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Musician’s COVID-19 death illustrates how racial inequities sow illness and death

Brandon McCray:
Beloved preacher. Talented gospel musician.
Lost to Covid-19.
More than 60 Black Kansans have died from COVID-19 in the
pandemic. McCray’s story helps illustrate what’s been lost and how
the problem of health inequalities runs so much deeper than a virus.

On March 20, Brandon McCray took his saxophone to the Miracle Temple Church of God in Christ in Kansas City, Kansas. The beloved preacher and gospel musician had been invited to play at the church’s Spring Workers’ Meeting.

Nine days earlier, Wyandotte County had recorded its first COVID-19 death. McCray knew about that death, knew of the virus, but attended the event anyway. “We were all aware of it,” says his half brother Jarius Jones. “But he wasn’t one that was watching TV all the time. Knowing my brother, he probably was not thinking, ‘OK now if I do this, I’m going to get sick.’ He probably would have hugged people. He would have shaken hands. All the things he normally would have done.” 

As it turned out, a last-minute change in the program kept McCray from performing. Still, he sat up front, close to other church elders and pastors. He was there, it’s true, because it was his job. His performances were usually paid affairs. Besides, it was spring break and, as a part-time substitute teacher, he needed the extra income.

But mostly McCray was there because he had long ago committed to inspiring others to follow Christ and find comfort in God’s love and mercy. He was an evangelist through and through – a popular one who traveled the country with his saxophone and a sermon in tow. He wasn’t going to turn down an invitation to do what he loved most. “He ministered to all the major Christian denominations,” Jones says. “He even played at a mosque. He played at churches, a variety of arenas. He totally dedicated his life to it.”

On April 19, the 52-year-old McCray lay dying in the intensive care unit at the University of Kansas Health System. Friends and relatives surrounded him virtually, on Zoom, offering words of love and comfort and bearing witness as he took his last breath. It is possible, Jarius says, that McCray was one of the nine people whose deaths are attributed to a COVID-19 outbreak at the weeklong Spring Workers’ Meeting. But he does not know for sure. A week earlier, McCray had preached at an event in Louisiana, where there were already at least a dozen confirmed cases of the virus.

But McCray did share something in common with the other attendees at the Spring Workers’ Meeting who died. All of them were Black.

The Price of Inequality: Disparities Revealed by COVID-19

The Price of Inequality: How Should Communities Deal A KLC Journal Magazine Virtual Launch Event and Discussion with the Disparities Revealed by COVID-19? Join us July 28 for the virtual release of the KLC Journal magazine’s Summer edition with a focus on the kind of leadership needed to address the racial and ethnic health disparities brought to light during the COVID-19 pandemic.

‘I WAS OUTRAGED’

Even before McCray’s death, Wyandotte County health officials were well aware of a disturbing trend in their community, in Kansas and across the country: Black people were dying at a far greater rate from COVID-19 than any other racial or ethnic group. By early July, 41 of the 85 who had died from the virus in the county were Black, even though Black residents make up just 23% of the population.

Statewide more than 60 Black Kansans had died from COVID-19, a rate of about 29 deaths per 100,000 people. The death rate for whites was about 9.43 per 100,000 and for Asians, 8.39. When broken down by ethnicity rather than race, the death rate for Hispanics was 13.8 per 100,000 and 9.2 per 100,000 for non-Hispanics. These death rates underscore how lethal the coronavirus is for Black Kansans. But public health officials and Black leaders stress that the virus is a symptom of a broader problem – one grounded in government policies that for decades have created insurmountable roadblocks to equal opportunity and imperiled the health of millions of Black Americans. Including McRay’s.

Wyandotte County’s first coronavirus death – the first in the Kansas City region and Kansas, as well – got the attention of Broderick Crawford. For 35 years before taking the helm of a Kansas City, Kansas, nonprofit, Crawford worked in the healthcare industry. He knew the virus would spread quickly even before it reached his community. Indeed, six members of his own family would, in time, contract it. And he knew, given Wyandotte County’s high poverty rate and its ethnic and racial makeup, that many people would be at risk of infection.

Why then, he and other Black leaders wanted to know, were coronavirus tests available in the region’s more affluent communities but not in Wyandotte County? Especially when the county had already recorded the region’s first death? Crawford, the executive director of NBC Community Development Corp., got on his phone to sound the alarm. He reached out to the health department at the Unified Government of Wyandotte County and Kansas City, Kansas, and the KU Health System.

“I was outraged,” says Crawford. “We need to do testing in Wyandotte County. Why is testing occurring in the Plaza and Johnson County, where there were no deaths (at the time) instead of Wyandotte?”

The health department did not have the resources or supplies to provide tests. Sharon Lee Family Health Care did, and by March 19 the Kansas City, Kansas, clinic had a system in place to begin testing. Founder and CEO Sharon Lee said that although the health department was “slow out of the gate” in response to the crisis, it has since “stepped up.” She attributes that slow response, in part, to a lack of resources. “We were just a little more nimble,” Lee said. “But the health department has worked with us throughout, helped us determine what the testing criteria should be, worked with us as we try to identify hot spots.”

Crawford’s immediate anger may have been directed at the lack of tests, but it was grounded in something deeper. It stemmed from years of battling social and health inequities that affect not only Black residents but also Latino, Asian and refugee populations. To address these inequities during the pandemic would require action as well as recognition that those injustices did not happen in a vacuum. They came directly from decades-old racist practices that continue in various forms and bring devastating economic and psychological consequences to this day.

Redlining, which denies minorities access to quality housing and services, is one such practice. Police oppression reinforces these effects, as seen in the recent case of a white Kansas City, Kansas, officer who used bribes and threats to coerce testimony in the wrongful conviction of a Black man.

Crawford believes that everyone working to improve community health must acknowledge these realities if they are to achieve deep and lasting change. He, along with other Black leaders, are encouraged by recent protests in Wyandotte County and across the world against police brutality. And he’s pleased that health officials responded quickly to stem the spread of coronavirus in Wyandotte County’s communities of color. But the effect of those positive actions can only continue if the awareness of racism’s practical consequences is kept on everyone’s radar. “What people need to hear is the truth,” Crawford says. “The challenge is: We have been burying the truth of what’s gotten us to where we are today.”

 

Broderick Crawford, a veteran of the health care industry, believes that health disparities in places like Wyandotte County can only be closed if people face up to the corrosive effects of decades-old racism.

‘JUST PART OF A CONTINUING STORY’

As the first weeks of the pandemic passed, and as the county recorded more deaths, the reality that it was striking the county’s Black residents especially hard began to sink in. By April, the county knew the full extent of the Miracle Temple outbreak. Deaths at Riverbend Post-Acute Rehabilitation increased almost daily. In all, 37 would die from that outbreak, the worst recorded in the county. Of those, 17 were white; 20 were Black.

African Americans weren’t the only ones at great risk. Many in the Latino population, which represents 29% of the county’s total, were reluctant to get tested, which challenged health officials who were trying to determine how much the virus had spread in that community. Asians in Wyandotte County make up just 5% of the population, yet their infections represented nearly 21% of the total through late June. These numbers alarmed the region’s health officials. But they were no surprise.

“This is just part of a continuing story that highlights the inequities that we’ve always known to exist,” says Qiana Thomason, the president and CEO of the Health Forward Foundation in Kansas City, Missouri. “We know that people of color are more likely to have underlying health conditions that affect their immune system, like diabetes, or affect their respiratory system, like asthma. Not because we’re genetically predisposed to getting these conditions, but because the social conditions in which we live result in their development.”

Those social conditions include poverty, food deserts and a poor access to quality health care. Wyandotte County has long recorded some of the highest percentages of poverty and lack of health insurance in Kansas. A smaller percentage of people in Wyandotte County hold postsecondary degrees than in the rest of Kansas, making it more difficult to land higher paying jobs with good benefits. And Black communities, specifically, have shouldered the devastating economic and mental health effects of redlining.

“I get really irritated when I hear people say, ‘I can’t wait until we get back to normal,’” Thomason says of people’s impatience with the pandemic. “I’m like, ‘Look, normal was not working for everybody.’ We have to create a new normal and establish new societal expectations and norms where everybody thrives.”

THE LOSS OF A MENTOR

McCray’s life reflected many of the conditions that contribute to poor health outcomes, though not all. At the time of his death, he lived not far from his childhood home, in the county’s 66104 ZIP code, one of the poorest ZIP codes in one of the poorest counties in Kansas. Although he was in demand as a preacher and musician, hailed as one of the leading gospel saxophonists in the country, and had recently earned a Doctor of Musical Arts in saxophone performance from KU, McCray struggled to make ends meet. “As a substitute teacher and a freelance person, he didn’t make much money,” Jones says. “He didn’t have access to good care much of his adult life. He finally got it through the Affordable Care Act.”

A former standout high school athlete, McCray didn’t drink or smoke. But he struggled with high blood pressure, dental issues and obesity. “He was a big guy and had been working diligently to try to reduce his weight,” Jones says of his brother, a divorced father of one child. “But as a musician, I’m sure he did not eat healthy. Being on the go. Processed food. He was single when he died, a bachelor. And he lived like a bachelor.”

McCray also lived with a sense of urgency, not only to make a living but to follow the teachings of his Christian faith – a faith that he seemed to have been born with. As a toddler, having absorbed the cadences and gestures of pastors at his church, he’d stand up at a coffee table and mimic them. When he was just 5 years old, Jones says, McCray was moved to answer the altar call at his church. He never strayed from that early expression of faith and even served as a model for his family – his parents and five half siblings included.

“A month after Brandon turned his life over to Christ, my mother, who smoked five packs a day, she followed his example – and quit her smoking,” says Jones. “My father, who was an alcoholic, he made the same decision. Stopped drinking. All of this came as a result of Brandon showing his dedication to Christ as a young boy.”

Music came naturally to him as well. As a boy he played the upright bass and guitar. Then as a young adolescent, McCray found his true calling when he saw world-renowned gospel saxophonist Vernard Johnson, a close family friend, play at the Miracle Temple. Defying a high school teacher who said he’d never make it as a saxophonist, McCray dedicated himself to the instrument, often practicing in the family garage until 2 or 3 a.m. Soon, churches across the city were inviting him to play. Having played by ear for his entire childhood, he learned to read music under the guidance of a professor at Kansas City Kansas Community College. At Emporia State, he joined the jazz and marching bands. His talent matured, and one day he asked Johnson if he could learn more from him.

“Brandon became his protege,” says Jones, himself a musician. “He was learning, practicing every move he made. Even the hand gestures. He mimicked it, and then made it his own.”

McCray traveled with Johnson to performances around the world. “Brandon was there to get whatever he could, careful to make sure he never stepped on any toes,” Jones says. “He even carried Dr. Johnson’s saxophone for him. It wasn’t that he made him. Brandon said he did it as a sign of respect.”

After two years with Johnson, McCray branched out, setting up performances for himself.

The sermons came gradually, with words of inspiration between songs, Jones says.  Eventually, he started full-on preaching. “He would play, then he would preach, then he would play some more.” When Brandon blew on his horn, Jones says, “it was almost as if you could hear the words that he was playing. It was like he was talking to you. He was really preaching to you. It was mesmerizing. It would evoke all kinds of emotions. People would cry. They would cheer. Brandon just really embodied that.”

But it wasn’t enough for McCray to stand before a congregation. He also played the role of mentor to a number of young musicians. In recent years, he could be found at F.L. Schlagle High School in Kansas City, Kansas, helping band director Reginald May with his classes.

“He became a kind of father figure with these students,” May says. “Doctor (McCray) would always preach, ‘You gotta know these particular scales and these kind of chordal progressions.’ A lot of times, a kid wants quick success. But he let them know it’s a process: When you master this, you can go on. It was a gentle exchange. That was pretty much his approach. Mild-mannered. Patient.”

 

Mariana Ramirez worked with health officials to add a Spanish language section to the Wyandotte County website that provides information on COVID-19.

COORDINATING A RESPONSE

The ZIP code in which McCray lived is not only one of the county’s poorest; it also has recorded the second-largest number of COVID-19 cases in the county. Two adjacent ZIP codes – 66102 and 66112 – round out the top three. By early July those three areas had seen 67 deaths from COVID-19, compared with 85 in the entire county. They also have long had some of the greatest socioeconomic needs in the Kansas City metropolitan region – needs that correlate with poor health outcomes in a county that annually ranks as one of the state’s least healthy.

This unwelcome designation, first brought to the county’s attention more than a decade ago, has prompted the Unified Government and area health foundations to invest in numerous efforts to address the county’s “social determinants of health.” By 2011, community leaders formed an initiative called Healthy Communities Wyandotte, which today promotes policies to improve community health. A separate endeavor, the recently-adopted County Health Improvement Plan, has marshalled the resources of dozens of nonprofit organizations, neighborhood groups and individuals to improve access to health care, education and quality jobs; reduce violence; and increase the availability of safe and affordable housing.

But addressing so many complex issues takes time – and money. As a result, year-to-year improvements are difficult to see. Those involved say it will take years, and much more money, to improve the county’s health outcomes. Some also say that in a few months, the coronavirus brought more attention to health disparities in Wyandotte County than they’ve ever seen.

“This exposes how health inequities work to create illness and death,” says Allen Greiner, a physician and the county’s chief medical officer. “And it exposes it in a really dramatic way.

“The efforts that have been made in Wyandotte County before the coronavirus are good, but they’re nowhere near the level of funding and support of key stakeholders that they need to be. If you do things the right way, you actually can have a dramatic impact on how health inequalities do or don’t play out. This gives us an opportunity to show how it works.”

By the end of March, Crawford and other Black leaders seized that opportunity. With Greiner’s support, they approached the Unified Government Public Health Department and other organizations about forming a Health Equity Task Force. For most of the spring, the task force focused on the source of Crawford’s outrage – the dearth of testing and the implications that lurked beneath the surface of that shortage.

“Broderick was appropriately angry, in my opinion, and we really all expressed our anger over this together early on in the life of our equity group,” says Erin Corriveau, a physician and the county’s deputy medical officer. “This totally affected us at the health department and guided our response.”

The task force, made up of public health officials, leaders of nonprofit organizations, neighborhood organizations and faith communities, meets at least once a week online to discuss strategies for stemming the inequities related to the virus.

From the beginning, it recognized the need to not only provide more testing but also to improve communication with the county’s diverse communities. “We really didn’t have what we needed and weren’t providing the community what they needed as far as testing,” says Corriveau, who organizes the meetings with Greiner.

That included testing in Latino communities. Mariana Ramirez, director of the Juntos Center for Advancing Latino Health at the KU Medical Center, believes that “fear and misinformation” have discouraged many Latinos from getting tested. “Fear related to immigration,” she says, “whether they have documents or not.”

 

Testing for COVID-19, here taking place at the Kansas City Kansas Community College Technical Education Center, is seen as a crucial part of limiting the spread of the disease, along with contact tracing. In early June, Gov. Laura Kelly set a goal of testing 60,000 Kansans a month.

 

The task force, Corriveau says, quickly determined that many of the people it needed to reach were not coming to the testing site the health department had created in its parking lot. So it reached out to the department’s staff, the Community Health Council of Wyandotte County and two safety net clinics – Vibrant Health and Swope Health – to coordinate free pop-up testing sites in neighborhoods with large percentages of vulnerable residents. The task force has aggressively marketed the dates and locations of the sites, promoting them in multiple languages via social media, websites, fliers and neighborhood and church networks.

Their message is simple: People with symptoms need to get tested immediately, as should anyone who thinks they may have been exposed to the virus.

“Together as a task force we jelled on this idea that we need to be in neighborhoods at trusted community sites that primarily serve the most vulnerable people,” says Corriveau.

Since April 20, more than 1,000 residents have received tests at those sites, representing about 10% of the county’s total tests. (Tests are also provided at the health department, primary care offices, safety net clinics, long-term care facilities and job sites.) The ramped-up testing has given health officials a better, though not perfect, picture of how the virus is spreading. It has allowed them, for example, to identify nearly 1,000 positive cases (and six deaths) among Latino residents, which represents nearly 39 percent of the county’s total. It has also helped with the county’s contact tracing efforts, which for the moment rely on a volunteer network of medical professionals and students, and a few paid staff. The contact tracing has enabled health officials to identify more outbreaks – some at essential work sites such as food warehouses, meatpacking plants and nursing homes, industries that often employ large numbers of Black, Latino or Asian residents.

More recent tests have revealed that the virus is hitting the county’s Asian population especially hard, many of them employees of Triumph Foods, a meatpacker in St. Joseph, Missouri, that has seen nearly 500 of its workers sickened. Of the more than 3,000 individuals who have tested positive for the virus in Wyandotte County, more than 430 are Asian. Three have died.

So far, task force members are encouraged – both by the results and the level of coordination.

Crawford is among them.

“The key is getting people tested,” Crawford says. “So the more numbers we have, the better we can assess the impact or potential devastation in our community. That helps us to make better decisions as we move forward.”

 

For Qiana Thomason, president and CEO of the Health Forward Foundation in Kansas City, Missouri, COVID-19’s toll is a sad reflection of the social conditions that people of color endure.

‘ABOUT THE LONG TERM’

The task force’s work has received praise from many quarters inside Wyandotte County. Asian, Latino and Black leaders have all said in interviews with The Journal that its outreach into their communities, and its willingness to listen to their needs, has helped them target those who can most benefit from the testing. It has also helped them address misconceptions and fears that some people may have about the virus and the tests.

“Some people think they can catch the virus because they came to be tested,” says task force member Tony Carter, pastor of Salem Missionary Baptist Church. “So there’s just a lack of information. As a pastor I have worked diligently to inform my congregation about what the truth is, what the facts are, to pay attention to the doctors and the scientists, and hopefully dispel some of these misconceptions.”

The task force’s aggressive approach has also earned the attention of leaders in the Kansas City region. Aaron Deacon is the managing director of KC Digital Drive, a nonprofit organization whose work includes spearheading a health innovation team. When the virus hit the Kansas City metro area, Deacon was impressed with how quickly the health department was able to put a self-reporting coronavirus form online. “It was a good example of Wyandotte doing something that was copied in some form or other in other places,” Deacon says.

The work didn’t stop there. The county was one of the first in the region to begin tracking race and ethnicity on its COVID-19 hub. The hub itself had been created in short order and was imitated in other counties. “Wyandotte County has really been at the forefront in terms of being able to respond quickly,” Deacon says. “Dr. Greiner and his management are both predisposed to take an entrepreneurial approach to problem solving.”

Greiner knows that for these efforts to continue the county will need more resources. Even what it’s doing now isn’t always enough. Wyandotte County, he says, should be conducting about 230 tests a day for at least the next six months, paying special attention to capturing the area’s racial, ethnic and geographical diversity. It also needs about 45 full-time, paid contact tracers. The county has met that testing goal a few times but not often. And its contact tracers are mostly volunteers, who won’t be able to keep performing this task for free. But the money for all this isn’t there – at least not yet. Wyandotte County, Greiner notes, was not large enough to receive any of the money provided by Congress in the CARES Act. So it will have to go elsewhere – perhaps to the state, which will be doling out $1.2 billion it got from the CARES Act – to find $6 million to hire community health workers and liaisons, as well as to help fund area nonprofits

But that’s not the only need. If the county is truly going to use this moment to address health inequities, both longstanding and those related to the pandemic, Greiner says, it must “add value back to the community.” One example: providing masks at recent protests against police brutality. Another: having contact tracers provide letters with Greiner’s signature excusing them from work because the health department has requested them to quarantine. “We don’t want anyone to get fired because they don’t have a doctor’s excuse,” he says. “Patients value that. I think it’s been well received.”

The county also needs to “add value back” by addressing conditions the pandemic has exacerbated – conditions that have long existed in Wyandotte County and that create the foundation for many of its poor health outcomes: inadequate housing, food insecurity, mental illness. Greiner tells the story of a couple of refugee families. Contact tracers reached out to tell them they’d been exposed to the virus.

“They had no food to make it through the weekend, so some people in the Health Equity Task Force provided food and transportation for the weekend,” Greiner says. “That’s the kind of stuff we need to keep doing, and we need a bigger and better structure for doing it.”

The list goes on. The county needs contact tracers who look like and speak like the people who live in the communities they’re working in. It needs to provide training for those who have lost jobs due to the shutdown. It needs to offer more help for people who struggle with substance abuse. If it can meet these needs with the same kind of urgency it has tapped to stop the spread of the virus, it might sow the seeds for future success in addressing health inequalities when the virus is finally contained.

“For me,” Greiner says, “this health equity work is really about the long term.”

 

Erin Corriveau, Wyandotte County’s deputy medical officer, helped devise a testing procedure aimed at reaching vulnerable populations; More than three dozen patients have died at Riverbend Post Acute Rehabilitation Center in Kansas City, Kansas, the worst coronavirus hot spot in the state.

A HISTORY THAT CAN’T BE ESCAPED

Brandon McCray’s family received word from his doctors on April 15 that multiple small strokes had left him with irreversible brain damage. McCray had already told them he did not want to live his life attached to machines, so they decided to honor his wishes. Hospital staff set up a computer tablet next to his bed and left it on for the next four days. Dozens of friends and family held a vigil on Zoom, coming and going at all hours. Vernard Johnson, McCray’s mentor, was one of the last to pay his respects. He said a prayer. McCray died about an hour later, just a little after midnight on April 19.

“When he eventually passed away, it was myself and some siblings who were on,” Jarius Jones recalls. “My sister noticed he had been still and his breathing had become really faint. Everyone was saying goodbye. I saw a shadowy figure come in the room with a stethoscope.

“They came in and poked Brandon and they shook him and checked his heart. When they opened his eyelids, that’s when I knew.”

At the time of his death, McCray was the 46th person known to have died from COVID-19 in Wyandotte County. The number of confirmed cases in the county had reached 423. The task force was just beginning its work. Since that day, the number of deaths has nearly doubled. The number of cases has more than quintupled.

The good news, for now, is that the county’s rapid succession of deaths that occurred from mid-March to mid-May has slowed, even as its cases rise. From June 1 through July 6, just 10 people have died from the virus.

But that news does little to soothe the fear, anxiety and trauma of those who have been sickened by the virus. And it offers cold comfort to those who had to say their last goodbyes to a loved one through a computer, tablet or phone screen – if they were lucky enough to even do that. No matter one’s race or ethnicity, the virus has permanently changed thousands of lives in Wyandotte County – not to mention millions around the world.

But in Wyandotte County and other places with large communities of color, the sting of the virus, and the stress that comes with it, can be especially acute. Black and Hispanic people across the country are more likely to know someone who died from the virus than white people are.

Bishop A. Glenn Brady is pastor of New Bethel Church in Kansas City, Kansas. Its congregation of 800 is largely African American and represents a cross-section of socioeconomic backgrounds. No one in the church has died from COVID-19. But some of its members have been infected. And a fair number know one or more people who have died. Brady personally knew some of the clergy who died in the Miracle Temple outbreak, including McCray. As he recalls all that has happened since March – the closing of his church, the virtual or socially distanced funerals, the protests against systemic racism in law enforcement  – it doesn’t take him long to reflect on decades of history. That history takes him back to the redlining, the lynchings, Jim Crow and slavery. It’s all of a piece with the health disparities in Wyandotte County and the disproportionate effect the virus has had on communities of color.

“Redlining is still pretty much a part of the Wyandotte community,” he says, using it as an example of how racism still inflicts its wounds. “When you talk about the stress levels of all of that, and you have a major pandemic on top of it and you’re still trying to survive? That can be stressful.”

And heartbreaking. Literally. In the days leading up to McCray’s death, the family’s second oldest brother, Ted Jones, had a series of small heart attacks and had to be hospitalized. He’s recovering, Jarius Jones says, and should be OK.   

“They said it was broken heart syndrome. I asked the Lord, ‘Whatever you’re doing to me, Lord,’ I said, ‘I don’t want to be the patriarch of the family. Not yet.’”

A version of this article appears in the Summer 2020 issue of The Journal, a publication of the Kansas Leadership Center. To learn more about KLC, visit http://kansasleadershipcenter.org. Order your copy of the magazine at the KLC Store or subscribe to the print edition.

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