An analysis of COVID-19 testing in
the Baltimore-Washington metropolitan area of the United States found that
Latinx people were around three times as likely to test positive, compared with
any other ethnic or racial group.
Share on PinterestLatinx communities
in the US may be hit harder by the pandemic, new research suggests.
The researchers who carried out the
study believe that crowded living conditions and the economic necessity to
continue working outside the home during the outbreak have contributed to
higher rates of infection among Latinx communities.
They also note that Latinx people
in the U.S. are less likely than those of other racial or ethnic groups to have
health insurance.
“It is clear that the systematic exclusion of this population
from healthcare services has contributed to the disparities we see today,” says
study author Dr. Kathleen R. Page, an associate professor of medicine at the
Johns Hopkins University School of Medicine, in Baltimore, MD.
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Dr. Page treated many of the patients included in the study.
“This pandemic has taught us that we are all
interconnected,” she says. “At the very least, we must engage with communities
early and provide [language-appropriate] and culturally appropriate information
and services, removing as many barriers to care as possible.”
The research, which has been published in JAMA, involved a
collaboration between the Johns Hopkins University School of Medicine and the
university’s Center for Data Science in Emergency Medicine.
The researchers analyzed results of tests for SARS-CoV-2,
the coronavirus that causes COVID-19, at five Johns Hopkins Health System
hospitals and 30 outpatient clinics in the Baltimore-Washington metropolitan
area.
All the tests were carried out between March 11 and May 25,
2020.
Of the 37,727 tests performed, 6,162 (16.3%) were positive
for the new coronavirus. The occurrence of positive tests by ethnic and racial
grouping was 42.6% for Latinx people, 17.6% for Black people, 17.2% for people
identified as “other,” and 8.8% for white people.
Unusually for this infection, the
majority of the Latinx patients who tested positive, 61.5%, were
relatively young, aged 18–44 years.
By contrast, 28.6% of Black patients who tested positive and
28% of white patients who did so fell within this age range.
In another discrepancy, Latinx patients who tested positive
and were hospitalized were much less likely to have been diagnosed with preexisting
health conditions than people of other races and ethnicities.
Rates of hypertension, congestive heart failure, pulmonary
disease, and chronic obstructive pulmonary disease were seemingly much lower
among Latinx patients than Black or white patients.
It is unclear whether poor access to healthcare among Latinx
people meant that these conditions remained undiagnosed.
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The study also found that the daily number of positive test
results among Latinx people peaked several weeks later than the numbers among
other ethnic and racial groups. The highest number among Latinx patients was on
May 10, compared with April 19 for Black patients and April 16 for white
patients.
Dr. Page says that a majority of
Latinx patients with COVID-19 are immigrants to the U.S. who work low-wage
jobs, such as construction and cleaning, that are classed as “essential.”
“Many of these patients tell me they delayed coming to the
hospital until absolutely necessary because they were worried about medical
bills and were not sure if they could receive care because of their immigration
status,” she says.
“Most of the patients I’ve met are not eligible for
benefits, have no health insurance, and rent rooms in crowded houses. The need
to work, lack of occupational protections, and crowded living conditions have
led to high transmission in this community.”
A recently published study suggests
that the new coronavirus spreads more easily in crowded homes.
The team suspects that disparities similar to those in the
Baltimore-Washington area may exist elsewhere in the U.S., though their extent
and causes may differ.
“Knowing what is driving these health disparities in each
region is much-needed evidence to develop tailored policies and interventions
to better serve all of our people,” says Diego A. Martinez, Ph.D., an assistant
professor of emergency medicine at Johns Hopkins and the first author of the
study.
The researchers hope that their findings will inform policy
changes throughout the country and slow the spread of COVID-19 among minority
populations.
“Protecting
Latinx individuals, building trust, and reducing barriers to engagement in
public health initiatives — such as [by] providing equal protection for
workers, reducing the threat of deportation, and performing charity care for
those unable to afford healthcare — should be essential as our nation grapples
with strategies to contain the impact of COVID-19.”
– Prof. Diego A. Martinez
In their paper, the authors caution that their analysis was
limited to patients using the Johns Hopkins Health System and may, therefore,
not reflect infection rates regionally or nationally.
In addition, they acknowledge that
their investigation was unable to determine the cause of higher positive test
results among Latinx patients.
The finding may reflect a higher prevalence of COVID-19 in
this community, differences in access to healthcare, or both.
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