HISPANIC HEALTH AND COVID-19: A STORY OF DISPARITY
Written by Natalia Casas.
COVID-19 impacted industries and people across the board, in particular people of color, and many of the long-term repercussions are yet to be seen. Here is a brief look at the situation, how have Hispanics fared the pandemic and what should the healthcare and wellness industry respond to regarding the most affected.
Minorities are the biggest victims of the coronavirus pandemic in the United States. Blacks, Indigenous and Hispanics did not fare well. By May 2020, Hispanics had the second-highest rate of coronavirus deaths in New York City, but they were also dying above their population share1 in states like Tennessee and Wisconsin, areas normally not thought of as Hispanic dense. And in terms of job and income loss nationwide, 40% of Latinos, compared to 27% of all Americans had to take a pay cut, and 29% lost their jobs, as opposed to 20% of the overall population2.
One valid question to ask is why did this happen? The answer can be reduced to one word: lack. Hispanics, like other minorities, experience lack of information, lack of appropriate healthcare resources, insufficient access to education and social support networks, etc. All of these factors combined made them easy victims of the pandemic.
It’s no coincidence that in Google, the most popular search terms during the first 4 weeks of the pandemic in Spanish were all about and related to unemployment. “Desempleo por coronavirus”, “aplicación para desempleo” and “prueba del coronavirus” spiked across states. And around the first weeks of reopening in most states, the searches changed, but not the theme” “cheque” and “segundo cheque de estímulo.”
The math is not hard to do. If minorities lack proper health and healthcare systems, yet they’re also at the forefront of the country’s essential jobs, those who faced the pandemic head-on so the country could keep running were the most affected. Data from the U.S. Bureau of Labor Statistics show that fewer than 20% of black workers and roughly 16% of Hispanic ones are able to telecommute3. They are the ones out there cooking, storing, working in shipping or food processing plants, etc. In many cases, under subpar conditions (remember the meat plant in Colorado?), enhancing their probabilities of contracting COVID-19 and other illnesses.
As we already know, the exposure to the virus is exacerbated by the fact that Hispanics have the highest uninsured rates of any racial or ethnic group in the U.S., with only 49% of Hispanic insured, vs. 75% of NHW4. This number actually includes those Hispanics who have insurance through the Affordable Care Act. To add insult to injury, the Hispanic population is also at a high risk for many medical conditions such as heart disease and diabetes that heighten the risk for COVID-19 complications.
But where do all these issues come from? Is it cultural, dietary, or is it genetics? Is it due to socio-economic factors? The answer is all of them. The conditions in which people are born, grow and live are primary drivers of health. But if they also live in neighborhoods or towns with little to no support from the government, the lack of proper education, clean environment, employment, social and cultural resources and access to healthcare, all the odds are against them. Health and access to healthcare are different factors, yet they are deeply intertwined.
UNCERTAINTY AND FEAR
During the beginning of the pandemic, Hispanics had to rely on the news or on hearsay to understand what was going on. When the official CDC guidelines were published, it took 4 days for these guidelines to be published in Spanish5, for millions of people to have access to the basic information they needed to know about the virus and its symptoms, what to do, where to go or what measures to take.
Of course, the levels of uncertainty, stress and anxiety among Hispanics skyrocketed, hence the impact on their mental health. They not only felt helpless, alone, ignored, and hopeless when relatives or friends became ill, or worse, started to die. But they also had to continue taking care of children or elders, while figuring out their new job situation, or worry about their immigration status. The health crisis added to the delicate political situation they live in. Thousands saw their process of becoming legal come to a sudden stop and DACA students saw their future even more uncertain.
Therefore, mental health is something to pay attention to when thinking about Hispanics. How can they be vulnerable when emotions are still raw, but also, when there is also a huge taboo about mental health in the Hispanic community? Young Latinos, gravely affected by mental health issues, hear from their elders that “they are spoiled brats” because they want to talk about their feelings. Meanwhile, those same elders who discount the importance of social and psychological help are also scared to talk about feeling lonely or worried about their future and the future of their families. Bottled up stress is the cause of other diseases present among Hispanics.
WHAT COMES NEXT?
As the country moves past the peak and more reliable data is available, brands and private entities are faced with the need to rethink their purpose and their role in people’s lives. It becomes almost a moral responsibility to be of service to consumers within the realm of the brand’s category. Brands need to walk the path their consumers are walking, and consumers have to feel it.
What does this mean for healthcare brands? It means they have to be more in-tune than ever with the reality of all patients, their fears and needs, their craving for accurate and timely information, and above all the understanding of patients as whole human beings, with families and lives that go beyond their ailment.
In the autopsy of the pandemic, there are lessons to learn and actions to take:
The more you know. The Hispanic community is diverse, yet they have suffered a big hit as a whole. Brands should take account of what they know about the community and how the virus has directly impacted the treatment or condition of their consumers. Doing research to uncover accurate and timely data about the consequences of the pandemic from a cultural and public safety angle will provide important answers, and therefore actionable insights.
How can brands be a source of information and education? Yes, they can, in particular in areas where public entities are not meeting the public’s expectations or when it comes to conditions that are predominant among Hispanics, such as heart disease, diabetes, dementia and Alzheimer’s.
Healthcare won’t be the same. Aside from the physical changes to medical offices, visits and procedures, there is no doubt that healthcare won’t be the same. Healthcare workers have finally been recognized for their hard and delicate work, yet patients expect more. In particular Hispanics who feel they missed critical information in the beginning, and now more than ever will expect and deserve accurate, timely and in-language information and treatment. The cultural barrier is a hard one to overcome, and brands still have a lot of work to do in this regard. A study done in 2018 by the Associated Press-NORC Center for Public Affairs Research6 showed that nearly 6 in 10 Hispanic adults have a difficult time communicating with a healthcare provider because of a language or cultural barrier.
Bilingual doctors, interpreters and culturally-relevant health information is still scarce, and healthcare providers and pharma companies have dedicated only 2% of their ad budgets7 to the Hispanic audience. This population is missing important allies in the medical and healthcare workforce who truly understand them and can provide the information they need to empower the patient and build trust.
Telehealth is here to stay. Job and income losses have impacted adherence to treatment, doctor visits and insurance enrollment, and Hispanics are protagonists in this reality. Appointments have been cancelled, procedures postponed, and treatments stopped or interrupted. Now more than ever, Telehealth is a reality for patients and although Hispanics tend to view it under a positive light, there is still room for growth.
Pharma and healthcare companies can partner with Telehealth providers to develop better strategies, better material and culturally appropriate information for all sorts of patients, from those who need to fine tune their healthcare routines to those who need treatment for chronic conditions. The most important improvement in this area is the possibility to bring Hispanic professionals to the forefront, both doctors and nurses, who understand cultural nuances and generate a stronger bond with patients and their families.
1. APM Research Lab, “The Color of Coronavirus: COVID-19 Deaths by Race and Ethnicity in the U.S.”
2. Pew Research Center “U.S. Latinos among hardest hit by pay cuts, job losses due to coronavirus”
6. Associated Press “AP-NORC Poll: Latinos see health care communication barriers”