SciLine interviewed:Dr. Alex Ortega, a professor of health policy and the director of the Center for Population Health and Community Impact at Drexel University. His research focuses on health and well-being of Latino youth and families in the United States.
Is COVID-19 having a more significant effect on Latino communities than other groups?
ALEX ORTEGA: So the epidemiological data that have been coming in over the last several weeks have shown that vulnerable populations, particularly Latinos, are at especially high risk of being infected with COVID-19, as well as having serious complications as a result of the infection.
What are some of the factors contributing to the severity of COVID-19 in Latino communities?
ALEX ORTEGA: Sure. So I think there’s a myriad of factors that contribute to their risk, which include lack of access to health care, particularly for Latinos who live in rural areas. You know, Latinos in the United States are much less likely to have health insurance and have access to care and to utilize primary care. And they’re much less likely to be aware of diseases they have because of their lack of access to care and be properly managed for any diseases they might have. Also, Latinos are much more likely to be on the front line of the kinds of jobs that – the essential jobs, such as, you know, restaurant – the restaurant industry, agriculture, you know, and they’re much more likely to live in – especially immigrant Latinos are much more likely to live in households where there are multiple generations of family members. So you might have grandparents and parents and kids, and all of which – ’cause we know that COVID-19 – a big risk factor for COVID-19 is density. So when you live in households where there’s a lot of people, and you have jobs where you can’t socially distance, or it’s difficult to socially distance, and you’re constantly being exposed to the virus and putting yourself at risk for the virus – of catching the virus – that’ll put you at high risk for the disease.
Is the pandemic having particular effect on Latinos who are undocumented or otherwise disenfranchised?
ALEX ORTEGA: So undocumented Latinos are much more likely to – they’re much more vulnerable for a variety of reasons, including, you know, working in jobs that – like, you know, in farming and in agriculture, that – where they can’t socially distance, where they work very close to each other, where there’s not good access to health care. And they generally are in rural areas but not exclusively rural areas – also urban and suburban areas, but rural areas, particularly – undocumented Latinos, especially migrant workers, are much more likely to be in rural – you know, in rural areas. And they also work in the restaurant industry. And even though restaurants have been closed across the country, you know, many restaurants are still open, serving food in a – you know, either pickup or, like in Pennsylvania – at least in Philadelphia right now, you know, people are allowed to eat outside, but, you know, still, Latinos – undocumented Latinos are much more likely to be in the back, working in the kitchen, working close to each other.
Do you have any advice you’d share with people who are concerned about coronavirus, and in particular, those in a community at elevated risk?
ALEX ORTEGA: What I would say is, you know, practice, you know, what the CDC recommends – wear your masks, socially distance, if you can. You know, shelter in place if that’s a possibility. But for most Latinos, especially those who are immigrants or work in jobs where – that are essential, it’s not possible for them to shelter in place. So, you know, the other thing is that we know that those who are at risk of having severe complications as a result of being infected with COVID-19 are those who have chronic conditions or multiple chronic conditions. And we know that Latinos and other minority groups are much more at – have higher risk of having chronic conditions, particularly obesity-related chronic illnesses, such as – excuse me – such as hypertension, diabetes, kidney diseases and also asthma, which put them at – makes them much more vulnerable to the disease and have more serious complications as a result of the disease.
And so this is a real call, I think, for public health and for local communities to invest much more in combating chronic illness and, for those who have chronic illness, to make sure that they’re managing their disease because there’s some evidence that suggests that, even if you have multiple chronic illnesses, if those illnesses are well-managed, you’re much less likely to have serious complications as a result of COVID-19.
You’ve studied public health for decades. From your point of view, what’s missing from the conversation about COVID-19 right now?
ALEX ORTEGA: As I just mentioned, I mean, you know, there’s a lot of attention right now to – you know, emphasis on having people wear masks, on social distancing, on trying to come up with therapeutics and a vaccine. But we also can’t forget about other preventive strategies that will put people at reduced risk of having serious complications of COVID-19 like chronic disease management and prevention.
And we can’t forget that chronic disease prevention is essential here, especially for at-risk populations. And smokers are much more likely to have complications to COVID-19. So we really – you know, the bread-and-butter public health prevention strategies that reduce risks of a lot of different kinds of diseases, chronic and infectious, should be emphasized here. So we shouldn’t forget them, and we shouldn’t just spend all of our money and efforts on the curative side but also on the prevention side. You know, we should be thinking about prevention.