COVID-19 unmasks Austin’s long-standing health inequities—with Latino residents hit hardest by the pandemic

Same storm, different boats

While Austin has seen its mid-summer surge deflate, the Latino community continues to be disproportionately impacted by the pandemic.

Latino residents, who make up 34% of the Travis County population, account for 52% of cases, nearly 60% of hospitalizations and 50% of deaths, according to Austin Public Health data. At one point, in late May, seven out of 10 hospital patients with COVID were Latino. The positivity rate among Latino residents who were tested last week is nearly 15%, compared to around 9% for the overall population.

These disparities are not unique to Austin. But while the outcomes for Black residents have improved in recent weeks, the city has had little success closing the gap for Latino residents, who make up more than a third of its population.

"It's hard for us to correct decades of disparities that these communities [of color] have faced," Austin-Travis County Interim Health Authority Dr. Mark Escott said on Wednesday.

Many reasons

There are a number of reasons Latino residents are more at risk of contracting COVID—and suffering worse outcomes—said Dr. Rene Salazar, assistant dean for diversity and a professor of medical education at Dell Medical School.

They are more likely to lack access to care, whether because they are uninsured or cannot afford monthly premiums and copayments; be undocumented and avoid seeking out care for fear of legal consequnces; face language and other cultural barriers that make getting care more difficult and less satisfying; and live in multigeneration households.

"Coming through the door, you're not able to social distance potentially," CommUnity Care CEO Jaeson Fournier told Austin Mayor Steve Adler during a Facebook live on Thursday. "And then there's a higher rate of transmission that occurs."

Latino residents are also overrepresented among essential workers, Salazar said, and undocumented residents do not qualify for stimulus funds or unemployment benefits, which further tilt the playing field.

"They really don't have an option [not to work]," he said. "It becomes a question of survival."

Other communities of color also struggle with historical and present inequities. But while Black Austinitess faced worse outcomes earlier in the pandemic, recently their share of the confirmed caseload and the hospitalized population has fallen. Disparities among Latino patients, however, remain.

"The biggest differences between the two communities are around language and immigration status," Salazar said.

What is being done

To address these disparities, the city has made funding available for rental assistance and other basic needs, introduced bilingual media briefings in June, hosted mobile testing events in hard-hit communities and convened a volunteer task force.

But Saldaña, who is a member of the task force, feels this is not enough, especially six months into the pandemic.

To address the disparities in COVID outcomes for Latino patients, he said the city needs to expand access to testing, so that residents without email addresses are still able to register for a free appointment and those who are unable to take time off work during the day are not shut out. Other priorities include increasing distribution of masks and financial assistance for those communities that are hardest hit.

"This is not just a Latino issue," Saldaña said. "When you buy your groceries, who's checking you out? Who's putting the produce [out] and who's restocking all the shelves? It's probably someone from our community, because we're overrepresented [among essential workers]. So you should be concerned."

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