by Carina Cione, Deziree Jackson, Abby Ferdinando, Jhamiel Prince, Sarah McCarthy, Ernesto Castañeda, and Emma Vetter
The coronavirus pandemic has been racialized since its emergence in the United States with some leading political figures, including the President, referring to it as the “Chinese virus.” The conversation thus far has primarily focused on African Americans, and Hispanics in the U.S. have received relatively little attention despite their vulnerability to COVID-19. Based on our risk assessment of the possible impact of COVID-19 in El Paso and analysis of literature on health disparities, we found that the Hispanic community is significantly at risk of severe illness or death. The disproportionate number of Latinos working in “essential” positions and being diagnosed with pre-existing health conditions account for racial health disparities regarding COVID-19. With rising rates of infection and the recent resignation of the city’s Public Health Director, El Paso must take proactive precautions to suppress the spread of the virus and counteract disparities that threaten the lives of Latinos.[i]
In New York City, the death toll and infection rates in the Latin community are among the highest in the world.[ii] On May 27, NYC Health reported that at least 5,026 Latinos in New York alone have died of COVID-19 since the outbreak began on March 11, exceeding the number of White deaths by over 800 lives. Even so, these numbers are understood to be low estimates since the data include only lab-confirmed COVID-19 cases, effectively leaving out asymptomatic and other cases not confirmed in a laboratory.
Coronavirus Deaths by Race/Ethnicity in New York City
|Hispanic||Black||White||Asian/Pacific Islander||Other/ Unknown||Total Deaths|
The reasons behind why the Latin population in the U.S. is disproportionately suffering from COVID-19 remain unclear, but the horrific numbers in New York City reveal a troubling trend that is mirrored in states and cities across the United States.
Texas is one of the 21 U.S. states that report infection rates that exceed their total Hispanic population. The Latin community has suffered 46% of the state’s total confirmed COVID-19 cases, although they constitute 40% of the state population. Texas is one of the top ten most infected states with 59,039 positive cases, and an estimated 1,595 people have died as a result of complications related to COVID-19. El Paso, which is predominantly Latino, is one of the counties that have been most affected and reports 4.3% of the state’s documented deaths. The region is experiencing mounting pressure as time passes, and more people are admitted to hospitals because of COVID-19. Sixty-five people were hospitalized in the first week of May, 17 of which were dependent on ventilators for survival.[iii] Local public health officials worry that El Paso will suffer from limited resources, as the county only has 285 licensed beds in their Intensive Care Unit.[iv] On top of these concerns, Robert Resendes, the City Director of Public Health, resigned on May 4. His replacement still has not been selected, but the city insists that his resignation will not negatively impact preventative action since the Office of Emergency Management is handling the public health crisis. Ciudad Juarez, which sits parallel to El Paso across the southern border, is also grappling with an upward trajectory of COVID-19 cases and reported a new total of 1,087 confirmed infections on May 28.
According to the Centers for Disease Control and Prevention (2020), adults over the age of 64, racial and ethnic minorities, the homeless, incarcerated individuals, and people with underlying medical conditions are at heightened risk of severe illness or death caused by COVID-19.[v] Our data that was gathered with the support of the NIH revealed that an overwhelming amount of Hispanics living in El Paso in 2011 met one or multiple criteria of being at higher risk of COVID-19 in addition to other risk factors, such as being an “essential” worker, undocumented or low-income.[vi] A significant number of Latinos in El Paso that year had at least one underlying health condition that would now categorize them as especially vulnerable to severe illness or death by COVID-19. Some of those health conditions include obesity, diabetes, asthma, kidney disease, cancer, emphysema, HIV/AIDS, heart attack, and stroke, nearly all of which have been documented as prevalent causes of hospitalization for people with COVID-19.[vii] However, many Hispanics with underlying health conditions were found to be vulnerable in more ways than one. For example, more than half (51.7%) of Hispanics with asthma did not have medical insurance, as well as nearly half (42.2%) of those with chronic kidney disease. The Affordable Care Act in 2013 created medical benefits for naturalized citizens, but legal visa holders, DACA recipients, and undocumented immigrants received limited to no help from it.[viii] Citizenship status affected a person’s overall likelihood to have medical coverage in 2011, and 89.3% of undocumented Hispanics in El Paso lacked coverage. Since the Affordable Care Act barely recognizes them, it is likely that this percentage of uninsured undocumented people has not drastically changed in the region.
Health disparities are not the only cause for increased exposure to COVID-19 for the Latin community in the U.S. We also analyzed “essential” employment and incarceration as causes of a disproportionately high Hispanic death toll across the country. The CDC (2020) reports that one-quarter of the U.S. Hispanic population works in the healthcare, service, hospitality, transportation, delivery, maintenance, education, and food industries, all of which are considered “essential” or “emergency” under shelter-in-place orders issued across the U.S.[ix] Frontline workers are required by law to report to work under COVID-19 regulations, including those who are considered high-risk, and do not qualify for unemployment insurance unless they are laid off.[x],[xi] Given that more Hispanic workers are in this position than Whites or Asians, they are more likely to come into contact with COVID-19. Incarcerated communities, who are predominantly racial and ethnic minorities, are also contracting the virus at alarmingly high rates. The close quarters, shared spaces, lack of comprehensive medical care and culture of punishment in correctional institutions foster an environment where the virus is easily contracted and spread. On May 20, 2020, 29,251 cases of COVID-19 were documented in federal and state U.S. prisons.[xii] The Marshall Project defines these numbers as “almost certainly an undercount” because there is no testing protocol for individual states.[xiii] Given the mass incarceration of communities of color, this puts racial and ethnic minorities at further risk of severe illness or death from COVID-19. Texas has the fifth-highest amount of cases, but the Latin community will be impacted more harshly because the ratio of Hispanic prisoners compared to Whites is 2:1.[xiv]
We conclude that Hispanics in the U.S. are particularly vulnerable to COVID-19 as a result of multiple structural inequalities that increase their exposure to the virus and obstruct their access to resources. Also, our data revealed that the Latin community in El Paso suffers from extremely high rates of disease that puts people in danger of severe illness or death from COVID-19. We will not know the disparities in mortality rates among racial and ethnic groups until a higher proportion of the overall population is tested for COVID-19, and all data is reviewed. Right now, it remains unclear whether more Hispanics living in the U.S. will die from COVID-19 since the pandemic is projected to make a return in early autumn. Even so, it is clear now that cities and towns with higher numbers of working-class Latin people, including El Paso, should be prepared to properly allocate health resources, provide financial support for high-risk individuals, and conduct extensive community-based health education and outreach in the effort to minimize the spread of COVID-19 and prevent more deaths.
Carina Cione, Deziree Jackson, Abby Ferdinando, Jhamiel Prince, Sarah McCarthy, Ernesto Castañeda, and Emma Vetter are affiliated with the Department of Sociology at American University in Washington, DC.
[i] Willard, Keenan. May 4, 2020. “Public Health Director in El Paso Resigns as City Response to COVID-19 Continues.” KFOX14, https://kfoxtv.com/news/coronavirus/public-health-director-in-el-paso-resigns-as-city-response-to-covid-19-continues.
[ii] Bureau of Communicable Disease Surveillance System 2020. “Age-Adjusted Rates of Lab Confirmed COVID-19.” April 16, 2020. https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-deaths-race-ethnicity-04162020-1.pdf.
[iii] “El Paso COVID-19 Cases Surpass 1,000 Mark.” May 4, 2020. KTSM.com, https://graphics.reuters.com/HEALTH-CORONAVIRUS-USA/0100B5K8423/index.html.
[iv] “El Paso COVID-19 Cases Surpass 1,000 Mark.” May 4, 2020. KTSM.com, https://graphics.reuters.com/HEALTH-CORONAVIRUS-USA/0100B5K8423/index.html.
[v] Centers for Disease Control and Prevention 2020. “People Who Are at Higher Risk for Severe Illness.” https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html.
[vi] Report COVID-19 Susceptibility among Latin People in El Paso, TX https://www.academia.edu/43139124/REPORT_COVID-19_Susceptibility_among_Latin_People_in_El_Paso_TX
[vii] Centers for Disease Control and Prevention 2020. “Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 – COVID – NET, 14 States, March 1-30, 2020.” https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm?s_cid=mm6915e3_w.
[viii] National Immigration Law Center 2014. “Immigrants and the Affordable Care Act (ACA).” https://www.nilc.org/issues/health-care/immigrantshcr/.
[ix] Centers for Disease Control and Prevention 2020. “COVID-19 in Racial and Ethnic Minority Groups.” https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html.
[x] District of Columbia Department of Human Resources 2013. “E-DPM Instruction No. 12-51.” Government of the District of Columbia, https://dchr.dc.gov/sites/default/files/dc/sites/dchr/publication/attachments/edpm_12_51_guidelines_essential_and_emergency_personnel.pdf.
[xi] Stewart, Emily. 2020. “The Essential Worker Trap.” Vox, https://www.vox.com/2020/5/5/21245713/unemployment-insurance-recalled-workers-voluntary-quit-state-.
[xii] Bureau of Communicable Disease Surveillance System 2020. “Age-Adjusted Rates of Lab Confirmed COVID-19.” April 16, 2020. https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-deaths-race-ethnicity-04162020-1.pdf.
[xiii] Park, Katie, Tom Meagher, and Weihua Li. 2020. “Tracking the Spread of Coronavirus in Prisons.” The Marshall Project, https://www.themarshallproject.org/2020/04/24/tracking-the-spread-of-coronavirus-in-prisons.
[xiv] Bureau of Communicable Disease Surveillance System 2020. “Age-Adjusted Rates of Lab Confirmed COVID-19.” April 16, 2020. https://www1.nyc.gov/assets/doh/downloads/pdf/imm/covid-19-deaths-race-ethnicity-04162020-1.pdf.