisis. Maternal mortality rates in the U.S. are the worst of any developed country. And Black women are three to four times more likely to die from pregnancy-related complications than white women.

US Representative Lauren Underwood of Illinois has made maternal health care reform one of her main missions in Congress. She's a registered nurse who worked at the US Department of Health and Human Services before being elected to the House in 2018. And she's co-founder and co-chair of the Black Maternal Health Caucus. Representative Underwood, welcome.

Rep. Lauren Underwood:

Thank you. Hi Farai, I'm so glad to be with you.

Chideya: I am really glad to be with you and you really have such an extraordinary background to bring to lawmaking, start off by telling us about your work in the Black Maternal Health Caucus. Why did you decide to do this work?

Underwood: In 2017, as I was wrapping up my service in the Obama Administration, a friend of mine from graduate school was preparing to become a new mom. Her name was Dr. Shalon Irving. She was a lieutenant commander in the United States Public Health Service Commissioned Corps, working at the CDC on health disparities. And we did our master's in public health together. Anyway, she had a baby, a beautiful baby girl named Soleil, and three weeks later, we lost her. She died of complications related to her pregnancy. Now, as a nurse, I had long been aware of maternal mortality disparity that we see in this country where black women are three to four times more likely to die from a pregnancy related complication than white women. However, this is the first time that it really touched my life personally. And I knew that if I won my campaign for Congress, that this is an issue I want to work on. So I teamed up with Dr. Alma Adams. She's a Congresswoman from North Carolina, and we started to work on this issue. Now because it's Congress, we gave ourselves a name and we called ourselves the Black Maternal Health Caucus, really thinking it was just going to be the two of us, but quickly we got lots and lots of interest and support from colleagues on both sides of the aisle in the Congress. And so now we have over a 100 members and we have some support in the Senate side. And in 2020, we introduced a piece of legislation called the Black Maternal Health Momnibus Act, which is comprehensive legislation to end this maternal health crisis that we face as a country.

Chideya: I'm so sorry about your friend's passing. What's in the Momnibus that we should really know about that sticks out to you?

Underwood: So everything that we are doing is designed to comprehensively address this problem. In the American Rescue Plan, which is this most recent COVID relief package, we have finally passed into law a postpartum Medicaid expansion. And so, so many of the interventions to tackle maternal mortality in this country have had that intervention, that policy change as a foundation, we've done that now, that states have an incentive to extend Medicaid coverage to the full year postpartum. However, we know that Medicaid on its own will not solve this problem. That's where the Momnibus comes in. So we have, for example, in our Social Determinants for Moms Act, funding to expand WIC for postpartum and breastfeeding people to extend WIC coverage and eligibility. Really important, because as we talk about social determinants of health, these are factors like nutrition and housing and transportation that all impact our health status, right? And we have to do this kind of intervention at a systems level to change the policy if we're going to hope to improve the nutritional status of individuals. Our Perinatal Workforce Act to grow and diversify that health care workforce, so that we have the diversity of OBs and midwives and nurse midwives and doulas and lactation consultants. We want to make sure that every birthing person has a choice. And in that another example is mental health. So in my state of Illinois, black women are six times more likely to die from a pregnancy related complication than white women. And the data has shown us that mental health conditions, overdose and suicide are the leading cause of maternal death in our state, which is just a statistic that is mind blowing. We need to have this care and the specialists available in all of our communities, because we're going to continue to lose people if we don't solve this. So that's when I talk about a systems level approach. As the federal government, there are things that we can do to enhance and refined existing programs like WIC, but also to create additional resources for families and communities to solve this problem.

Chideya: Let's talk a little bit about generations. You are a millennial, from what I understand the first millennial representative for your district in Congress.

Underwood: Yes.

Chideya: And all generations have their ups and downs, but the millennials have been dealt a pretty rough card in terms of educational debt, job market fluctuations. And there's a lot of signs that a lot of people are just really frustrated and even people who want kids are like, "I don't know if I can raise a kid in this country, in this economy." For people in your generation, how do you view your work on maternal health in the context of these other things like the economy?

Underwood: So, listen, this is the second recession of my career. My generation is less likely to be homeowners. We're less likely to outpace our parents in terms of wealth acquisition, and that's across race and ethnicity, that is not just a people of color thing. And when we talk about making choices to start a family, making choices and sometimes get married or have a partner, that is something that I think a lot of us feel a real sense of agency in. And that's an opportunity that millennials have that prior generations, particularly for women or other birthing people have not had that same sense of agency. So I would acknowledge that, how far we've come as a society. However, there is a recognition, particularly among people of color, that when we make these decisions, it comes at great risk.

Underwood: Because one of the things we haven't talked about in this conversation is... We've talked about maternal mortality, maternal death, but severe morbidity is also an issue, right? Near misses, people who've had extraordinarily difficult birthing experiences or postpartum experiences. And the statistic says that for every death in this country, there are 70, seven zero near misses. And so, as the result, when we talk about this black maternal health crisis, we talk about it in terms of both. The deaths and the near misses, which as a result, it means that so many of us, from a cultural standpoint, we all know someone. If it's not us, it's our sister, our best friend, our sorority sisters, somebody at our church, the girl from around the corner, we all know these stories and it's become this cultural force. It's not just Beyonce or Serena Williams or Allyson Felix, the great track star. It is something that is so pervasive culturally, that I think as millennials and particularly a millennial in Congress, this is when representation matters, this is a disparity that's been around my entire lifetime and I'm 34 years old. That means we're talking about decades of inaction. And so yes, I'm the youngest black woman to serve in Congress. Yes, there's responsibility that comes with sitting at these tables as a policymaker. And if we cannot solve problems like this... This is what I want people to remember. This is a problem that has not only a solution, but an evidence-based solution. We know what to do. It's about having the courage and having the opportunity to make the change. And I think that among the American people, at least I certainly had the assumption before I was elected, that Congress worked on the most important things, the most important issues in our country. Worked on the toughest challenges, that there was something that was directing our work. No, the members of Congress decide what we work on. We make that decision. And so if we are not present in these chambers, in these bodies, then some of these problems don't ever get addressed. And this is one of these issues where it's just never been on the agenda, but guess what? We're here now. And we built the coalition now. And so now we have this opportunity to save lives and make change.

Chideya: Your bio on your website says that you are a lifelong girl scout. I also was very active in scouting and have great memories of going to sleep-away camp and any number of things. And also my local troop. What do you think that you got from being a girl scout that you've carried forward into your career as a member of Congress?

Underwood: I have been a girl scout. I was a Gold Award recipient, which is the highest award in girl scouting. I've also been a troop leader. I don't have children, so I was a troop leader for some girls in Washington, DC, and I was very involved. And one of the things I always emphasized to my girls in my troop, was that piece of being a sister to every girl scout. And what that means, about working together, about solving problems, about leading with love and compassion and understanding, and patience and teaching some middle school girls in a challenging urban environment about that concept, was something that was difficult for me. But I think that that approach has helped me so much as I do this work in Congress where I'm facing a severe partisanship were in our community, we have so many people who fall all along the ideologic spectrum and are so interested and willing to put up barriers and make those divisions rigid. And my job, and a lot of times, is just to break down the barrier. Well, how do you do that? It's by being a sister to every girl scout and it's a lesson that I learned as a young girl that I've taught other young women. And now I get a chance to implement in my role as the Congresswoman, it's important.

Chideya: Well, Representative Underwood, it has been a great pleasure to talk to you. Thank you so much.

Underwood: Thank you for having me.

Chideya: That was Representative Lauren Underwood of Illinois's 14th Congressional District and co-chair of the Black Maternal Health Caucus. There are so many factors that can impact our health beyond our actual medical history. There is access to social and economic opportunities, jobs, schools, and environment. Dr. Rachel Hardeman researches a root cause of health disparities in the US, racism. Dr. Hardeman is the founding director of the New Center for Antiracism Research for Health Equity at the University of Minnesota School of Public Health. Welcome Dr. Hardeman.

Dr. Rachel Hardeman:

Thanks for having me.

Chideya: So a lot of eyes are on Minnesota right now where the trial of Derek Chauvin is taking place. And it seems, on the surface, to be unrelated to some of the work that you're doing, but what does a trial like this have to do with what people who are black and giving birth have to go through?

Hardeman: I would actually say the two are deeply related, for a couple of reasons. First and foremost, we are watching this trial play out and currently reliving the trauma that we experienced last May, watching George Floyd be murdered. And the pain that came with that as a member of the black community and for me, as someone who grew up just six blocks from where the incident happened. From a public health standpoint, first and foremost, I think people all across our communities and all across the country are struggling right now as we live through the trial. And then as I think about my research, some of my research has actually sat squarely in the space of looking at, does police violence, does living in communities where there are disproportionate amounts of police surveillance, does that impact birth outcomes? And we've actually found in some recent work that will be published soon that indeed it does. So living in a Minneapolis community that is being over-surveilled by police is associated with poor preterm birth outcomes. All of these things happen within the communities that we live in. And so therefore, all of the ways that trauma is happening in those communities or racism is showing up in those communities, it's going to be inextricably linked to the ways that black people in particular are able to give birth in healthy ways or not.

Chideya: We talked to Representative Lauren Underwood about her Momnibus bill. What do you think of trying to legislate approaches to health and public health as part of a broad sweeping approach to ensuring that black maternal life and the children who come from it are preserved?

Hardeman: I think we have to be attacking this issue from all sides and in a bunch of different ways. And so one of them is what we call them public health big P policy, right? So things like the Momnibus bill, which does some incredible things to really bake into the system equity and opportunities for birth equity. We also have to be thinking about little p policy, meaning what's happening in our healthcare systems and at the organizational level. And then we also have to be thinking about this at our community level, right? And thinking about what is it that we can do in our own backyard and what is it that we can do today, tomorrow, because we know policy change takes a long time. One big piece of the puzzle that we've seen happen or get put in place over the past few years is just the attention by the popular press and the media to this issue. And I think that's incredibly important and it's leveraged policy, it's leveraged resources, and it's also created a space for my scholarship and the scholarship of other incredible folks across the country who are really naming the root cause of these maternal outcomes, and that's racism. And so I think what we have to do is be willing to continue to name racism as a fundamental cause for these maternal outcomes and we have to be thinking about, just as we just talked about the fact that we have to be engaging in this work at the big P policy level and across the board, it's going to require undoing racism and dismantling racism at all levels.

Chideya: My grandmother was an incredible person and she died of what I consider race-related medical malpractice, where she should have been diagnosed years before she was with colon cancer based on just everyday protocols, but she was given antacids for her pain. And there's a lot of research showing that black pain is not treated the same way that pain in white patients is treated. And she passed away from what could have been curable. You also had an experience watching your grandmother navigate the healthcare system. Can you tell us about it and what lessons you've taken away from it?

Hardeman: Sure. So I'm sorry to hear about your grandmother. And we certainly share that experience, that lived experience of watching someone we love be mistreated by a system that is supposed to be there to care for them and to heal them and to protect them. And for me as a child, my grandmother had kidney failure and she was on dialysis and would go to a dialysis center multiple days during the week. I remember my twin sister and I spending hours doing our homework sitting next to her at the dialysis center. And as a result, some other comorbidities crept in along the way. And as she sought out care for all of the things going on, she never felt as though the system was being responsive to what she was needing, what she was requesting, how she was feeling. And she got to a point at a very young age in her early 60s where she was just done fighting that fight and ultimately decided to discontinue her care, her dialysis treatments that were keeping her alive and enter into hospice. And at 61 years old, there's no reason that someone should have to make that decision for themselves. There's no reason that their 15 year old grandchildren have to watch them go through that process and help them decide what belongings they're going to give away and how they're going to... The legacy that they want to leave. When I think about that experience and I also think about... I'm a mom. I have a seven-year-old daughter and I had a wonderful birth experience. And I think about that birth experience, my birth experience, and I think about my grandmother's horrible experience with the healthcare system and the two shouldn't have to exist in the same space, right? So I know what can be possible, right? I know what equitable care looks like. I've experienced it. And I feel like it's my duty, it's our duty to ensure that everyone has that opportunity.

Chideya: When you talk to your daughter, and seven is that age where you're old enough to ask questions that are pretty interesting, what does your daughter ask about your work or see in your work? Or how do you tell her about it?

Hardeman: I talk to her a lot about my work and she knows that the goal of my work and the reason I work so hard is to manifest racial justice so that black women and black girls can live healthy and free lives, and that means that she gets to live a healthy and free life. And so we are always talking about what that looks like in our household and grappling with hard questions. We just talked to her the other day about the Chauvin trial and what that means. And I remember even last May when George Floyd was murdered, she kept saying, "This time feels different." And on one hand, it broke my heart that at seven years old, she could say this time feels different, right? But she remembered Philando Castile and she remembered Jamar Clark. And now we get to talk about how it is different. How George Floyd's murder has changed, certainly changed my work and changed the dialogues and the conversations that I get to have about how to, again, manifest racial justice.

Chideya: Well, Dr. Hardeman, thank you so much for spending some time with us.

Hardeman: Thank you so much for having me.

Chideya: That was Dr. Rachel Hardeman, Blue Cross Endowed Professor of Health and Racial Equity at the University of Minnesota School of Public Health. She's founding director of the new Center for Antiracism Research for Health Equity.

Chideya: Each week we bring you the latest news on the coronavirus pandemic and how it's impacting people of color, especially women of color. Health data shows that overall women do better with COVID-19 than men, but according to a new study, it's not that simple. Researchers at the Harvard GenderSci Lab analyzed mortality data in Georgia and Michigan and found that Black women are more than three times more likely to die of COVID-19 than white and Asian men in those states. Here's Dr. Sarah Richardson, director of the lab in an online presentation.

Dr. Sarah Richardson:

Early in the pandemic in aggregate, men look to be having much poor outcomes than women. And largely the debate at that point was around which biological factors might explain those outcomes. But with our toolkit, we tended to think about social and biological factors.

Chideya: The study suggests that occupation is a factor in putting Black women at high risk. They're overrepresented in jobs like home health aides and nursing assistants, where they're often directly exposed to COVID positive patients. This week we're also focusing on maternal health. Research suggests that pregnant women might be at higher risk of severe illness and death from COVID-19 than women who are not pregnant.

Asasiya Muhammad:

The health disparities for women, particularly black women, have been great before COVID-19. This just made it worse.

Chideya: That's Asasiya Muhammad, a home birth midwife in Philadelphia, speaking in a short film by Define American. There's been a surge in women seeking home births. She says it's partly for fear of being exposed to COVID-19 at the hospital and partly because many hospitals won't allow another person in the birthing room for support.

Muhammad: You still have the right to dignified care, you still have a right to a labor companion, and you still have the right to express your concerns. This is a sacred time and you still have the right to treat it as such.

Chideya: We don't know for sure how safe COVID vaccines are for pregnant people. They weren't part of the initial trials.

Dr. Anthony Fauci:

Those studies are going to be done soon and some are ongoing right now, but for pregnant women who have already taken it after the EUA, the Emergency Use Authorization, there doesn't seem to be any problem.

Chideya: That's Dr. Anthony Fauci in a reassuringly cheery White House video this month. A bit more reassurance for the new moms out there. The Centers for Disease Control and Prevention says women who are infected with COVID-19 can safely breastfeed as long as they wash their hands and wear a mask to protect nursing babies. Next week we'll dive a bit deeper into who's at highest risk from COVID-19 and why.

Chideya: We love to ask for your input on the show by inviting listeners to call the speak line. This week we're asking you, how did the pandemic change how you parent? To leave us a message call (929) 353-7006. That's (929) 353-7006. Or go to ourbodypolitic.show for a Google form to respond in writing.

Chideya: Four years ago, journalist and public relations strategist Sylvia Lambe was exploring her new hometown of Denver, Colorado. In the Five Points District, which used to be called the Harlem of the West, she came across the Black American West Museum.

Sylvia Lambe: When you first get there, there's a volunteer docent and she gives you information about what the house is all about and the museum. And I learned that this house actually belonged to the first ever black female licensed doctor in Colorado, and her name was Dr. Justina Ford. And she had delivered 7,000 babies and she was denied membership to the Colorado Medical Society and Denver Medical Society because she was black and she was a woman. And the significance of that was that she was unable to work on staff in any of the hospitals. So she set up a surgery in her home.

Chideya: The museum is well-known for its history of black cowboys, but for Sylvia, Dr. Ford was the star of the show. She decided to become a docent herself.

Lambe: And so every Friday in the morning I would go down there and volunteer. And I knew that Dr. Justina Ford's story was inspirational. And I kept thinking to myself, why don't people know more about this? So one day I was behind the desk and then somebody came in. It was this Hispanic guy came in with his wife. And he was all in suit. He looked pretty smart. And then he says, "Is this Dr. Justina Ford's house?" And we said, "Yes, it is. Yeah, this was her surgery as well." And he goes, "Oh, okay." And so he reaches into his pocket and he pulls out this piece of paper and he goes, "She delivered me." And it was his birth certificate. It had her name, her initial on it. And it was, "Oh my God, one of the babies." Because in the spill, we always talk about these 7,000 babies.

Joseph Martinez:

My name is Joseph Martinez. I was born in October 13th, 1948. I am one of 7,000 Ford babies.

Chideya: Sylvia began documenting Joseph Martinez's story starting with when he saw Dr. Ford's name pop up on an ad for Black History Month and how that prompted him to show up at the museum.

Martinez: So when I got down there and saw her picture, I melted. Couldn't believe it. It was like her spirit was there and entangled with my spirit all over again, like that moment when I was delivered. It was just overwhelming. It still is. To this day, every time I think about it, it's great. It's a good feeling.

Chideya: Martinez's story gave Sylvia an idea. She put a call out on social media to find other Ford babies and invited them to the dedication of a mural honoring Dr. Ford.

Lambe: Starting from six people on my now burgeoning spreadsheet, I had 50 names. It was beyond my wildest imagination that so many people will be so interested in being part of this event. And all of them talked so fondly about Dr. Justina Ford. And you know what was beautiful about all these different kinds of people, different cultural heritage people turning up was that they could pass each other on the street and not realize that they have this massive thing in common, this joint love for Dr. Justina Ford. A lot of the people she said were the underserved communities. For the immigrant communities, a lot of people didn't have insurance. Often, they paid her in vegetables and did work in her home because they didn't have money to pay her. They talk about her going to their house and staying at their house for two days while their mother was in labor. And when the children were sick, that she would come to the house and stay in the house until the child was better.

Chideya: Sylvia began filming a documentary and gathering more testimonies. One of the people she found was a woman named Olivell Owens who gave birth to twins when she was just 14.

Lambe: She talks about Dr. Justina Ford in the fondest way. She has a clear memory of her. And she said, "Yes, I was only 14. And Dr. Justina Ford didn't even tell me that I was having twins because she thought I would be too scared to know that." Oh, she goes, "One baby came out. Then the next baby came out. And then she told me that I needed to concentrate on my career, I needed to do something for myself. And just the fact that I was 14, with these two children, didn't mean that my life had to stop." And she goes, "She was not just my doctor, she was my doctor friend."

Chideya: Sylvia says Dr. Ford was ahead of her time.

Lambe: Dr. Justina Ford's message to the medical community today would be, "Really? Has nothing changed after all these years? Do we still have such high disproportionate rates of maternal mortality? I've come back and I'm looking down on you and I'm shaking my head and wondering why this is still an issue that we do not have universal health care, we are not looking after the disadvantaged in our society." Her story is a story of black America, of the underserved in America, of multicultural America, and of people that struggle. Let's make sure that she understands that we are carrying that baton, that for her legacy, we're going to continue making sure that people have medical care that they deserve.

Chideya: That's Sylvia Lambe, PR strategist and journalists. If you want to help honor Dr. Ford's legacy, or if you're a Ford baby yourself, you can find more information at lambepr, that's L-A-M-B-E-P-R.com or search for the Dr. Justina Ford Facebook Page. Each week on the show, we bring you a roundtable called Sippin' the Political Tea. And joining me this week is Our Body Politic contributor, Errin Haines, editor at large at The 19th. Hey, Errin.

Errin Haines: Hey, hey Farai.

Chideya: And we've also got Fernanda Santos, contributing columnist at the Washington Post and professor at Arizona State University. Welcome to Our Body Politic, Fernanda.

Fernanda Santos:

So glad to be here.

Chideya: Errin, another week in politics. What are we going to tackle today?

Haines: So it is Farai. Listen, we're approaching the end of the first 100 days of the Biden-Harris administration. And by all accounts, there is an increase of migrants at the Southern border. Here's President Biden with ABC's George Stephanopoulos just last month.

George Stephanopoulos:

It's going to take some time, though, to get those policies in place again. Do you have to say quite clearly, "Don't come."?

President Joe Biden:

Yes. I can say quite clearly, don't come. And what we're in the process of getting set up, and it's not going to take a whole long time, is to be able to apply for asylum in-place. So don't leave your town or city or community.

Haines: Fernanda, what do you make of the increase in President Biden's response?

Santos: First of all, this is not a new issue. Right? Biden is the third, at the very least, the third president who has had to deal with an increase in the number of migrants coming to the Southern border. And this idea of stay home until everything is set up here so that you can come and we have a nice, smooth process going for you, doesn't really work when you are living in countries where there is no stability, where violence is at numbers that are approaching war-place numbers, where there are no jobs, where there's no food, where you cannot feed your kids. So, there is a lack of understanding, in my opinion, of the real situation in Central America. And any kind of reform has to start there and has to start with the US's cooperation because part of the problem or part of the problems that Central America has faced have a lot to do with the way the US responded back there in 80s when they had civil wars.

Haines: Yeah. Earlier in the Biden-Harris administration, the White House called the increase a crisis. But here's White House press secretary, Jen Psaki, late last month saying just the opposite.

Jen Psaki: Children presenting at our border who are fleeing violence, who are fleeing prosecution, who are fleeing terrible situations is not a crisis.

Haines: Farai, help us understand the calculus behind this administration's choice of words.

Chideya: One of the reasons that the language is so complicated here, in addition to what Fernanda was saying about the US international relations having really displaced a lot of political stability in Central America over the years is that this is also a chance to follow the money. US businesses, as we'll continue to discuss in this roundtable, use undocumented workers all the time, particularly in agriculture and hospitality, but many, many, many different fields in the US. And so, I think that despite the fact that some people come here to earn money, the reality is that the US is a place that benefits tremendously from people who are willing to work for less. And yet that is not seen as sort of a valid reason to come to the US without papers. And then, on top of it, you have all of the people who are fleeing direct violence, who are not economically displaced. I would argue that economic displacement is a form of violence. There can be economic violence just as there is in the United States. Not everyone agrees with that. But people who were fleeing direct violence are seen as more sympathetic and do have a different place in America's legal structure of applying for asylum. And so, the Biden-Harris administration is slicing everything very thinly and trying to thread the needle. But I think this is something where these issues are not going to carry the same way across partisan lines and some of the backstory and the facts here are not necessarily going to produce alignment around solutions.

Haines: Yeah. Good points. So Fernanda, let me come back to you. Would you say there is or isn't a crisis?

Santos: I want to add one quick thing to what Farai said that I think is really important to remember, and that is also that they're suffering in Central America with climate change issues. They have dislodged subsistence farmers from lands where they had farmed to feed their families for generations. So there are also a lot of people coming to this country because of that. And that makes this pattern of migration a global crisis. And I use the word crisis because climate change is a crisis, economic displacement is a crisis. And it's not unique to Central America. Recently, here in Arizona, I was at a church that's receiving some of the overflow migrants that have not been able to be served by a welcome center set up here in Phoenix. And many of these migrants were from Brazil, my home country, a country where right now there is a major economic crisis and a major crisis related to the pandemic. And so, it's interesting to see how the ripple effects of all the different policies or lack of policies that started here, in many ways, or that didn't start when should've started, have created conditions in these countries. And many people in these countries feel that the only way out is to leave and to come to the United States. This idea of the "yellow brick road," right, has always been sort of like the myth of the immigrant dream of the United States. The "yellow brick road" that if you work hard here, you make money and you make a decent living, that's still very much something that migrants all over the world, but in particular in Central and South America, think about when they decide to come here.

Haines: Yeah. So many factors that you rightly point out there. I just add to that that I do find it telling that the Biden-Harris administration's decision on day one to prioritize the family separations and in these recent days, delegating and working with Honduras, Guatemala, and Venezuela to find solutions, delegating that to Vice President Harris in these first 100 days of the administration seems to be a clear sign kind of what their priorities on this issue are. So, as I just mentioned, President Biden chose Vice President Harris to be in charge of the border crisis. Fernanda, what are your thoughts on why he did that?

Santos: Well, I think that in some ways he's preparing her to replace him in four years, to be quite honest. I also think that Kamala Harris has a reputation as a fierce negotiator and a very capable negotiator. And there's a lot of negotiating that's needed here, both in Congress, but also internationally. And he wants to put her front and center to give her a chance to show her diplomatic skills and her negotiating skills. I also think that she had a very ambitious plan as a candidate for president when it came to immigration. And that's something that progressive groups that supported the Biden candidacy that helped elect him, in particular, here in Arizona, might be pushing to see someone who will be pushing, not only for keeping families together while they come into the country, but also to finding a way, a path to citizenship for families that have here for quite some time.

Haines: Yeah. As you mentioned, I mean, we saw Vice President Harris as a presidential candidate in the 2020 Democratic Primary involved in this issue in Florida visiting a detention center, very concerned about what was happening to the folks who were there. And then, obviously, I think, her lived experience as the daughter of an immigrant combined with her political resume and her experience prior to becoming a presidential candidate and now vice president, she could bring that to bear. It'll be interesting to see how she does that as she attempts to tackle this issue.

Haines: So let's talk about other happenings on the national level. Several bills could put undocumented food and farm workers and others on the path to citizenship. Farai, how far are these bills likely to go?

Chideya: Well, there's a flurry of legislation. Every now and then, you have to get into your nerd mind. And there's something called govtrack.us that lists bills that are circulating by topic, among other things. And so, I went on that and it's like, "Oh, there's just too many to name." But there are some that are really out in front. That are really out in front. What's interesting to me is looking at also where there's even a hint of bipartisanship. So one of them is the Farm Workforce Modernization Act. There are agricultural workers who are undocumented and who are, yet, absolutely integral to the food supply chain in America. And finally, the US is after, frankly, at the start of the pandemic, in part saw food rotting in the fields because the supply chain just doesn't acknowledge, essentially, how it functions on a lot of undocumented labor, as well as American labor and resident labor. That one actually did get, in the House, 30 Republicans helping to pass it, but it's not clear that any of these bills will pass the Senate with the slim margins. It seems more likely for something like the Farm Workforce Modernization Act, that's more narrowly tailored, than for the overall, omnibus, US Citizenship Act, which was proposed by President Biden and introduced to Congress in February. That will probably have a harder time navigating all of Congress. And then there's a Citizenship for Essential Workers Act, establishing a track to citizenship for 5 million essential workers on non-immigrant visas and their family members. And in addition, there's another look at what is happening to people who are the Dreamers. There's a Dream and Promise Act that also passed the House of Representatives. So, I think that some of this is waiting on tenterhooks to see what the Senate does. And there probably will be a series of negotiations around how many smaller, more tailored immigration-related acts make up something that looks like Omnibus. But right now, a lot of people who are longtime political observers don't see the overall political will to pass something like the US Citizenship Act.

Haines: Yeah, it's interesting to me that this latest immigration debate is really just kind of wedged between the passage of the American Rescue Plan last month and the start of the push to pass infrastructure. We're discussing immigration against the backdrop of an ongoing pandemic, as the country is looking towards recovery. And I think if we've learned anything in the past year, it is really that so many immigrant workers are indeed part of this country's human infrastructure, and that the country needs a new normal around this issue going forward.

Haines: So, let's go to the state level. Fernanda, you teach in Arizona, let's talk about what's been happening with access to higher education for Dreamers. Undocumented Arizona residents would be allowed to pay in-state tuition under a measure approved by the Republican-led state Senate last month. What does that mean for students, like those you interact with, and do you think this would ever be possible on a national level?

Santos: So it's very interesting here in Arizona because, in 2006, a voter approved proposition, and it was approved by like 73% of the voters, stripped undocumented immigrants from the right to pay in-state tuition. So, undocumented immigrants who are residents of the state of Arizona no longer had access to in-state tuition, to any kind of publicly sponsored scholarships, so state or county level or city level, and also the availability of other types of services for undocumented immigrants, including, for example, adult education for undocumented immigrants. So, if they come from a country whose language is not English, and they want to come here and take advantage of state-sponsored or County sponsored ESL classes, they cannot do that. They have to pay if these classes are free. So, in this current legislative session, a bill recently passed the Arizona state Senate, which is majority Republican, and it passed because three Republicans broke with the majority and voted for it. And in fact, one of them was the sponsor of the bill, and that bill would restore the right of undocumented immigrants to pay in-state tuition in state colleges and universities, and also community colleges, which, for many of them, is the entryway into the higher education system. Now, we're talking what, 14, 15 years after this voter sponsored proposition, right? So, there's an entire generation that suffered from this decision. And in a state like Arizona, where currently about 33% of the population is Latino, and where Latinos are projected to become the majority, or so-called minority groups are projected to become the majority in 10 years, really to continue policies like that is to shoot yourself in the foot. It's to undermine your ability to grow as a state, because you're not allowing people to be educated. So, there is some hope. I don't know how it's going to be in the House, because it's also a Republican controlled house. So, we would need some brave Republicans to break with the majority and vote for it. But I think that, if there's any time for it to happen, is now because again, this is a very sympathetic constituency. It's a group of people that both sides of the aisle want to give some permanency here, or want to see some type of solution for them. Not everybody, but a good number of people on both sides of the aisle. So, there is some hope here.

Haines: Yeah. Farai, I'm wondering if you see a benefit to making immigration policy like this on the state level.

Chideya: Well, Fernanda obviously is in Arizona, and I spent some time there in 2010 recording radio documentaries. I interviewed local immigration organizers. I also interviewed Russell Pierce who created the law, SB-1070, that was a real watershed in the anti-immigrant laws, that really crossed the line in terms of looking at how they intersected with anti-discrimination policies, and really set off or intensified the racial profiling of Sheriff Joe Arpaio. And I do think that one of the things that's really happened, that Fernanda knows a lot more about than I do, is that law in 2010, SB-1070, really was, in many ways, a factor for Arizona turning blue in 2020. Policy has consequences and that was a case where, over time, I think that it did help bring Latino Arizona voters together. And even non-voters. When I went in 2016 to interview people in Arizona, there were a lot of undocumented teens who were actually knocking on doors, trying to get people to vote and saying quite directly, "We can't vote. We hope you will." And so, all of that, I think means that every state has specific dynamics. And often we do see these cyclical changes in policy, as different groups are activated.

Santos: And you made such excellent points Farai, and it is true that what SB-1070 and Sheriff Joe Arpaio did sparked this resistance movement here, both by undocumented immigrants, but also the children of undocumented immigrants, and many immigrants who are here legally. I mean, it's not just a state full of undocumented immigrants, and that's one of the things about immigration that's been so corrupted out there, is the idea that if you are from Latin America and you are in this country, you are automatically, in the minds of many people, considered an undocumented immigrant. If you're in Arizona, you are an undocumented Mexican, you know? So it's interesting for me to be a naturalized citizen from Brazil and Arizona, and go around interviewing people because I noticed the puzzlement in their faces. "What are you doing here?" And so, it's great to see this evolution, really, the political evolution of this class that was so oppressed under Arpaio. And that, today, is really leading the change here. For Joe Biden to have won Arizona, and he needed the support of these grassroots organizations.

Haines: The tea goes for us around here. We're going to have to leave it there for now, but it was nice talking with you, Fernanda.

Santos: It was great talking to you. Thanks for having me.

Haines: And always nice to chat with you again, Farai.

Chideya: Thanks so much, Errin. Thank you so much for joining us on Our Body Politic. We're on the air each week and everywhere you listen to podcasts. Our Body Politic is produced by Lantigua Williams and Co. I'm the creator and host, Farai Chideya. Juleyka Lantigua-Williams is executive producer. Paulina Velasco is senior producer. Jen Chien is executive editor. Cedric Wilson is lead producer and mixed this episode. Original music by associate sound designer, Kojin Tashiro. Our producer is Priscilla Alabi. Julie Zann is our talent consultant. Production assistance from Mark Betancourt, Natyna Bean, and Sarah McClure. This program is produced with support from Craig Newmark Philanthropies, from the Charles and Lynn Schusterman Family Philanthropies, from BMe Community, a network designed to build caring and prosperous communities inspired by Black people, and from generous contributions from listeners like you.


Chideya, Farai, host. “The Black Maternal Death Crisis, the Real Reason Black Women Die from Covid-19 More Than White Men." Our Body Politic, Diaspora Farms LLC. April 9, 2021. https://our-body-politic.simplecast.com/