Latinos are among the most vulnerable populations during the COVID-19 pandemic for the following reasons:
• Language barriers are highly prevalent and limit the effectiveness of communications between the patients, the health system and their providers
• Latinos are frequently front line workers in the service and production industry where the virus is easily transmissible
• They usually lack unemployment safety options and have a higher risk of bankruptcy if temporarily unemployed which can increase the likelihood of choosing to go to work despite the risk of infection
• They are often unable to work from home due to limited access to technology and/or internet services or because their jobs cannot be carried through a virtual interface
• They have lower health literacy and fewer means to overcome this challenge
• Latinos are marginalized by the anti-immigrant rhetoric which discourages them from seeking timely medical attention
• At baseline, they are more likely to be uninsured or underinsured which results in poor access to medical care, including primary care physician services
• They have disproportionately high rates of obesity, diabetes, and hypertension and more importantly are less aware of the presence of these conditions in them
• Because rates of obesity, diabetes and hypertension are pervasive and frequently unrecognized among members of this group, it effectively positions Latinos into a high-risk category for COVID-19 complications
Max Luna, MD, and his team from the UVA Schools of Medicine and Nursing working in collaboration with University and Community organizations form the Latino Health Initiative. During COVID-19, this work has become even more vital to our community. Recently, UVAHS and collaborators delivered a weekend for Targeted COVID-19 testing to the Southwood Community in Charlottesville.
Practicing systematic, scientific, and culturally sensitive delivery methods from an academic medically centered source, while constantly examining procedures on how to build a scalable approach to target COVID-19 services to vulnerable groups, careful attention was placed on how to approach this community of more than 1500 individuals and more than 700 Hispanic residents (the Southwood Community mobile home park) while minimizing the risk of discomfort, avoid creating fear, yet continue to build bridges.
The following are how the initiative is being carried out to date:
1. Delivery of COVID-19 testing for symptomatic people and people that have experienced exposure to COVID-19 positive individuals
2. Medical support for people in need
3. Social determinants of health support to ease the family burden for positive people
• Thomas Jefferson Health District
• Habitat for Humanity- managers of the Southwood Community
• UVAHS groups with specific expertise
○ Ambulatory Services leadership
○ UVAHS Community Health and Wellbeing
○ Laboratory Medicine and Infectious Disease
○ Community Program with cultural insight and community trust- UVA Latino Health Initiative
○ Department of Pediatrics and Medicine
• UVAHS Community Relations
• Academic expertise in social determinants of health- the UVA Equity Center
Stages of Delivery (9 days total)
• Crafting of idea and planning with the health department and appropriate UVAHS groups
• Invitation flyers, public health education flyers, and information on how to access COVID-19 care for people without primary care physicians delivered to more than 350 mobile homes
• 5 hours of COVID testing on Saturday May 2nd followed by running tests, reporting results, and securing housing for optimal social distance and food assistance to the COVID-19 positive individuals and their families within 24 hours. All were provided direct numbers to call in case further questions and medical care is needed in the near future.
• All services delivered in Spanish without medical interpretation
• 19 people tested – 1 positive subject
Although the total number of people serviced and detected positive was small, the greater goals were achieved. A team composed of UVAHS leadership, physicians, nurses, medical students, non-SOM faculty, and community health workers, multitasked from the most complex to the simplest roles, regardless of professional stature, to service and to give the Latino community support.
In summary, what was accomplished:
1. Organized a COVID-19 Latino community response team that involved, faculty, community organizations, and the health district where the following needs were shared and discussed: health and wellness, economic support, food security, and legal support.
2. Created the attached flyer informing people without PCPs about COVID-19 evaluation locations in Spanish and in English that is updated weekly. UVAHS has strongly endorsed this effort.
3. Organized three Facebook Live educational interviews for the Latino community as well as shared widely CDC educational material in the Charlottesville area social media.
4. Participated in the Community Health and Health Equity (in the setting of COVID-19) weekly Steering Committee Meeting.
5. Co-led the first Albemarle county community Covid-19 testing event and reported to leadership