Although everyone has been affected by COVID-19 and the pandemic that gave birth, not all populations have been affected equally. In the United States, for example, COVID-19 cases and death rates have been disproportionately high in Latino and indigenous peoples.
To understand how health determinants affect the perception of coronavirus, its spread and decision-making around COVID-19 testing and vaccination in vulnerable populations, a team of researchers at the University of California, Riverside, conducted a study in the Eastern Coachella Valley region of the interior of Southern California, home to Latin American and Native American farming communities.
Led by Ann Cheneyan associate professor in social medicine, population and public health in School of Medicinethe team reports in BMC Public Health that these immigrant populations are vulnerable to inequalities that increase their risk of COVID-19 exposure, morbidity, and mortality.
“Common themes that emerged across seven focus groups we implemented include misinformation, lack of trust in institutions, and insecurity around employment and residency,” Cheney said. “Our study clearly shows that the pandemic reinforced historically entrenched structural inequalities and social factors that shape health disparities among marginalized color communities. Minority groups have disproportionately high chronic medical conditions and poor access to health care.”
Cheney and her colleagues conducted the study from August 2020 to January 2021 and used community-based participatory research. The team conducted six focus groups in Spanish and one focus group in Purépecha, a language spoken among Native Americans in the Mexican state of Michoacán. Fifty-five people participated, all of whom identified themselves as either Latin Americans / Latinos and / or Purepecha. More than a third of the participants identified themselves as farm workers.
“Most participants felt affected by coronavirus due to reduced working hours and income, inability to work or no work, childcare responsibilities and COVID-19 infection,” he said. Daniel Gehlbach, the first author of the research paper and a fourth-year medical student. “Themes of misinformation as well as insecurity and fear associated with concerns about employment and deportation came up in discussions across our focus groups. It was clear that exclusion, discrimination and violence shape attitudes in the Eastern Coachella Valley about coronavirus and its spread, affecting behavior. concerning COVID-19 testing and vaccination and ultimately increase the risk of COVID-19 exposure. “
The Coachella Valley, an area of racial-ethnic inequality identified as a hotspot when the pandemic began, includes nine towns and rural rural communities. Many Latino and Native Mexican immigrants in the region live below the poverty line and work in the nearby agricultural lands.
“There is an urgent need for intervention here to address mistrust of both government and public health among this population, which will help reduce structural vulnerabilities,” Cheney said. “Residents of the Eastern Coachella Valley suffer from health inequalities due to low income and education, limited English skills and undocumented status. It should come as no surprise that the pandemic has hit this population hard. “
Key results of the study are that many residents of the Eastern Coachella Valley:
- Has limited Internet access and may not have access to reliable public health sources for information on COVID-19. Many rely on word of mouth or social media platforms.
- Lack of reliable and credible sources of information in Spanish and Purépecha, leading some to believe that they would be infected by going to test sites.
- Experience job insecurity, shape decision-making around COVID-19 testing, and fear of job loss if you test positive.
- Are unsafe using COVID-19 testing services because of their immigration and citizenship status. Participants noted that fears of being identified as undocumented at test and vaccination sites are significant concerns among Latino and Native Mexican farming communities.
- Has limited confidence in government entities. Participants talked about society’s perception that government and public health work together to harm minority groups. This lack of trust in institutions extends to hospitals and healthcare.
“One way to build trust in government institutions and health care is to engage those most vulnerable to COVID-19 in public health outreach and service decision-making,” Cheney said. “Positive COVID-19 messages from providers and trusted community members, such as community health workers or promoters de salud, increase vaccine acceptance. When medical leaders and trusted community members promote COVID-19 testing and vaccination, it can positively shape decisions. on COVID-19. “
Cheney calls for more emphasis to be placed on providing public health information and news in ways that are accessible to culturally and linguistically diverse communities, particularly underserved and marginalized communities that may not be proficient in English and have limited access to broadband Internet access.
“We encourage sharing COVID-19 material with vulnerable Latin communities through community and ethnic media sources such as print, radio and television,” she said. “A printable Community report we have prepared is available in English and Spanish. “
Cheney and Gehlbach were joined in the study by community investigator María Pozar, co-investigator Evelyn Vázquez, graduate and medical student Gabriela Ortiz, Erica Li, Cintya Beltran Sánchez and health nurse Sonia Rodríguez.
The study was supported by grants from the Desert Healthcare District & Foundation and the National Institute of Health Community Engagement Alliance (CEAL) initiative.
The title of paper is “Perceptions of Coronavirus and COVID-19 Testing and Vaccination in Latinx and Native American Immigrant Communities in the Eastern Coachella Valley.”
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