LULU GARCIA-NAVARRO, HOST:
This pandemic is devastating communities of color. According to the CDC, Latinos and African Americans are hospitalized at rates more than 4 1/2 times that of white Americans. African Americans are dying at rates that are at least twice as high as their white counterparts, too. Why such disparity? A new study from Harvard may have some answers. Lead researcher Dr. Jose Figueroa joins us now from Boston.
Welcome.
JOSE FIGUEROA: Thank you for having me.
GARCIA-NAVARRO: I just used the words communities of color in my introduction. One of the things that's very interesting about this study is that you found that there is a real difference between why Latinos are getting sick and why African Americans are getting sick, for example. Not everyone can be lumped together.
FIGUEROA: That is correct. There's differences in the environment that these communities live in.
GARCIA-NAVARRO: Well, let's break that down. Let's first talk about Latinos. Can you talk us through why they are getting exposed? What are the factors there?
FIGUEROA: Yeah. So we looked at the data, and the three biggest predictors of Latino communities are, No. 1, they tend to live in crowded housing. They live in multigenerational households that include kids, working adults and older grandparents often. No. 2, high proportion of people who work in the food service industry. I'll give you an example of Chelsea, a community in Massachusetts. One of the highest case rates in that community - about two-thirds of the population is Latino, and about 60% of the population works in essential food service jobs. The third big predictor is the proportion of recent immigrants within the community. The more recent immigrants in the community, especially among Latino communities, the higher the COVID-19 case rates.
GARCIA-NAVARRO: So explain why that would be. I mean, in February, the Trump administration started enforcing a public charge ruling basically allowing the U.S. to deny green cards, visas, citizenship to anyone who seeks public aid. That rule has been temporarily suspended during the pandemic, but is that playing into why people might not be going to a doctor or clinic when they start feeling ill? Is that linked to their immigration status in some way?
FIGUEROA: Yes, we believe so. We do really believe that the fear of the public charge rule is deterring some people for seeking medical care when they need to. So it is terrible policy at the worst time possible. Even though there's a current deferment in the rule itself, I think the Latino community has a great distrust of the current administration, and people will not seek care in case the rule comes back.
GARCIA-NAVARRO: Because - we should make clear - if people aren't seeking care, first of all, they're likely to have worse outcomes. And second of all, it's difficult for public health officials to track who's getting sick.
FIGUEROA: That is correct.
GARCIA-NAVARRO: Now let's talk about African American communities. What are the issues specific to them?
FIGUEROA: Oftentimes, Black communities live in these large multiunit residential buildings that, even though they might not have a lot of people living within each unit, they're really in a closely confined, dense area where they have a lot of neighbors coming in and out of these large buildings that could increase their exposure to COVID-19. That's No. 1. And No. 2 is we know that Black Americans tend to use public transportation at much higher rates than other people.
Other things - we know that Black Americans tend to live in environments that is not great for their health. Black Americans, on average, tend to breathe more polluted air than other people. And there was a study also that showed that in communities that have a lot of air pollution - are communities that are getting infected at higher rates with COVID-19.
And other things to consider - there's a disproportionate number of Black Americans in certain facilities. That includes prisons. Prisons are being decimated in some areas with high - really high COVID-19 rates. Other things we know is nursing homes are getting hit at pretty high COVID-19 rates, and the nursing homes that are worse off are ones that have a lot of minority patients, including Black Americans.
GARCIA-NAVARRO: You're parsing out these different things, and the two communities are being exposed in very different ways. But there is an overarching thing, which is the structural inequality.
FIGUEROA: Yes. And that - we cannot go away from the fact that structural racism is playing a huge role in these disparities. When testing sites first started popping up across America, they tended to pop up in certain neighborhoods, and they tended to be wealthier neighborhoods of mostly white Caucasians. Other thing, too, is some of the initial testing sites required people to drive and get testing. It was drive-through testing. So what does it mean when a person of color does not own a car? And so what we believe that was happening is lack of testing in communities of color was leading to higher spread of COVID-19.
GARCIA-NAVARRO: I'm going to ask you bluntly, though, Dr. Figueroa - why should people care about these issues? I mean, why should people care that communities of color are being impacted in an outsized way?
FIGUEROA: COVID-19 does not care about the color of your skin. And right now, unfortunately, because of the structural discrimination, years of systemic inequities, right now we are seeing that certain communities are being exposed at higher rates than others, and that disease will eventually spread to other communities. It will not stop with the Black and Hispanic community.
GARCIA-NAVARRO: Finally, with this information, how can public health officials start to target the specific needs of the communities that you looked at?
FIGUEROA: The data shows that there needs to be at least three big interventions. One is the public charge rule - the new revised public charge rule needs to be reversed and eliminated permanently. No. 2, we need to address issues of crowded housing. It is really difficult to quarantine someone within a household that has multiple people within not a lot of square footage. Certain cities and states need to invest in temporary housing to allow people to quarantine safely away from them.
Another thing is because a lot of communities with a lot of food service workers are the ones that are getting infected at higher rates, we need appropriate PPP (ph) for them. And importantly, we need adequate paid sick leave. These people are dependent on these jobs, which are often low-income, to put food on the table, pay their bills and take care of their family members. And we need good policy to help people through this unfortunate time.
GARCIA-NAVARRO: That's Dr. Jose Figueroa, assistant professor of health policy and management at Harvard University.
Thank you very much.
FIGUEROA: Thank you. Transcript provided by NPR, Copyright NPR.