Maryland’s Latino population has been hit hard by the COVID-19 pandemic. There are many metrics to show this, but for Del. Joseline Peña-Melnyk, JD, one in particular hits close to home.
“The ZIP code in the state of Maryland with the highest number of COVID-19 cases is 20783,” says Peña-Melnyk, who represents District 21 spanning parts of Prince George’s and Anne Arundel counties. “Who lives in 20783? Immigrants. Latinos. It’s the towns of Hyattsville, Langley Park, Adelphi, and Chillum. And it’s no surprise that black and brown people are being affected the most by COVID-19.
“The people suffering are often the invisible people who do not have a voice. And they’re the ones I see as a legislator who are hurting the most, because many of these people don’t have access to social services.”
Peña-Melnyk discussed the challenges faced by Latinos as one of three panelists in the Oct. 13 virtual presentation “COVID-19 and Health Equity: Impact of the Pandemic in the Maryland Latinx Community,” which was hosted by Latinos Unidos @ UMB, an affinity group of the University of Maryland, Baltimore’s (UMB) Diversity Advisory Council.
(Watch the presentation here.)
The other panelists were Magaly Rodriguez de Bittner, PharmD, BCPS, CDE, FAPhA, professor at the University of Maryland School of Pharmacy (UMSOP), and Milagritos Tapia, MD, professor at the University of Maryland School of Medicine (UMSOM) and the Center for Vaccine Development and Global Health (CVD). Wendy Camelo Castillo, MD, MSc, PhD, assistant professor at UMSOP, was the panel moderator, and Sandra Quezada, MD, MS, associate professor at UMSOM, moderated a Q&A session to close the one-hour presentation.
UMB President Bruce E. Jarrell, MD, FACS, thanked the participants in his opening remarks, saying he was eager to hear the panelists discuss their work on COVID-19 disparities and health care inequities overall. “This obviously is an important topic,” Jarrell said. “I want to learn a lot about it, and I want to know what we as a University can do to act appropriately to help address these issues.”
Camelo Castillo led off by saying systemic racism has prevented Latinos and other under-represented minorities from having opportunities for satisfactory economic, physical, and mental health, and that COVID-19 has exacerbated the problem. She said Latinos account for about one-third of COVID-19 cases in the United States and have the second-highest hospitalization rate among people of color, pointing to the makeup of the workforce as a mitigating factor.
“We know that essential workers are disproportionately people of color, and only about 16 percent of Hispanics are able to work from home,” Camelo Castillo said. “They often don’t have access to paid sick leave and health insurance, and there’s insufficient personal protective equipment available for essential workers who are not in the health care system.
“Housing instability, food insecurity, and homelessness are also significant concerns. And all of the inequities we’re seeing — in terms of infection rates, death rates, hospitalization, and access to testing — just mirror the disparities of a prior crisis.”
To address these issues in the short and long term, Peña-Melnyk said she will introduce bills in the next legislative session to boost the budget of the Office of Minority Health and Health Disparities and to declare racism as a public health crisis in Maryland. Beyond that, she wants to see action, community engagement, and results.
“Anyone can propose a bill or make a resolution, but I want to have measurable goals,” said Peña-Melnyk, who is vice chair of the House of Delegates’ Health and Government Operations Committee. “I want to look at the chronic illnesses that affect the Latinx and the Black communities — diabetes, heart disease, high blood pressure. I want to put money into this effort, collect data, communicate, and work together to solve these problems.
“We need to make sure that these communities are not invisible anymore, that they get the care they need, that they can make not just a minimum wage but a living wage, and that they can live in a space where they can socially distance. We have our work cut out for us, but we’re ready. It will take a village to do this, and I’m counting on you to help us do that.”
Rodriguez de Bittner added a real-world example to the discussion, relaying the story of a 25-year-old immigrant from Honduras who came to a health clinic complaining of a persistent cough. She said he is living in an apartment with 12 other men and that they rotate sleeping arrangements based on their work shifts, with three men using the same bed at different times of the day.
“That's the way they can afford their housing,” she said. “This case illustrates what we’ve talked about with COVID-19 and the social determinants of health. Many of these patients have diabetes, hypertension, or asthma, things that put them at high risk for COVID. They’re in crowded living conditions, employed in public-facing occupations, and use public transportation.”
She said many undocumented Latinos might not go to health care clinics for fear of being reported to Immigration and Customs Enforcement for deportation and that many also lack the ability to read in Spanish or English. “So we provide them with wonderful patient education flyers, and we try to provide written education,” said Rodriguez de Bittner, who called for more support from the federal and state governments and the public at-large.
“We need new policies to protect immigrants during this crisis,” Rodriguez de Bittner said. “And if you take anything away from this panel, my call to you is to be an advocate for our community, to raise your voice and advocate for changes in legislation.”
Tapia also touched on the Latino community’s fears as she talked about recruiting participants for CVD’s COVID-19 clinic trials and making sure that when vaccines are available, they are effective for and accepted by hard-hit under-represented populations. Part of that is assuring transparency and addressing the climate of mistrust, she said.
“We’ve reached out for Latino trial volunteers, and the first response has been, ‘Why do you want us to participate now? We don’t want to be guinea pigs for white people. Why are you coming now to look for us?’ And the ‘why now’ is important, right? Because these populations have been disenfranchised and marginalized for so long. Why do we suddenly care about them?
“We have to confront those questions and say, ‘No, we’re not just coming to ask you to participate, we’re asking everyone to participate. And we’ve been able to get out really positive messages to the community that participation in these studies is so important.”