Marc Ramirez, USA Today, February 28, 2021
Funeral director Goulade Farrah is haunted by his clients, whose bereavement over loved ones lost to COVID-19 plays over and over in his head.
Roughly 90% of the deaths Farrah handles at Olive Tree, the mortuary he oversees in Stanton, California, about 26 miles south of Los Angeles, are COVID-19-related. Many are Arab Americans.
Arab Americans and their advocates fear alarming rates of COVID-19 infection and deaths in their communities – but there is little data to back up these concerns because most are categorized as “white” by the federal government.
The nation’s 3.7 million Arab Americans are unable to self-identify as such on the census and other government forms. As a result, official health care data can be hard to come by, and experts and community leaders are forced to rely on patchwork, often self-compiled data.
The issue has been exacerbated by COVID-19 in a community facing numerous risk factors for the virus, including large numbers of immigrants and refugees, poverty, multigenerational households and high rates of hypertension, diabetes and heart disease.
“We are told we are white when in reality, we are deprived of proper and accurate statistical data,” Hasibe Rashid, of New York City’s planning department, said during a web panel this week on the virus’s social and economic effects on the city’s Arab immigrant and refugee populations. “We are expected to conform to something we do not agree with, and worse yet, something society does not see us as. We do not live the life of white privilege.”
Without a racial or ethnic identifier, community coronavirus infection rates are “extremely unreported,” said Madiha Tariq, deputy director of the Community Health and Research Center run by ACCESS, a Dearborn, Michigan-based social service agency serving a largely Arab American population in several surrounding counties. “This has led to a false sense of security among community members who believe this is not a disease that impacts them.”
Hasan Shanawani, a pulmonologist in Ann Arbor, Michigan, and president of American Muslim Health Professionals, a nonprofit group focused on public health, said Arab Americans’ unrecognized status consigns them and their health issues to obscurity.
“They all just check the ‘white’ box and get absorbed into the mainstream,” he said.
Raed Al-Naser, a critical care physician at Sharp Grossmont Hospital in La Mesa, California, in east San Diego County, noticed a disproportionate number of Arab Americans coming through the intensive care unit for COVID-19-related complications during the pandemic’s first waves early last year.
As president of the National Arab American Medical Association’s San Diego chapter, he checked with colleagues in other Arab American enclaves around the country, who confirmed they saw the same thing.
By summer, Al-Naser was penning editorials in local publications, hoping to bring attention to the issue. He combed through hospital records from March through December and determined that of those admitted to Sharp Grossmont with COVID-19-related conditions, 11% were Arab American – about twice the rate of admissions he typically saw for that population.
More than 500,000 Americans have died from COVID-19. Federal data shows that compared with non-Hispanic whites, Blacks are nearly twice as likely to die from the virus, while death rates among Hispanics and Native Americans veer closer to two and a half times in comparison. There is no official data on Arab Americans, who are bundled into the white category.
The nation’s Arab American population has at least doubled since 2000, driven by the arrival of mostly Muslim immigrants and refugees, the product of multiple wars and instability in the Middle East. Coming from embattled places such as Syria, Iraq, Yemen and the Palestinian territories, they’ve joined larger populations of more established, mostly Christian Arab Americans with roots in Lebanon and Egypt, as well as Arab Chaldeans, an ethno-religious group from northern Iraq.
Many Arab Americans have avoided being screened for the virus, either unaware of available services or so worried about providing for their families that they don’t want to face a positive test result.
The American-Arab Anti-Discrimination Committee and Arab American Institute has fought to change the census classification of Arab Americans as white since the 1980s. As 2020 approached, confidence grew that the federal bureau would finally add a so-called MENA option, for people of 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 – hasn’t always offered the accompanying privileges of being white.
There’s more at stake than identity: Without a racial or ethnic identifier, Arab Americans miss out on funding for cultural- and language-specific social and health services available to other marginalized groups – services that advocates say are crucial to address issues uniquely faced by the community.
A Census Bureau study in 2015 found that when offered the MENA option, people from Middle Eastern and North African regions who previously self-identified as white plunged from 85% to 20%.
In 2018, Trump administration officials tabled the MENA option, saying more research was needed to decide whether the category should be considered an ethnicity rather than a race – meaning the community’s next chance to be federally recognized won’t come until 2030.
The lack of data is crucial when it comes to countering skepticism, misinformation and pandemic fatigue, issues that also plague the general population, experts said.
It looms larger given the Arab American community’s risk factors – including cultural and language barriers and, for many, a distrust of government authorities fed by experiences here and elsewhere. Some feel stung by a record of post-9/11 vilification and xenophobia, while others fall prey to rumors bandied in communication networks tied to their homelands or Arabic-language sources on social media platforms such as Facebook, WhatsApp or YouTube.
Advocates say some in the community struggle to socially distance because of the largely social culture.
Advocates fear that the same factors fueling doubts about the virus drive skepticism about COVID-19 vaccines. Without clear data on Arab Americans, many fear officials won’t know whether Arab Americans are receiving the vaccine in proportionate numbers.
In Dearborn, Meroueh said that despite having two chemist siblings who work on virus vaccine research, she had to accompany her Lebanese mom to a clinic to ensure she went through with her first shot after a neighbor spouting sketchy information in her vastly Arab American neighborhood filled her with last-minute doubts.
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-San Diego found a troubling two-thirds of respondents unwilling to be vaccinated. Survey results published in December showed that barely 24% of Blacks and 34% of Latinos planned to get the vaccine, compared with 53% of whites.