By: Sara Dickmyer and Veronica Cool
As if it’s not bad enough that positive cases of COVID-19 are on a rapid rise across the U.S., a collaborative study by three departments at Johns Hopkins Medicine here in Baltimore that was published June 18 in the Journal of the American Medical Association (JAMA) put the coronavirus positivity rate at three times higher for Latinos than for other U.S. minorities. The results were based on the testing of nearly 38,000 samples in the Baltimore-Washington area.
In the study, over 6,000 positive coronavirus tests were recorded with Latinos factoring in at 42.6%, whereas positives for Blacks were 17.6% and whites were 8.8%. For those with coronavirus symptoms severe enough to require hospitalization, far fewer Latino patients (29.1%) were admitted to hospitals than were Black (41.7%) or white (40.1%) patients. And those Latinos were younger, predominantly male, and also had fewer underlying conditions such as diabetes, heart disease or hypertension.
That news is startling enough to make headlines and it is not isolated to the Baltimore-Washington corridor. The CDC is also reporting that Latinos across the U.S. have been three times as likely to become infected as their white neighbors based on 640,000 positive test results (as of May 28) spanning nearly 1,000 counties from east to west. Worse still, Latinos are twice as likely to die from the coronavirus as whites. Geography played no perceivable role – the same disparities appeared in rural towns, suburban areas, and big cities.
WHAT’S TO BLAME?
Dense Living Conditions and Financial Insecurity
Several factors unique to the Latino community played major roles including dense living conditions and financial insecurity. Latinos are more likely to live in crowded conditions with multigenerational extended families and to hold essential worker status jobs that they rely upon for basic survival. Those jobs are typically front-line, low pay, and part-time – cleaning, restaurant workers, store clerks and stockers, construction crews, but also include food manufacturing/processing and agricultural industries. In the U.S., about 43% of Latino and Black workers are employed in service or production jobs that cannot be done remotely compared to about 25% of whites according to 2018 census data. Many workers in these positions hold several part-time jobs, none of which offer benefits like insurance, paid time off, or sick leave. And to further complicate matters, think about how they typically get from job to job…Public transportation like buses and subways where social distancing is nearly impossible.
Lack of Healthcare and Concerns About Immigration Status
These factors also played large roles. The Hopkins study noted systemic exclusion of the Latino community from basic healthcare services. According to local expert Dr. Kathleen R. Page, “Many of these patients tell me they delayed coming to the hospital until absolutely necessary because they were worried about medical bills, and were not sure if they could receive care because of their immigration status.” In Latino communities across the country, those most at risk for getting sick were the same ones who were not eligible for benefits and had no health insurance, but needed to keep working to support their families. Additionally, misinformation abounds regarding Public Charge and the implications of seeking healthcare. Those misinformed individuals would rather remain sick than take a free Covid-19 test that might risk their ability to become U.S. citizens in the near future.
“… they were worried about medical bills, and were not sure if they could receive care because of their immigration status,” – Kathleen R. Page, M.D., associate professor of medicine at the Johns Hopkins University School of Medicine
Our neighbors in Virginia are experiencing similar disparities. Fairfax County, Virginia, one of the wealthiest counties in the U.S. has a Latino community in which four times as many Latinos have tested positive for the Coronavirus than whites. The pressure is high to keep working while sick and to quickly return to work – there is always someone else willing to take over the job.
Cultural Norms and Limited English Proficiency
As the Coronavirus pandemic began to swirl around us all and blanket the U.S., nearly all information was being shared only in English. Some areas with higher Latino populations saw local agencies or community organizations jump in to provide their own translations of basic instructions on handwashing and social distancing, if they were lucky. In Maryland, we collaborated with the Maryland Emergency Management Agency (MEMA) to provide emergency translations in Spanish. Over time, the CDC, OSHA, and other federal government agencies began to provide important resources in Spanish, as well. But that lack of early and well-disseminated resources in Spanish was detrimental to the Latino community.
“Social distancing” was not a concept Americans were used to hearing before coronavirus, let alone Latino communities that thrive on being close-knit, warm and welcoming, with hugs and kisses for all. Explaining the need to stay 6 feet apart, wash hands regularly, wear a mask, stay at home – these were all very challenging concepts that threatened to crash in on ingrained cultural norms. The messages, although increasing in frequency, are still not getting through, and the rapid spread of the coronavirus through Latino communities certainly can be attributed at least in part to the lack of Spanish-language resources.
WHAT DOES THIS MEAN TO NON-LATINOS?
Diversity and disparity have historically gone hand-in-hand. The patchwork economy long relied upon by minorities has become even more unstable under the pressures of a global pandemic. History shows us that recovery periods from troubled times such as the Recession of 2009 are markedly slower for Latinos. In spite of that, “Latinos have continued to power the U.S. economy and strengthen it with their high levels of labor force participation, economic purchasing power in excess of three-quarters of a trillion dollars, and above national average rates of entrepreneurship,” according to a Unidos US White Paper published in July 2020. That purchasing power alone reflects how deeply the entire U.S. economy will continue to suffer as lost wages have severely cut all but essential spending across Latino communities.
Already, that lack of money and lost wages in the economy has had trickle down effects – small businesses closing, mid-size companies scaling back, and even large companies are scrambling. It is finally becoming obvious how integral and important Latinos are to the overall economic stability and future growth of our neighborhoods, states, regions, and the United States as a whole. Now is the time to expand our ways to support the Latino community and begin to shore up the disparities that have hovered just beneath the surface for so long.
HOW CAN YOU HELP?
Advocacy Efforts – A multi-pronged approach: helping at the grassroot level and at the policy level.
- Locally, encourage your local Latino small business entrepreneurs to apply for available funds such as through The CARES Act and the U.S. Small Business Administration Paycheck Protection Program. The National Network to Eliminate Disparities in Behavioral Health (the NNED) has issued guidance for racial and ethnic minority populations. To further reduce worry, many of the assistance programs do not have to be repaid. Better yet, take an entrepreneur under your wing and guide them directly through the process of applying. It may be their best chance of continuing to provide their goods and services within their community.
- At the government level, advocate for language access and equity, ensuring legislators and decision-makers consider immigrants and individuals with limited English proficiency as they craft policy. For instance: Are you aware that mixed households (comprised of a U.S. citizen married to an undocumented individual) are excluded from receiving the Federal stimulus? Not very fair, is it? This is simple inequity with tremendous disparate impact that needs to be addressed urgently.
Communication, Resources, Awareness – Any notices and important information that you post in your physical business location or in your online webpages and social media sites needs to be posted in Spanish, too. The CDC offers a database of Fact Sheets and Notices to choose from. The World Health Organization and Salud America are other great resources offering bilingual information. If you have a specific industry need or technical language, use a verified translation service like Cool & Associates, LLC to be sure your message is translated properly and with the appropriate cultural and regional sensitivities. Poorly translated information will be ignored (would you believe garbled English?), or worse, could be potentially harmful.
DONATE & SUPPORT – Whether it’s monetary contributions, staff volunteers, or something else, as an individual or business, you can help our community organizations that are fighting daily for the health and well-being of not only our Latino brothers and sisters, but Marylanders. Faith-based leaders are providing spiritual and mental health support; community organizations are providing free meals for in-need students and families. This locator can help you find new ways to help.
Amigos – juntos, together, we can do this. The time of looking to others for help has passed. The time for action by each of us within our own communities is now. If you are unsure what you can do, reach out to Hola@coolassociatesllc.com.