AAAS Kavli Lecture: Amy Maxmen on Inequality as a Frontier for Science Journalism

Michaela Jarvis

Within months of its onset, the COVID pandemic revealed that communities of color were at far higher risk of disease and death than white people, journalist Amy Maxmen said in a Nov. 3. AAAS Kavli Science Journalism Award lecture. Some researchers searched for biological explanations to explain away the disparities, and many researchers briefly noted unequal living conditions, Maxmen said, but they failed to address the problems in any substantive way.

An October 2020 report by the Centers for Disease Control and Prevention, or CDC, for example, noted that Hispanic people were dying of COVID-19 at dramatically disproportionate rates. The article suggested that these higher death rates might be due to such factors as living in crowded households, dependence on jobs requiring in-person work, and less access to healthcare. Yet the CDC subsequently recommended preventing the spread of the deadly disease with face coverings, social distancing and hand washing.

Amy Maxmen

“To me, that’s just not good science,” Maxmen said in her lecture at the University of California, Berkeley. “There’s no way you say a problem is less access to healthcare and then you say, ‘Wash your hands.’”

It is partly this avoidance of the root problems that might explain why, more than 150 years after researchers started documenting how disease disproportionately affects marginalized people, “We’re still dealing with the same old problems in public health,” Maxmen said.

Her talk was the second of three in this year’s AAAS Kavli Science Journalism Award lecture series and was co-hosted by the Graduate School of Journalism at the University of California, Berkeley and the university’s Kavli Center for Ethics, Science, and the Public. Each year, the lecture series brings winners of the prestigious award to university campuses for public lectures and workshops with journalism students. Maxmen, now an Edward R. Murrow Press Fellow at the Council on Foreign Relations, won a 2020 AAAS Kavli Gold Award while working at the journal Nature.

While writing articles on global health and infectious diseases, Maxmen’s reporting has often led her to situations where she has found inequality plays a significant role in provoking, furthering and exacerbating health crises. As a science journalist, she says, it is her responsibility to report on that connection.

In her talk, Maxmen said she was “trying to make the argument that inequality belongs as a subject within science and for science journalists to cover.” Inequality is often brushed aside, she said, with the explanation that the underlying issues are not about science. But Maxmen argued that the point of science is progress, and that progress will lag if the fruits of science are only available to the few.

Maxmen graduated from UC Berkeley with a Bachelor of Science degree before moving on to Harvard, where she earned a PhD in evolutionary biology. She published her doctoral thesis, on sea spiders, in Nature — and then decided to become a journalist. “It’s another way to satiate my curiosity,” she said, while being able to “jump around a little bit more.”

In 2014, Maxmen traveled to Sierra Leone to report on a massive Ebola outbreak. She discovered that people who had contracted the illness were avoiding hospitals, not necessarily because of beliefs and superstitions around traditional medicine as was commonly believed, but because “people had had really bad experiences in hospitals.”

Hospitals were overcrowded, without enough nurses to provide care, and healthcare providers would ask for money for treatment that was supposed to be free, people told Maxmen. Visiting the hospitals, she learned that healthcare providers were not being paid or protected from contagion. Walls were covered with flyers showing photos of doctors, nurses, and ambulance drivers who had died, very quickly and at young ages, while trying to care for patients.

In 2015, an Ebola burial team in Sierra Leone prays with family before taking a body for burial. |Shutterstock

Although $3 billion had been donated to handle the outbreak, there was no system for payment and the fraction of the aid money meant to compensate national healthcare workers, was not reaching them.

“I didn’t go to Sierra Leone to write about payroll,” Maxmen said, but that problem was behind a significant breakdown in the management of the epidemic. “I talked to health workers who said they would never work in an outbreak again.”

In 2020, Maxmen reported on similar circumstances when COVID-19 hit California’s San Joaquin Valley, causing so many deaths that refrigerated produce trucks were converted into makeshift morgues. What Maxmen found were people who worked on farms and in meat-packing plants with little access to healthcare, no labor protections and “not a whole lot of agency to do anything about these problems. “It was a setup for a really bad time with a transmissible disease,” Maxmen said.

Workers on farms, in processing plants and meat-packing facilities told her that they had continued to work when sick because they needed every bit of pay, and some worried they would be fired if they tested positive for COVID-19. Many who were ill avoided hospitals because former President Donald Trump had made a statement that undocumented workers who went to emergency rooms were subject to deportation. A study found that in 2020, food and agriculture workers in California had a 40 percent increased risk of dying, compared with the rest of the state’s residents.

Maxmen said the situation was reminiscent of an 1848 report by a Prussian doctor named Rudolf Virchow on a typhus-ravaged part of Eastern Europe known as Upper Silesia. Virchow asserted that the affected residents, mineworkers, were being exploited and therefore could not protect themselves from the disease. Virchow said the Silesians were viewed as tools, not humans, by the plutocracy. His observation seemed to reverberate in the San Joaquin Valley, where people working on farms had told Maxmen that the COVID-era term “essential worker” was curious because it sounded like an honor, only they did not feel that they were treated with care by the country they fed throughout the pandemic.

“What part is essential,” Maxmen asked. “Is it their work or their lives? The resounding answer seemed to be their work.”

Maxmen pointed to an alliance between community organizations in the San Joaquin Valley and local universities and institutions as being a worthwhile example of how science could participate in combatting some of the health problems associated with inequality. Local researchers and doctors collaborated with community organizations — each dedicated to different groups, including African Americans, Southeast Asian refugees and indigenous people from Oaxaca — in an effort known as the COVID-19 Equity Project. Workers in the valley trusted the community organizations, whose representatives worked to know and meet their communities’ needs. They offered food, help in staving off evictions, free on-site COVID-19 testing and valuable information about the illness. The collaborative effort was effective, Maxmen said.

“I think one thing that comes out of this is that public health might be able to meet more of its goals by working more closely with community organizations,” Maxmen said. The article she wrote about the San Joaquin Valley, entitled “Inequality’s Deadly Toll,” was well received generally, Maxmen said, and by scientists and science journalists alike.

Public health effects related to inequality are “huge problems and they’re not simple to solve,” Maxmen said. “ They’re complex. By reporting on them, that’s where we can start to see solutions, or at least the challenges blocking the way.”