The pandemic is hitting Latinx people harder; HIV researchers say it’s time to create policy changes

Like the HIV epidemic, the COVID-19 pandemic shows what happens to people who are socially and economically disadvantaged—a greater risk of disease and death.

Already understanding how these disparities are harmful to health, two groups of HIV researchers working together documented the greater COVID-19 risks for two vulnerable groups—Black and Latinx people.

The researchers say they want more than just statistics to show to government officials and other policymakers. They want policymakers to work towards ending the inequities in the first place.

Study on COVID-19 and Latinx

Carlos E. Rodríguez-Díaz, PhD, MPH, is a community health scientist with the Milken Institute School of Public Health, George Washington University, focusing on action research on the social determinants of health. He is the lead author of the first nationwide analysis of COVID-19 cases and deaths in the Latinx population, “Risk for COVID-19 infection and death among Latinos in the United States: Examining heterogeneity in transmission dynamics,” published July 23 online in Annals of Epidemiology. He discussed his study during an August 5 webinar organized by the Latino Commission on AIDS in collaboration with other agencies. Note: Dr. Rodríguez-Díaz used “Latinos” for the sake of simplicity while recognizing the many ways that people identify.

“The attention to the Latino community has been part of the discussion of the pandemic since very early, because, unfortunately, there were disparities in our Latino communities that the pandemic is just highlighting.

“For those of you engaged in work with Latino communities, you understand this. But do not underestimate the importance of the discussion that we’re having and how we are framing that discussion, because the issue of health disparities is not obvious for the overall population of the United States. Crowded housing. Chronic medical conditions. Environmental racism.”

“The purpose of our research was not only to highlight structural drivers of the pandemic among Latinos in the United States, but to make sure that we come up with findings that are useful to make changes and have a positive impact on the health of our communities.

“We have a great opportunity to respond to the emergency and change the negative impact that the pandemic is having among Latinos, but also to make changes that can have a durable impact on Latino communities.”

“Our study was in part developed because of our historic involvement in health disparities. Many of us have worked in the HIV field for decades. And the knowledge that we have gained in health disparities and HIV in the Latino communities was very transferrable and useful these days.”

The study was modeled on one published a month earlier examining the impact of COVID-19 on Black communities. Dr. Rodríguez-Díaz pointed to differences between Latinx groups.

“We know that not all Latinos in the U.S. share one unique story. We have people who speak different languages, Spanish or English for the most part. They are geographically located in different places. They have experienced migration in different ways. So, all those elements were considered in the way we approached the data.”

The study looked at county-level data through May 11, when some states began to relax stay-at-home policies. Counties considered “Latino” were those with a Latinx population greater than 17.8%, which is the percentage of the Latinx population in the country as a whole. Latinx make up the largest racial and ethnic minority group in the U.S. Puerto Rico, which does not have counties, was added as one county. Fourteen percent of all counties (443 out of 2,700) were predominantly Latinx. The Latinx counties had a Latinx percentage ranging from 22.9% to 47.9%.

Nationally, COVID-19 diagnosis rates were greater in Latinx counties: 90.9 vs. 82.0 per 100,000 persons.

Predominantly Latinx counties were more likely to

  • Have people who were younger (on average, under 35)
  • Have a greater number of individuals without health insurance
  • Have a greater number of persons per room in a household
  • Have fewer monolingual English-speaking Latinx
  • Have a greater proportion of monolingual Spanish-speaking or bilingual individuals

These differences were statistically significant. Dr. Rodríguez-Díaz said this was no surprise: “It’s a profile we see very often.”

Because so many early COVID-19 cases in the U.S. occurred in the Northeast, the study looked specifically at different regions to make comparisons.

It found that in the Midwest and the Northeast (specifically New York, New Jersey, and Connecticut), the rates of COVID-19 cases were highest in the counties with greater Latinx populations.

“This means that Latinos were disproportionally affected early,” said Dr. Rodríguez-Díaz.

In the South, however, no greater risk was found.

For counties across the country with more Latinx people, the COVID-19 rates were higher with

  • A greater proportion of Spanish-monolingual people
  • Lower unemployment rates
  • More heart disease deaths
  • Less social distancing, and
  • More days passed since the first reported case

“We know, unfortunately, that for monolingual Spanish speakers to have access to prevention information and to engage properly with the healthcare system is much more difficult. We also found more COVID cases among those with lower unemployment rates, and this is interesting. … Consider this as we move forward to deaths. What we are seeing here is that the cases are more common among Latinos that are working, who couldn’t stay at home to prevent infections.”

In terms of deaths from COVID-19, the numbers were greater in;

  • Latinx counties in the Midwest
  • Latinx counties with
  • crowded living conditions
  • elevated air pollution
  • higher rate of employment
  • age (younger than 35)

“What we know about crowded housing in the Latino community is that we often have households with multiple families because it’s part of the experience of migration. It’s part of some cultural practices. People have different explanations, but we have documented this in the past. With crowded living, you have multifamily housing. So people are coming in and out for work, but there’s also less space for distancing.

“Air pollution has been associated with respiratory conditions that are exacerbated when the person is infected. Air pollution has often been documented where communities of color live. There are different reasons for that. In some cases, it’s because communities of color, including Latinos, are living in metropolitan areas where you have more air pollution because of transportation and other industries. In rural areas, it has to do with industries that are there, as in the case of Texas, or other parts of the states where you have refineries and other industries that are constantly polluting the air. This compares with other trends in environmental justice and how communities of color are disproportionately affected by environmental pollution.“

The employment findings were consistent, he said, with U.S. reports that most Latinos couldn’t stay home.

“They had to go out and work because they are frontline workers and they are working in the industry, some of which were considered essential, like the meatpacking and multiprocessing industries.

According to the study’s conclusion, “COVID-19 risks and deaths among Latino populations differ by region. Structural factors place Latino populations and particularly monolingual Spanish speakers at elevated risk for COVID-19 acquisition.”

“We have demonstrated that not all Latinos are equal. But again, there are many assumptions and there are several discourses in our country that make it harder to communicate challenges in our communities. I hope that this study serves to document challenges and the nuances in the experiences of the Latino communities in the U.S. Because we also know that we need policy changes, but the policy response cannot be the same for all counties, all communities, and assuming that all communities of color or other communities are equally affected by the implementation of certain policies.

“We are okay with people working and feeling productive, and getting an income. However, we need to provide the best conditions possible to prevent infection at work.”