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Racial inequality plagues US vaccine rollout



People living in areas hit hardest by the pandemic are being vaccinated at a slower rate than the rest of the US population, according to a Financial Times analysis of data from five major metropolitan areas, underscoring deep-seated racial disparities in access to inoculations.

Government health officials are alarmed by lower vaccination rates in neighbourhoods where people of colour tend to live, especially African Americans, and the FT’s analysis suggests that this is among the biggest factors in whether someone has received a jab. 

That is especially true in Chicago, where a map illustrating vaccine distribution by zip code underscores historic segregation in the city, which has more resources — from grocery stores to parks — in the predominantly white North Side and downtown, and fewer in majority-black neighbourhoods to the south and west.

Maps of Chicago, Illinois, Covid-19 mortality rates, black and Latino population, first dose vaccination rates and income by zip code. The South and West sides lag behind in vaccination rates despite being disproportionately affected by Covid-19

The vaccination disparity has persisted several weeks after the city has expanded the group of people eligible for a jab to include frontline essential workers and people aged 65 and over.

For instance, the zip code containing Streeterville, a neighbourhood that is home to a Gucci boutique and Chicago’s Museum of Contemporary Art, has one of the highest vaccination rates in the city. The area is more than 70 per cent white, with a median household income of almost $107,000. Just 40 per 100,000 residents have died of Covid-19, while about 24 per cent of them have received a first dose of the vaccine.

Sixteen miles south, the zip code containing Roseland is more than 90 per cent black with a median household income of $41,000. Covid-19 has killed 279 people out of every 100,000; just 6 per cent of residents have received a first dose of the vaccine.

“There’s that old saying: every map of Chicago is a map of racial segregation,” said Chicago demographer Rob Paral. “The biggest issue is that access to resources in the US, and certainly in Chicago, continues to be determined by race.”

Patterns of segregation

The situation in Chicago is replicated in other urban areas in the US, according to the FT’s analysis of data from localities that release more granular vaccination statistics by geography.

In Washington, DC, residents of the majority-white, wealthy north-west wards have received the most jabs by far, while in majority-black wards, which have seen a disproportionately high share of cases and deaths, vaccinations continue to lag.

Maps of Washington, DC Covid-19 mortality rates, black population, first dose vaccination rates and income by ward. Majority-black wards have the highest Covid-19 death tolls but the lowest vaccination rates

In neighbouring Baltimore, many of the zip codes with the highest vaccination rates are located in the wealthy “white L” communities in the north and south.

Maps of Baltimore city, Maryland first dose vaccination rates, Covid-19 case rates, income and black or Latino population by zip code. Many neighbourhoods in the "white L" communities of the north and south are comparatively less hard-hit but have higher vaccination rates

Across the country in Washington state, zip codes in north-east Seattle have some of the highest vaccination rates in King County. Meanwhile, cities in the southern part of the county, home to more non-white and immigrant communities, have fallen behind in inoculations while being disproportionately affected by the virus.

Zip code maps of Covid-19 case rates, black and Latino population, vaccination rates, and income in Seattle, Washington and surrounding parts of King County. Cities in South King County have higher case rates but fewer vaccinations than whiter, wealthier parts of Seattle

In New York City, the average first-dose vaccination rate for residents of majority-white zip codes was 6 per cent, compared to 3.4 per cent in majority-black zip codes and 4 per cent in majority-Latino zip codes, according to the city’s data as of February 18.

Maps of New York City Covid-19 mortality rates, black and Latino population, first dose vaccination rates and income by zip code. The geographical disparities in NYC's vaccine rollout mirror racial and socioeconomic divides

Access and hesitancy

Medical groups say that requiring vaccine appointments to be made on websites or apps, and allocating slots to those who snap them up first, something that Chicago does, can exacerbate inequities.

Shikha Jain, co-founder of the physician advocacy group Illinois Medical Professionals Action Collaborative Team, likened the approach to “trying to get concert tickets”.

A person who lacks reliable internet access and works long hours “doesn’t have time to hit refresh every hour” to secure a vaccine, said Ali Khan, an executive medical director at Oak Street Health, a public company that operates 21 clinics for low-income seniors in the Midwestern city.

Oak Street has a waiting list with more than 15,000 names, added through multiple sign-up methods. If they had not actively reached out to people who had not signed up, they would be vaccinating “solely white and Asian people”, Khan added.

bar charts showing in cities across the US (Baltimore, Chicago, NYC, DC), the share of first dose vaccinations going to black residents is smaller than their share of cases and deaths

Surveys show black and Latino adults are more wary about getting the vaccine than whites. Some public health experts attribute this to scepticism of the medical establishment stemming from the four-decade Tuskegee scandal, when US health officials told black men in Alabama starting in the 1930s that their syphilis was being treated, when in fact it was not.

But David Hodge, lead ethicist at Tuskegee University, said “present factors are just as vicious — perhaps more so”.

Susan Lopez, a bilingual doctor at a Chicago hospital, said several Spanish-speaking Covid-19 patients had told her they delayed seeking medical treatment because they feared the US immigration authorities.

Lopez sees similar problems with vaccine distribution: undocumented immigrants worry that entering their information online could lead to detention or deportation.

The challenge is to “get the demand and the supply where it needs to be most, while we continue to make sure that everybody who is eligible has access”, said Helene Gayle, who heads the Chicago Community Trust and co-chaired the National Academies framework for vaccine distribution.

‘Pour the water where the fire is’

Gayle and others have called for residents from certain zip codes to be prioritised. The US Centers for Disease Control and Prevention, or CDC, released recommendations for priority groups in December, but the rollout has been left to individual states that are increasingly making and modifying their own rules.

Washington, DC’s health department has opened up vaccine appointments a day earlier for residents 65 and older who live in certain zip codes. In Chicago, officials have targeted 15 high-need neighbourhoods for outreach and mass vaccination drives. In one such neighbourhood, more than 1,500 residents received a first dose in one weekend.

William Parker, a University of Chicago medical professor, said that if a South Side zip code had five times the death rate than one on the North Side, it should receive five times the vaccine supply.

“It’s not just about the absolute numbers. You could rack up your numbers in Chicago real fast by focusing on the North Side. But that does nothing in terms of mitigating disparities,” he said.

“We need to pour the water where the fire is burning.”

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Musk well-positioned to steer cryptocurrency’s future direction of travel




When Elon Musk revealed three months ago that Tesla had bought $1.5bn worth of bitcoin, fans of the digital currency claimed the move would hasten its wider adoption as a tool of corporate finance.

On Wednesday, however, Musk withdrew his personal endorsement, swearing off accepting the cryptocurrency as payment for Tesla’s cars and undermining the company’s justification for using it as a destination to park its spare cash.

As usual, Musk’s comments provided immediate fuel for crypto traders as well as ammunition for the warring crypto tribes on Twitter. But it was harder to tell whether his announcement would have any effect on wider perceptions of the currency, or what role Musk’s views will play in the next phase of crypto adoption.

“He’s always saying things every two days and isn’t consistent,” said John Coffee, a professor at Columbia Law School. Tesla’s pretensions to pushing bitcoin into the mainstream of corporate use always sounded secondary to its interest in pure financial speculation, Coffee added. “I think his first investment was much more of a currency investment than anything else.”

Whatever lies behind Musk’s on-again, off-again love affair with bitcoin, his effect on market prices has been hard to ignore. The currency’s price jumped 15 per cent on the day that Tesla’s investment was revealed, and fell 6 per cent in the 24 hours after this week’s announcement.

The latest drop came just days after Musk jokingly denounced dogecoin — another cryptocurrency that he had heavily promoted — as “a hustle” on US television, sending its value down 15 per cent.

“Without question, he’s become the single most important factor in crypto,” said JP Thieriot, chief executive of crypto exchange Uphold. That influence extends beyond Musk’s ability to move prices and helps shape how people think about digital currencies, Thieriot suggested.

Even Musk, however, can’t force cryptocurrencies into mainstream commercial use. He said this week that Tesla had backed away from accepting payment in the currency because of the environmental effects of the energy-intensive “mining” that goes into validating transactions — a well-known issue he has ignored in the past. 

Many crypto experts said that Musk’s change of heart appeared to reflect an acceptance that bitcoin was not suitable for payments. Other companies that had accepted bitcoin as a form of payment in the past, including Dell and Microsoft, also later dropped it.

“I don’t think a lot of people want to spend their bitcoin,” said Wilson Withiam, an analyst at crypto research group Messari. “If there was actual money behind it, would [Tesla] have actually done that?”

Musk’s change of heart extended beyond the issue of payments. He also swore his electric carmaker off becoming an active participant in the bitcoin market, saying that it “will not be selling any bitcoin”.

The commitment came two weeks after Tesla surprised Wall Street with a $101m profit from selling part of its holdings, raising worries that the company’s performance would increasingly be tied to crypto trading.

The pledge not to sell may have reassured some investors, but it also effectively undermined Tesla’s case for using the currency as part of its everyday corporate treasury operations.

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Zach Kirkhorn, Tesla’s chief financial officer, told Wall Street two weeks ago that the liquidity of the bitcoin market justified Tesla holding the cryptocurrency, since it meant the company could buy and sell actively.

That flexibility was particularly important, he said, as Tesla faced greater cash demands to finance plants in Texas and Germany while also dealing with extreme financial stresses in its supply chain caused by the global semiconductor shortage.

“Being able to access our cash very quickly is super important to us right now,” Kirkhorn said. With one tweet that promised to lock in the company’s crypto investment, Musk has torpedoed that rationale.

Some bitcoin backers said that Musk had still helped prepare the way for the wider adoption of bitcoin by corporate treasurers by encouraging other companies to view it as a valid holding — even if there have been almost no examples of others announcing they were buying the currency.

His initial enthusiasm for bitcoin had generated interest — including among treasurers — that was likely to continue well beyond his recent turnround, said Rayne Steinberg, chief executive of digital asset management group Arca. “People were talking about it, it entered the zeitgeist.”

Some corporate treasury experts, however, said that Tesla’s flirtation with cryptocurrency holdings had done nothing to encourage wider adoption.

“It created conversation among treasurers, but I don’t think it changed anyone’s mind,” said Jerry Klein at Treasury Partners in New York. The overriding requirement for treasurers to preserve the value of their companies’ cash had completely ruled out cryptocurrencies, Klein added.

But if Musk’s dabbling in bitcoin failed to change the currency’s standing in the corporate world, his latest intervention has raised another prospect: that he could become a kingmaker for a future cryptocurrency to rival or even supersede bitcoin.

Using his celebrity to draw attention to bitcoin’s large energy consumption — and that many participants in the network are in China, relying on coal-fired power stations — could hasten the search for alternatives, according to supporters. Surveys of millennials and Gen Z, who are big buyers of cryptocurrencies, showed that they were also deeply concerned about climate change, said Thieriot at Uphold. “Eventually, those things have to converge,” he said.

Musk’s comments provoked an immediate scramble for attention among backers of cryptocurrencies that claim to have less adverse effects on the environment. Those included Bitcoin Zero — a carbon neutral version of bitcoin — and Cardano, one of several networks that use a so-called proof of stake mechanism to validate transactions, consuming less energy.

Most newer networks, however, have struggled to win attention and a share of crypto investment. Most of the displaced attention has focused on ether, the digital token used on the ethereum network. With a total value of $440bn, its tokens are worth almost half as much as bitcoin.

Ether is already used by some investors as a form of digital money, and its long-planned move to a proof of stake system could finally be completed within the next year, putting it in a strong position to win wider support, said Withiam, the analyst at Messari.

Musk did not show his hand about which cryptocurrency will win his favour as he turns away from bitcoin, saying only that it would be a token that consumes less than 1 per cent as much energy. His open-ended comment is bound to leave crypto investors guessing — and guarantee that all eyes stay fixed on his tweets for the next clue to his thinking.

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Where climate change meets business, markets and politics. Explore the FT’s coverage here 

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UK’s voter ID plan ‘an expensive distraction’




When the Queen announced in parliament this week that the British government was planning legislation that would require voters to carry photographic identification, her words stirred up worries nine miles to the east, in the London borough of Newham.

Junaid Ali, organiser of the Hope for Humanity Food Bank, which operates from a rundown shopfront in the deprived, multicultural West Ham area of the borough, said families using the service on Tuesday told him they would struggle to find the documents voters are expected to need.

“A lot of the families do not have identification,” Ali said.

Such stories — allied with the near-absence of in-person voter fraud — have raised suspicions that the proposed legislation is an attempt to make it harder for some sections of Britain’s electorate to vote.

A study commissioned by the Cabinet Office and published on March 31 found that 9 per cent of UK adults lacked photographic identification that was still valid and had a recognisable photograph.

Ali said many people reliant on the food bank were citizens of Commonwealth countries such as Pakistan — who have the right to vote in the UK — but that many spent long periods without identity documents while the Home Office processed their visa and immigration applications.

“For asylum-seeker families, the ID is held by the Home Office,” Ali said.

A man hands over ID at a polling station in New Hampshire, US
In the US there have been accusations that new voter ID laws in the likes of Georgia and Florida are part of an attempt to stop black and other minority groups from voting © Suzanne Kreiter/The Boston Globe/Getty Images

The UK government’s move received backing from former US president Donald Trump on Tuesday who said the UK measures were “exactly” what the US should do. There have been widespread accusations that new voter identification laws across a swath of Republican-controlled states — including Georgia and Florida — are part of an attempt to stop black and other minority groups in America from voting.

Jessica Garland, director of policy and research for Britain’s Electoral Reform Society, the election-rights pressure group, queried why a crackdown on in-person voter impersonation was a priority for the government when it was a rarely recorded offence.

“There’s no evidence that there’s a problem that the policy is trying to solve,” Garland said. “We really think this could be quite an expensive distraction.”

Despite vocal opposition to the proposals, the government has so far refused to back down, perhaps raising the prospect of another embarrassing U-turn further down the line.

“Having photographic identification is ensuring a problem doesn’t arise,” Jacob Rees-Mogg told MPs on Thursday. “This country has an electoral system of which people can be proud and of which people can have confidence. We mustn’t allow that confidence to slip.”

The arguments surrounding voter identification have been familiar to Angela Wilkins, leader of the Labour party group on Bromley council, in south-east London, ever since the council hosted one of the pilots for the voter ID scheme at local elections in 2018.

Chart showing that in the 2017 election voters without driving licences or passports were more likely to vote Labour than Conservative

The Electoral Commission, the UK elections watchdog, said after the pilot that the majority of voters had been able to meet the requirements, although some were turned away. It added there was no evidence the requirement significantly deterred people from voting.

Wilkins, however, said she believed the commission had underestimated how many people were put off.

“A lot of people didn’t even attempt to go and vote because they knew they couldn’t because they hadn’t got the right ID,” Wilkins said.

It is unclear, meanwhile, how far the proposed legislation would address issues raised by the UK’s biggest election fraud scandal of recent years, in the 2014 local elections in Tower Hamlets, a London borough that neighbours Newham.

That case — which led to the removal of Lutfur Rahman as the borough’s mayor — related mainly to false registrations of people with no right to vote and a range of other issues, including the exercise of unlawful religious influence over voters’ decisions by Muslim religious leaders.

Former mayor of Tower Hamlets Lutfur Rahman, centre
Former mayor of Tower Hamlets Lutfur Rahman, centre in blue tie, was removed from his post after an election fraud in 2014 © London News Pictures/Shutterstock

The Tower Hamlets case took place while prime minister Boris Johnson was mayor of London. Johnson closely followed the case and after the ruling against Rahman in 2015 said: “I’m very glad that justice has taken its course and the cloud has been lifted from Tower Hamlets.”

But Johnson is also a longtime sceptic of ID cards. Writing in the Telegraph newspaper in 2004 as a Conservative MP, he said: “If I am ever asked, on the streets of London, or in any other venue, public or private, to produce my ID card as evidence that I am who I say . . . I will take that card out of my wallet and physically eat it.”

Garland said the fraud in Tower Hamlets had been caught and there had not been another similar case since.

“To introduce this measure for an entirely different kind of fraud . . . seems like the wrong lesson to be drawn from that,” she said.

It is not clear, either, whether the legislation will follow a key recommendation from the Electoral Commission — that councils should offer a free, official form of photo identification for those lacking other forms. Voters in Northern Ireland — where photographic identification has been needed since 2003, and whose experience the government has cited as evidence the proposals can work — are offered such a card.

The plans are also likely to encounter some political opposition when introduced to parliament. Libertarian-minded Conservative MPs are unhappy with the proposals; one described them as “the very sort of thing we used to tear pieces out of Labour for”. But any rebellion is unlikely to undermine the government’s 80-seat majority.

Ruth Davidson, the former leader of the Scottish Conservative party, described the plans as “total bollocks”, adding they were “a solution to a problem that doesn’t exist”.

She told ITV: “I think that given where we are and the year we’ve had, we’ve got real problems to solve in this country, and the idea that this is some sort of legislative priority I think is for the birds.”

The House of Lords is also likely to seek to amend the legislation. Liberal Democrat and Labour peers are particularly unhappy with the proposals.

Garland said the introduction of a free, official form of ID would be the “absolute minimum” required to make any system fair.

In West Ham, however, Ali said the new plans had simply added to the suspicions of his food bank’s already marginalised users about the government’s intentions towards them.

“They have concerns that it might be another way to check the data of people,” Ali said. “They’re quite scared.”

Additional reporting: John Burn-Murdoch in London and Lauren Fedor in Washington

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Future of retail




FT reporters examine the future of retail after a year disrupted by the pandemic

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