This article is part of a collaboration with the Associated Press, Capital B, and Flint Beat. The work is part of the AP Inclusive Journalism Initiative supported by the Sony Foundation.

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Chimére L. Sweeney, a Maryland middle school teacher, was preparing to lead one of her first online classes after the pandemic shutdowns in March 2020 when she said she suddenly felt like someone placed a lit match on her spine.

Over the next several weeks, Sweeney’s vision became blurry, she frequently experienced vertigo, and she had difficulty processing basic information. She figured she had COVID-19, but because she didn’t have any of the primary symptoms — cough, fever, and shortness of breath — she was unable to qualify for a hard-to-find diagnostic test. 

In the ensuing weeks and months, Sweeney said she often felt like she had to convince her physicians that she was truly in pain. Ultimately, it took Sweeney two years to be formally diagnosed with a long-term case of COVID-19.

“No one can save this body like me,” said Sweeney, who’s 42 and lives in Baltimore. “The goal for me was to live.”

For Black Americans with long COVID, the first 100 days of the Trump administration have been particularly challenging. The White House has ordered drastic cuts to federal programs that provide funding for research for long COVID and other chronic diseases, including the Office of Long COVID Research and Practice. Those living with or working to treat patients with these illnesses are afraid of how these changes will impact them. 

The administration canceled a National Institutes of Health grant that supported an effort called Researching COVID to Enhance Recovery, or RECOVER. That $1.7 billion program was the single largest federal funding mechanism for research into long COVID, which is generally defined as instances when symptoms of the illness last for three months or longer.

And these changes are occurring at a moment when the nation’s top public health official, Robert F. Kennedy Jr., promotes conspiracy theories about COVID’s origins and questions the efficacy of the vaccine.

Taken together, those cuts disproportionately affect Black Americans, who, according to a 2023 report by the U.S. Census Bureau, make up about 32% of long COVID cases — second only to Hispanic Americans, who comprise about 36% of those patients. As many as 20 million Americans are estimated to have contracted long COVID.

Sweeney said she’s increasingly concerned about the reductions to these essential programs. 

“Long COVID has been one of the most devastating attacks on our workforce and economy because healthy people who became infected with COVID and now live with long COVID simply can’t work or have been forced to reduce their hours,” she said. “Black people are often more likely to be ill with the condition, but they often do not have the money or privilege to retire or stop working. They must return to work.”

Even before the administration’s cuts to programs designed to help the nation address the disease, studies have shown that Black Americans with long COVID encounter significant disparities in health care when compared to their white counterparts.

Researchers have found that Black long COVID patients report experiencing implicit bias, microaggressions, and other forms of discrimination when seeking treatment for their symptoms.

“They would ask questions like, ‘Are you on drugs? Or do you work? Or, what do you do for a living? Do you have insurance?’” Sweeney said of her physicians. “I’m, like, ‘You all must not be reading my chart because I am an educated Black teacher. I am generally healthy.” 

Discouraged by her own encounters with the medical system, and similar accounts from other Black Americans, Sweeney in 2024 founded the Black Long COVID Experience, a website dedicated to providing information about the illness and a resource for patients to find doctors or, as she calls it, “long COVID advocacy for Black folks.”

A cure for long COVID

Brooke Keaton, of Charlotte, North Carolina, is a former elementary school teacher, who — because of her long COVID diagnosis —  is dependent on government disability.

The 44-year-old mother of two — Bria, age 6 and Jaren, age 14 — said that she has experienced cognitive decline, asthma, heart issues, neuropathy, extreme spinal pain, numbness and weakness in her hands, and severe fatigue. 

Keaton says she belongs to several long COVID support groups, partly to make sure there are Black faces in the groups and also to learn what treatments and diagnoses non-Black patients are receiving.

She said she’s struggled to get physicians to take her symptoms seriously. One of her health care providers recently misdiagnosed a heart condition as anxiety. A new doctor finally helped uncover that she had inappropriate sinus tachycardia. 

“I don’t know that if I were not Black, if things would have gone differently,” Keaton said.

Keaton said Black people with long COVID have had to advocate to be included in research studies. Some patients have testified before Congress and written letters to representatives, all to make sure their voices were being heard.

“We are sick people, but we’re doing it to help find a cure,” Keaton said. “We need research. Our ultimate goal is for us to find a cure.”

Long COVID awareness in Black communities

Zanthia Wiley, an associate professor of medicine in the division of infectious diseases at Emory University School of Medicine, said the difference in treatment plans and outcomes between Black and white patients with long COVID often comes down to socioeconomics and access to medical care.

“If you are a bus driver and you have to drive your bus from 8 to 5 every day and you cannot take time off to go and see a doctor, then that is going to decrease the likelihood of your long COVID being diagnosed,” said Wiley. “I think also there is decreased awareness — and not just in Black people, but in the community — with respect to long COVID.”  

There are around 400 long COVID clinics in the nation, according to a report by the Long COVID Alliance, a network of patient advocates, researchers, and drug developers who inform the public about post-COVID care.

Wiley said most of the clinics are in urban areas or close to academic institutions. That reality can affect access for Black patients living in rural or exurban areas, particularly in the South.

In communities without long COVID clinics, Wiley said, physicians are seeking three key pieces of information: If a patient’s symptoms stem from other medical problems; if what a patient is reporting is actually long COVID; and how the disease can be treated.

Wiley said the lack of resources is all the more troublesome when you add deep federal cuts to research. 

“I am definitely worried about the tragic, chaotic loss of funding that is going to affect people and populations in general,” Wiley said. “And a lot of times in these scenarios, those who are affected the most are those who have, unfortunately, the smallest voice.”

Heather-Elizabeth Brown contracted COVID in 2020, before the release of the vaccine. She spent 31 days on a ventilator in a coma in a Royal Oak, Michigan, hospital, just outside of Detroit. When she finally woke up, she had to relearn to walk and eat. 

Brown is a member of the Long COVID Alliance.  She said to understand the racial disparities in how long COVID differs for Black patients, it’s vital to go back to 2020 and the start of the pandemic.

“I definitely think that what we saw a lot was patients — and Black patients, first of all — not even having access to the same type of care when the COVID infection happened, not being taken as seriously with some of their symptoms, or not being able to access the tests,” Brown said.

Brown, like other long COVID patients, enjoys legal protections through the Americans with Disabilities Act, which compels employers and others to provide accommodations, such as hybrid work arrangements, for those who are ill with the disease. 

Brown said she is deeply concerned that the Trump administration, which has already reversed policies regarding the needs of people with disabilities, might also roll back aspects of the ADA.

“Even just thinking about the fact that some of that could be rolled back or changed or challenged is terrifying, to be honest, because one of the ways that I’m able to do my job and do it well is because I was able to get accommodations,” Brown said.

Predominantly Black cities like Flint have “been hit in different ways” 

Aisha Harris, a family medicine physician in Flint, Michigan, said she is nervous about the effect of more cuts in funding for long COVID studies, particularly in places such as Flint. 

“Flint has made a lot of small steps as far as progress, even though with those steps, we’ve been hit in different ways,” said Harris, a professor at the College of Human Medicine at Michigan State University. “But the idea of those cuts happening will be devastating and will cause a crisis in Flint that I don’t really want to imagine,” she said. 

According to the July 2024 Michigan COVID-19 Recovery Surveillance Study, a joint project between the University of Michigan School of Public Health and the Michigan Department of Health and Human Services, of the 17,000 confirmed COVID-19 cases in the state between March 1, 2020, and May 31, 2022, 22.7% of Black adults reported symptoms of long COVID. 

In addition to Sweeney and Brown, several Black long COVID patients who spoke with Capital B said they often aren’t believed by doctors, that they have to push to be included in studies, and that receiving a diagnosis and treatment can be a challenge.

Raven Baxter, who works on educational initiatives at the Mount Sinai Health System’s Cohen Center for Recovery from Complex Chronic Illnesses in New York City, said clinicians failing to believe Black patients when they report symptoms is a significant issue. 

Baxter, herself a former long COVID patient, said that during a recent seminar she led, about 10% of the health care providers who were in attendance strongly doubted the actual existence of the conditions being reported by those seeking help.

“So education really goes a long way,” said Baxter, who is a molecular biologist and educator. “Unfortunately, people from all walks of life are already experiencing gaslighting in other dimensions, and it’s just unfortunate that that continues and is compounded by what’s happening with the onset of long COVID.”

Although the clinic where Baxter works is privately funded, she said any disruption in federal dollars for researchers could be devastating to the long COVID community. 

The youngest long COVID patients

Stephanie Cunningham, who lives in Warren, Michigan, about 20 minutes outside of Detroit, says doctors suggested that her 8-year-old daughter, Peyton Lee, had invented her symptoms and encouraged her to take Lee to see a psychiatrist. 

“Every time we would go to a doctor, they would dismiss me,” said Cunningham, who works with the Michigan Department of Corrections probation department. “I can’t tell you how many times I’ve been told through this process that, ‘You appear to be educated, so I’m going to provide you with knowledge, more information than I normally would.’

“What? That’s devastating to hear,” she said, “Not only for my child, but what about the families that are not educated? What about the families that don’t know how to advocate for their child?” 

Amy Edwards is a pediatric infectious disease specialist at University Hospitals Rainbow Babies & Children’s Hospital in Cleveland. Peyton is one of her long COVID pediatric patients. 

Edwards said children over the age of 10 are at the highest risk of developing long COVID. 

“Think about your life from 10 to 20 and everything that you did and everything that you learned and how much it shaped who you are as a person,” Edwards said. “Then imagine you’re already struggling with racism and classism, if you’re also poor, on top of being non-white. And then imagine having chronic fatigue syndrome or something, and long COVID just dropped right on top of that and how much that takes away.” 

Now, with the cuts to federal funding for COVID research, Cunningham said she’s scared for her daughter. 

“This is so new, and no one knows enough about it,” she said. “So, how does this affect Peyton? How does it affect her quality of life? She doesn’t have four years to wait on a new administration. We need this information now.”

The post The Fight to Be Believed: Long COVID’s Toll on Black Americans appeared first on Capital B News.

The U.S. Department of Agriculture announced late Tuesday it will release previously authorized grant funds to farmers and small rural business owners to build renewable energy projects—but only if they rewrite applications to comply with President Donald Trump’s energy priorities.

The move has left some farmers perplexed—and doubtful that they’ll ever get the grant money they were promised, given the Trump administration’s emphasis on fossil fuels and hostility toward renewable energy.

Some of the roughly 6,000 grant applicants have already completed the solar, wind or other energy projects and are awaiting promised repayment from the government. Others say they can’t afford to take on the projects they’d been planning unless the grant money comes through.

A Floodlight analysis shows the overwhelming majority of the intended recipients of this money reside in Trump country—congressional districts represented by Republicans.

After hearing of the USDA’s latest announcement Wednesday, Minnesota strawberry farmer Andy Petran said he suspects many previously approved projects won’t be funded. He’d been approved for a $39,625 grant to install solar panels on his farm. But like many other farmers nationally, Petran got word from the USDA earlier this year that his grant money had been put on hold.

“It’s not like any small farmer who is looking to put solar panels on their farms will be able to put a natural gas refinery or a coal refinery on the farm,” Petran said. “I don’t know what they expect me to switch to.”

Petran was counting on the benefits that solar power would bring to his farm.

After getting word in September that the USDA had approved his grant application, he expected the solar panels would not only reduce his electricity bill but allow him to sell power back to the grid. He and his wife figured the extra income would help expand their Twin Cities Berry Co. and pay down their debt more quickly.

Petran’s optimism was soon extinguished. A USDA representative told him earlier this year that the grant had been frozen.

His 15-acre farm about 40 miles north of Minneapolis operates on a razor-thin margin, Petran said, so without the grant money, he can’t afford to build the $80,000 solar project.

“Winning these grants was a contract between us and the government,” he said. “There was a level of trust there. That trust has been broken.”

In its announcement, issued Tuesday night, the USDA said grant recipients will have 30 days to review and revise their project plans to align with President Trump’s Unleashing American Energy Executive Order, which prioritizes fossil fuel production and cuts federal support for renewable energy projects.

“This process gives rural electric providers and small businesses the opportunity to refocus their projects on expanding American energy production while eliminating Biden-era DEIA and climate mandates embedded in previous proposals,” the USDA news release said. “… This updated guidance reflects a broader shift away from the Green New Deal.”

USDA Secretary Brooke Rollins said in the release that the new directive will give rural energy providers and small businesses a chance to “realign their projects” with Trump’s priorities.

It’s unclear what this will mean for grant recipients who’ve already spent money on renewable energy projects—or those whose planned projects have been stalled by the administration’s funding freeze.

The USDA didn’t directly answer those questions. In an email to Floodlight on Wednesday, a department spokesperson said the agency must approve any proposed changes to plans—but offered no specific guidance on what or whether changes should be made.

“Awardees that do not respond via the website will be considered as not wishing to make changes to their proposals, and disbursements and other actions will resume after 30 days,” the email said. “For awardees who respond via the website to confirm no changes, processing on their projects will resume immediately.”

IRA funding targeted

The grant funding was put on hold after an executive order issued by President Trump on his first day in office. It froze hundreds of billions of dollars for renewable energy under President Joe Biden’s massive climate law, the Inflation Reduction Act (IRA).

The law added more than $1 billion to the USDA’s 17-year-old Rural Energy for America (REAP) program.

About 6,000 REAP grants funded with IRA money have been paused and are being reviewed for compliance with Trump’s executive order, according to a March 5 email from the USDA’s rural development office to the office of U.S. Sen. Chris Van Hollen (D-Md.).

A lawsuit filed earlier this month challenges the legality of the freeze on IRA funding for REAP projects.

Earthjustice lawyer Hana Vizcarra, one of the attorneys who filed the suit, called the latest USDA announcement a “disingenuous stunt.”

“President Trump and Secretary Rollins can’t change the rules of the game well into the second half,” she said in a statement Wednesday. “This is the definition of an arbitrary and capricious catch-22.”

Under the REAP grant program, farmers pay for renewable and lower carbon energy projects, then submit proof of the completed work to the USDA for reimbursement. The grants were intended to fund solar panels, wind turbines, grain dryers, irrigation upgrades and other projects, USDA data shows.

At a press conference in Atlanta on March 12, Rollins said, “If our farmers and ranchers, especially, have already spent money under a commitment that was made, the goal is to make sure they are made whole.”

But some contend the administration is unfairly making farmers jump through more hoops.

“This isn’t cutting red tape; it’s adding more,” said Andy Olsen, senior policy advocate with the Environmental Law and Policy Center, a Midwest-based environmental advocacy group. “The USDA claims to deliver on commitments, but these new rules could result in awarded grants being permanently frozen.”

U.S. Rep. Chellie Pingree, a longtime farmer and Maine Democrat who sits on the House agriculture committee, said she thinks it’s illegal and unconstitutional for the administration to withhold grant money allocated by Congress. Beyond that, she said, it has hurt cash-strapped farmers.

“This is about farmers making ends meet,” she told Floodlight. “It’s not some ideological issue for us.”

GOP lawmakers silent

Using USDA data, Floodlight identified the top 10 congressional districts that received the most grants. They’re all represented by Republicans who have said little publicly about the funding freezes affecting thousands of their constituents. It’s impossible to tell from the USDA data which REAP grants will get paid out.

The congressional district that received the most REAP grants was Iowa’s 2nd District, in the northeastern part of the state. Farmers and business owners there got more than 300 grants from 2023 through 2025. The district is represented by U.S. Rep. Ashley Hinson, who has previously voiced support for “alternative energy strategies.”

“More than half of the energy produced in Iowa is from renewable sources, and that is something for Iowans to be very proud of,” she told the House Appropriations Committee in June 2022.

Hinson’s office did not respond to multiple requests for comment on the matter.

The No. 2 spot for REAP grants: Minnesota’s 1st Congressional District, represented by U.S. Rep. Brad Finstad. In that district, which spans southern Minnesota, more than 260 farmers and rural businesses were approved for REAP grants.

Finstad’s office did not return multiple emails and calls requesting comment. His constituents have been complaining about his silence on funding freezes. They’ve staged at least two demonstrations at his offices in Minnesota. Finstad said he held a February 26 telephone town hall joined by 3,000 people in his district.

In a February 28 letter to a constituent, Finstad said Rollins has announced that the USDA will honor contracts already signed with farmers and that he looks forward to working with the administration “to support the needs of farm country.”

Finstad is no stranger to the REAP program. Before becoming a congressman, he was the USDA’s state director of rural development for Minnesota. In that role, he was a renewable booster.

“By reducing energy costs, renewable energy helps to create opportunities for improvement elsewhere, like creating jobs,” Finstad said in a 2021 USDA press release. That has since been deleted from the agency’s website.

Rollins, meanwhile, called herself “a massive defender of fossil fuels” at her confirmation hearing, and she has expressed skepticism about the findings of climate scientists. “We know the research of CO2 being a pollutant is just not valid,” Rollins said at the Heartland Institute’s 2018 conference on energy.

She has also said that she welcomes the efforts of Elon Musk and his cost-cutting Department of Government Efficiency team at the USDA.

Losing trust in government

Jake Rabe, a solar installer in Blairstown, Iowa, said he has put up more than 100,000 solar modules in the state since getting into the business in 2015. More than 30 of his customers have completed their installation but are awaiting frozen grant funding, he said. At least 10 more have signed the paperwork but are hesitant to begin construction. Millions of dollars worth of his business are frozen, he said.

On top of that, Rabe said, the state’s net metering policies—in which solar users get credits for any excess power they send back to the grid—are set to expire in 2026.

“I kind of feel like it may be the beginning of the end for the solar industry in Iowa with what’s going on,” said Rabe, who owns Rabe Hardware.

Despite it all, he remains a Trump supporter.

“Under the current administration, I think we’re doing things that are necessary for the betterment of the entire United States,” he said.

On March 13, Earthjustice, a nonprofit environmental law group, filed a federal lawsuit against the USDA on behalf of five farmers and three nonprofits. They’re seeking a court order to compel the Trump administration to honor the government’s grant commitments, saying it violated the Constitution by refusing to disburse funds allocated by Congress.

Vizcarra, the Earthjustice lawyer, said she is disturbed by the lack of concern from Congress, whose powers appear to have been usurped by the administration.

She added, “These are real people, real farmers and real organizations whose projects have impacts on communities who are left with this horrible situation with no idea of when it will end.”

One of the plaintiffs, Laura Beth Resnick, grows dahlias, zinnias and other cut flowers on a small farm about 30 miles north of Baltimore.

Florists are her customers, and demand for her flowers blooms during cold-weather holidays like Thanksgiving. Each of her three greenhouses is half the length of a football field and heating them during those months isn’t cheap, Resnick said. The power bill for Butterbee Farm often exceeds $500 a month.

So a year ago, Resnick applied for a USDA renewable energy grant, hoping to put solar panels on her barn roof—a move that she estimated would save about $5,000 a year. In August, the USDA sent word that her farm had been awarded a grant for $36,450.

The cost of installing solar panels was $72,000, she said. So she paid a solar contractor $36,000 upfront, expecting that she’d pay the rest in January when the federal grant money came in. The solar panels were installed in December.

But the federal government’s check never arrived. A February 4 email from a USDA representative said her request for reimbursement was rejected due to the Trump administration’s recent executive orders.

Resnick said she sought help from her elected representatives but got “pretty much nowhere.”

After hearing about the USDA’s announcement Wednesday, Resnick said that based on the response she’s previously gotten from the USDA, she’s not confident she will get her grant money.

“I’ve lost my trust in the USDA at this point,” she said. “Our project is complete, so we can’t change the scope of it.”

Van Hollen, the Maryland Democrat, said he supports the legal fight against the funding freeze.

“Donald Trump and Elon Musk are scamming our farmers,” Van Hollen said in a statement to Floodlight. “By illegally withholding these reimbursements for work done under federal grants, they’re breaking a promise to farmers and small businesses in Maryland and across the country.”

Renewable projects on hold

Since 2023, when IRA funding became available, the USDA has given or loaned about $21.3 billion through programs to support renewable energy in rural areas, according to a Floodlight analysis of agency data, including the REAP program.

Those grant payments were processed until January 20, when the Trump administration announced its freeze.

Trump’s decision was in line with Project 2025, a conservative blueprint crafted by the Heritage Foundation aimed at reshaping the U.S. government. That document called for repealing the IRA and rescinding “all funds not already spent by these programs.”

Environmental groups have sharply criticized the administration’s move, and several lawsuits are challenging the legality of the freeze of IRA funding.

At a recent public roundtable, Maggie Bruns, CEO of the Prairie Rivers Network which supports Illinois communities’ transition to clean energy, listed REAP grants that have been held up in Illinois, where her multifaceted environmental nonprofit is based. A $390,000 grant for a solar array at the grocery store in Carlinville; $27,000 for solar panels at an auto body shop in Staunton; $51,000 for a solar array for a golf course in Alton.

Since 2023, farmers and businesses in Illinois have been approved for more than 590 REAP grants, making the state the third highest in number of recipients in the United States, Floodlight’s analysis shows. In an interview with Barn Raiser, Bruns said the decision to freeze such grants has caused unneeded stress for farmers. Before the executive order, USDA’s rural development team had worked hard to bring dollars for renewable energy projects to Illinois farmers, she said.

“That’s the thing we should be celebrating right now,” Bruns said, “and instead we have to fight to make sure that money actually does land into the pockets of the people who have gone ahead, jumped through all these hoops and are attempting to do the right thing for their businesses and their farms.”

In January, Dan Batson’s nursery in Mississippi was approved for a $400,367 REAP grant—money that he planned to use to install four solar arrays. He intended to use that solar energy to power the pumps that irrigate more than 1 million trees, a move that would have saved the company about $25,000 a year in electricity costs.

Seated in a wooded area about 30 miles north of Biloxi, his 42-year-old GreenForest nursery ships potted magnolias, hollies, crepe myrtles and other trees to southern states. Until a couple of months ago, Batson had been excited about what the grant money would mean for the business.

But when he saw news about the funding being held up earlier this year, he called a local USDA representative who confirmed the funds had been frozen. Batson had already sent the solar contractor $240,000. Now, his plans are on hold.

“I just can’t do the project if I don’t get the money,” he said.

Tuesday’s announcement from the USDA makes him no more confident he’ll get the money, he said.

Batson said he’s a fiscal conservative, so he understands the effort to cut costs. “But,” he said, “the way they’ve gone about it has disrupted a lot of business owners’ lives.”

Floodlight is a nonprofit newsroom that investigates the powers stalling climate action.

The post Farmers in Trump Country Were Counting on Clean Energy Grants. Then the Government Changed the Rules. appeared first on Barn Raiser.

Thurka Sangaramoorthy initially wanted to be a medical doctor. Her family, including her parents, her sister and her mother’s eight siblings and their children, were the only Sri Lankan immigrants in their community in Rochester, New York. Growing up, she watched her parents face discrimination, particularly in healthcare, and often translated for them in institutional settings. Her journey into anthropology began during her time at Barnard College, when she signed up for a course called “Perceptions of the Alien,” which explored how immigrants are made to feel othered, or excluded, by society, both in the United States and around the world. “I thought it was about extraterrestrial life,” Sangaramoorthy says, laughing. “[But] it was essentially a class about my life.”

After earning her Ph.D. in Anthropology from the University of California, Berkeley, Sangaramoorthy completed postdoctoral research at the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention at the Centers for Disease Control and Prevention. As a professor in the department of anthropology at the University of Maryland, she recalls noticing how much of the department’s research on immigration was focused on urban environments like Baltimore and Washington, D.C., even though more than a quarter of Maryland’s residents, and a majority of its jurisdictions, are rural. As a result, she started doing fieldwork in 2013 in the Eastern Shore, a largely rural and conservative area east of Chesapeake Bay, which relies on immigrant labor, mostly from Latin America and the Caribbean, for its main industries: agriculture, poultry and seafood processing. 

That fieldwork became the basis of her 2023 book Landscapes of Care: Immigration and Health in Rural America (University of North Carolina Press), in which Sangaramoorthy examines the impact of global migration on underinvested rural healthcare systems in the U.S., and how the “exclusionary logics” of immigration policy have combined with corporatized models of care to worsen disparities in health outcomes and care delivery. By exploring the shared conditions of suffering among those who navigate these healthcare “landscapes,” Sangaramoorthy reveals the ways that immigrants and rural residents have developed alternate forms of solidarity and inclusion, and how healthcare policy might be reshaped in response. (Read an excerpt from the book here.)

Since 2022, Sangaramoorthy, now a professor of anthropology at American University, has been coordinating the response to the refugee crisis from Sudan and South Sudan with the U.S. Embassy in Addis Ababa, Ethiopia.

Barn Raiser spoke to Sangaramoorthy about the making of Landscapes of Care, the dynamics between citizen and immigrant residents on the Eastern Shore and how healthcare providers and immigrants adapt to the lack of rural health infrastructure in the region. 

In the preface to Landscapes of Care, you mention that you initially set out to learn about immigration to the Eastern Shore in Maryland, but that after speaking with people in the area, you started to focus on the connections between rural healthcare systems and immigrants. What sorts of things did you learn in your fieldwork early on that helped you see those connections?

I didn’t make the connection, I want to make that clear. It was being made for me. 

I knew that there were things that I didn’t understand, things that I needed to really pay attention to. And I think what I was seeing on the ground, for instance, in terms of rural health, was really the manifestation of something that occurred decades ago, especially in terms of market-driven changes in the 1990s. This was going on, and it’s still going on in other kinds of global spaces where I work, in terms of managed care principles, emphasis on corporate and business models, that really have structured health care in this country. But their effects, how this affected rural spaces, were very different because there are fewer possibilities for cutting costs and increasing profits in rural spaces, because these are also spaces in which there is a lot of economic decline. 

The consolidation of healthcare through a model of corporate efficiency has had a much more drastic and negative effect in rural spaces. We had a little taste of it during the Covid-19 pandemic when there was so much discussion about rural hospitals closing. And I think many people were shocked, but this had been going on for a long time. There have been drastic reductions in healthcare institutions like hospitals and clinics. There’s lowered Medicare reimbursements. There are fewer physicians—in the 10 years that I’ve worked in Maryland’s Eastern Shore, I think I’ve interacted with literally only two physicians. Many of the people that I worked with were nurses and nurse practitioners or other types of providers.’

The ACA [Affordable Care Act], or what most people call Obamacare, which was passed in 2010, was designed to provide a lot of relief. But many people that I worked with, felt like it didn’t do very much for them. It increased the number of people that can have health insurance, but it didn’t do much in terms of providing the kind of spaces where people can access care. It didn’t get at the root of some of these issues.  

What I realized, and what people were trying to tell me, is that the kinds of vulnerabilities people have in rural spaces were very similar to the kinds of challenges that immigrants have as well. And it’s only compounded for immigrants because they have other types of needs and other kinds of vulnerabilities that [citizen] residents don’t have. There are a lot of people who are working in jobs that are really dangerous, and for low pay. They don’t have  many available clinics or hospitals. They don’t have a steady stream of healthcare professionals in their area. They have very limited access to care, and if they do, they have to go during workdays, and many people simply cannot afford the kind of costs that come even in  safety net programs to get treatment or to even be seen. 

Rural [citizens] in the Eastern Shore would say to me, “We understand what [immigrants] are going through, because we face it ourselves.” So it’s this kind of shared condition around vulnerability and security that really brings people together outside of these very formalized healthcare settings, in which very little care is actually there. 

Something that stuck out to me was the fact that there are forms of solidarity between citizens and immigrants that I think gets lost in national conversations about immigration and rural places.

It’s so complicated. There’s this shared sense of insecurity that is constant. And I think that’s what really kind of brings people together. I’m not saying there’s not racism or xenophobia. I’m not saying that people are on the same sort of political platform, but there’s care happening outside of what one might call healthcare. And that’s what I really wanted people to understand. I think this is what people were trying to tell me, is that this is how we’ve always existed. We’ve always had to know how to care for each other. We know how to get by. And if you’re going to understand immigration, you need to understand that. And I think sort of that was the message that I just didn’t understand, because I didn’t understand the context of what it’s like to live in “flyover country.”

In the book you talk about how, in the face of the abandonment of rural areas by businesses and state institutions, immigrants are seen as the solution, but they’re also blamed for the decline. How does that dynamic play out specifically in the Eastern Shore? 

I think this is so important because I think so much of our discussions around immigration are either about integration or feeling pushed out. I think it’s so much more complicated than that. There’s a huge tension, because immigrants are essentially keeping some of these industries alive where many people don’t care to work because the work is so difficult and pays so little. But these tend to be the only kinds of jobs that are available in rural areas. And so immigrants are there, doing this kind of work, keeping those kinds of rural economies going. 

These are spaces that are experiencing population decline in a real way. Many of their children want to leave or have left. So they appreciate people who can stay, and then there are more people around and more resources. Several people said to me, “I really appreciate the diversity. It was never like this when I was growing up. I’m so glad that my children have different kinds of friends, and they’re learning so much about a global world and the different kinds of people that are there.” But rural spaces are not necessarily experiencing a rebirth, so to speak. 

Oftentimes there is so much stress around the decline of these communities. Immigrants become an easy target to blame for deep-rooted causes that stem from the structural abandonment by state institutions and the federal government, taking away much of the social safety net. And so immigrants become the targets, or proxies for these issues. 

There’s also racial tension. Maryland was a slave holding state. You still have a lot of generations of African-Americans that have moved there, that have lived there for a very long time, that are from the area, who have been underpaid or unpaid for their labor. Now there’s competition that pits different groups against each other. So there’s also a dynamic where immigrants are seen as people who will undercut African Americans for lower paying jobs. So it’s really complicated. 

What industries on the Eastern Shore rely on immigrant labor? And what are the different demographics that make up that labor? 

Like many rural regions, when you think about immigrant labor, most people often think about farm work. There’s definitely that. Cotton and tobacco were the major economies historically in this region. Now it’s mainly fruits and vegetables. There’s a lot of tomatoes and other kinds of vegetables and fruits that are grown on the Eastern Shore. 

The demographics are really varied here: Latin America, Mexico mainly. There’s also this long tradition of Haitian and other current-day Black immigrants [primarily from the Carribbean and other countries]. There used to be African-American migrant labor forces that traveled from Florida up through the East Coast. Haitians and other Black immigrants have largely replaced that labor force.  

Poultry is huge. There’s quite a bit of poultry processing on the Eastern Shore of Maryland and particularly in Delaware. It used to be a heavily African American labor force, but now it’s much more of a mix of people from Mexico and Latin America. But it’s predominantly Haitians that are working in poultry. 

Seafood processing, particularly crabbing, is unique to the Eastern Shore because of its location on the Chesapeake Bay. This is a labor force that was almost entirely poor African American women, who lived in this area. Now, it is almost entirely Mexican women on H-2B visas. 

On a national scale, often what gets focused on, in terms of immigration, comes down to one type of immigrant, namely undocumented immigrants. It’s interesting how so many other types of immigration interact with rural spaces, and how the dynamics of it are way more complicated. 

It’s important to me to highlight what is happening in rural spaces, because the growth [of immigration] in rural areas is really drastic. We tend to think of immigrants as somewhat placeless, in a sense. One thing that I really want to highlight is that immigrants have always had so much influence over geography and placemaking. They’re not placeless people. They actually have an impact on the very places in which they are living, even if they’re mobile. 

I think this comes out of my own sense of being a brown immigrant, but also from my entry into immigration research, which was really through Black immigrants. And that is so different. And I think in some ways, researchers and academics haven’t done much better than policymakers by rendering immigrants into one particular kind of experience.  We’re also to blame. So much of the conversation is about legality and whether you’re legally supposed to be here or not, which is only one way of understanding it. 

It really flattens our understanding of how different things are on the ground and how many variations there are. People’s experiences are not just about legality. For Black immigrants, legality is important. But being racialized  so profoundly shapes how they experience their life in the U.S. And it is something that I think we forget because of this archetype of an immigrant as undocumented and Mexican. And as a result, our policies are about making that the very thing the state responds to. I don’t agree with that. We have to understand that there are different dynamics at play, that legality is not the only way to understand the experience of immigrating to this country. 

Near the end of the book, you talk about how both medical providers and immigrants adopt an “insurgent politics of care” to adapt to the lack of available healthcare infrastructure. Could you unpack that term a bit? What are the ways that a “politics of care” manifests itself? 

What I’ve been trying to explain is the informal way that rural healthcare works. For instance, on the Eastern Shore, it’s literally a few people that are holding up any sort of semblance of what we call a safety net. It’s not even really a net. It’s just people who are doing this work and do it in various ways. 

There’s this unbearable but very common way that healthcare works, which is a transactional relationship. You go in, you have insurance, you pay—it’s monetary, it’s corporatized, in that sense. There’s this rendering of what your risks are, what the insurance will pay for, etc. 

But in rural spaces, care often cannot get doled out this way. Otherwise, no one would get care, or very few people would get care unless they had a serious emergency. 

This is why the book is called Landscapes of Care because it’s really a varied sort of space, haphazard and much of it informal. 

For instance, bartering. I’ll use that as a prime example. Bartering happens all the time in these spaces. I had a provider who, when people couldn’t pay, they would come with some of their harvest, they were too proud not to pay. They were not only farmers, but also immigrants who were farmworkers, who were paying with watermelon or other kinds of produce for their care, as a way of thanking the provider. The same provider, this was like in different cycles, they would have crab because it was a fisherman or watermen who couldn’t really pay either the co-pay or the cost of treatment. So like, these are the ways that people manage. 

And I think in some ways it’s pushing back against how corporatized our healthcare system has become. It doesn’t work for a vast majority of people. And I think this shows us how you can care for people outside of these formalized environments, because that is essentially how people are caring for each other all over this country. 

But this is how people are getting by. Because there’s no one else to take care of them, right? There isn’t. And so this is how people are taking care of themselves. And to me, that’s really powerful. 

Read an excerpt of the book here.

The post Practicing an ‘Insurgent Politics of Care’ in Rural America appeared first on Barn Raiser.

R. Vincent Moniz Jr.
ICT

For five amazing decades, the world has been filled with the sounds, stories and voices of hip-hop. From music to brand deals, rapping to the beat has become a destination for poets and hustlers alike. But where in this behemoth of a building will you find exhibition space for Natives? Where is the room in this lodge for those who have been singing their prayers to beats passed down from their ancestors’ hearts?

It is a place much of Indian Country knows the direct location of. Every two-step those first Native rappers danced, another song was created. Star blankets transformed from curtains and doors, into soundproofing for closet turned recording studio.

There is not a specific date when Native people first reached for the mic. The cities and tribal lands they come from have their own creation stories and heroes of the game. The beginning of each rhymesayers origin story is as rich and diverse as the nations and neighborhoods they come from.

Gichi-manido wiidookawishin ji-mashkawiziyaan
(Great Spirit help me to be strong)

Mii dash bami’idiziyaan
(So that I can help myself)

Miizhishinaam zaagi’iiwewin
(Show us all love)

Ganoozh ishinaam, bizindaw ishinaam
(Talk to us, hear us)

Mii-wenji nagamoyaan
(That is why I am singing)

Nimishomis wiidookawishinaam ji-aabajitooyaang anishinaabe izhitwaawin
(Grand father help us to use the Anishinaabe customs)

Mii-ji-bi-gikendamaan keyaa anishinaabe bimaadiziwin
(So that we’ll know how to live the Anishinaabe way/the good life)

– Tall Paul, Ojibwemowin lyrics from ‘Prayers in a Song’

What is known, is that Native people immediately connected with the beats, dances, and the intricate plot being told by master storytellers. Tales of survival, of triumph and tragedy were kindling First Nations had already spit like hot fire.

Like many Native children, the start for “MuMu Fresh” began with teasing relatives. These Afro-Indigenous youth, who grew up in and around Baltimore, Maryland’s Indian Center, stepped up their smack talk with tight flows.

The Baltimore Native remembers her brother’s ability to battle rap was the stuff of front stoop legends. However, younger sisters, no matter how much they loved the word play, were not allowed. MuMu Fresh talked about growing the four sisters of her rhyme game with the determination to get outside. The front steps were linked to her start when she tore through the Goliath to Fresh’s David.

Related:
— Miracle Spotted Bear is stuck in between
— ‘I was raised through music’
—‘He who walks through the battle smoke’
—Rising Lakota musician ‘Hittin’ Home Runs’

Leech Lake Ojibwe citizen Tall Paul knows the front and back end of the hip-hop genre. His appreciation of Native rap is deeper than 10,000 lakes. This Anishinaabe rhymer has no problem listing artists he likes and the ones he is keeping an ear to. One of the things that separates Native hip hop is the inclusion of Indigenous melodies and languages. ‘Prayers In A Song’, written Tall Paul, features the hip-hop artist rapping to the beat in Anishinaabemowin. The track, now a classic, was a turning point. Our languages can be braided into any beat, but these two were like connecting puzzle pieces of a larger masterpiece

Paul, who was raised in south Minneapolis, knows that it takes a lot of work to find success. The rapper has many hopes for the next 50 years of hip-hop. He sees more opportunity for artists to have the freedom to express themselves and their personal experiences. To the Tallest of them all, hip-hop is a gift. It is for strong hearts with cold flows to begin a remodel of their own. Fitting more Indigenous people into the mansion hip-hop built.

ICT is a nonprofit news organization. Will you support our work? All of our content is free. There are no subscriptions or costs. And we have hired more Native journalists in the past year than any news organization ─ and with your help we will continue to grow and create career paths for our people. Support ICT for as little as $10.

On murky nights, when dullness stole the sky and blanketed the North Star, Harriet Tubman used her vast forestry skills to propel forward those escaping slavery.  As a child, she learned moss only grew on the northward side of trees and used that knowledge to help direct dozens of people on the Underground Railroad. To […]

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