Covid-19 Leadership Lessons for the Future with Dr. Elena Rios, President and CEO, NHMA

The COVID-19 pandemic has exacerbated several key issues among the Hispanic population that warrant attention from leaders in both public and private health care sectors, as well as leaders in our communities. Hispanics are 18% of the population yet account for 33% of new COVID-19 cases nationwide.

Hispanics have been found to be more vulnerable because they 1) have the highest uninsured rates, which limits access to health care and increases the impact of chronic diseases; 2) work in essential jobs that increase exposure to infection, such as in supermarkets, cleaning services at hospitals and nursing homes, and in the food industry; 3) live in multigenerational households that limit social distancing; and 4) have mixed-status families and/or limited English and health literacy, both of which decrease their participation in and understanding of public health education guidelines.

Health care leaders should work with their local public health agencies on recovery efforts over the next several years, targeting worksites, neighborhoods and families with Latinos.

Leaders in our hospitals, medical practices and clinics should partner with any virus education campaigns for Latino families — since Latino uptake of the flu vaccine over the past few years has only been at 37%. It is of the utmost importance to make the connection that a vaccine can decrease virus transmission to those most vulnerable in the community. Latinos who work at all levels of the health care system understand Latinos, and should be called on to share their experience for developing innovations to improve the health of our families.

Education for Latinos must include developing trust and empathy, traditional media and social media in English and Spanish, and health provider messengers. Latinos and other racial and ethnic patients have faced racism and discrimination in the health care system. There is a need to understand the root causes of health care disparities seen in obesity, diabetes, heart disease, cancer, HIV, asthma and other conditions. Some of these issues are due to social determinants of health, such as unemployment, food insecurity, poor housing, limited public transportation, poverty, educational attainment and English proficiency. In addition, Latinos also face limited access to quality care, limited mental health services and lack of diversity in the health care professions, research and decision-making positions in public or private health sectors.

The pandemic has significantly undermined health insurance coverage in the U.S. as the economic impact has forced businesses to close and eliminate health insurance, or stay open and decrease health insurance benefits for employees.

According to the National Center for Health Statistics, 31 million were uninsured and more than 40 million were underinsured before the pandemic. In 2019, according to national surveys, prior to the pandemic, the Hispanic population had the highest uninsured rate, at 16.7% uninsured for the entire year. Among U.S. adults aged 19 to 64 in states with Medicaid expansion, the uninsured rate was 9.8%, compared to 18.4% in the 14 states that did not expand eligibility. In addition, adults with health insurance find it easier to get care, tests, or treatment. Among the uninsured, 34% were Hispanic poor, and and 13% were Hispanic not poor, more than twice the proportion of uninsured non-Hispanic whites.

With the continued U.S. economic downturn and loss of jobs, many more people will become uninsured and stay away from testing, medical care and treatment.

Leaders in the Federal government need to provide incentives to increase health insurance for our population, including subsidies and tax credits; expanding Medicaid funding to States and to individuals (public option) and the undocumented; expanding mental health services and reimbursement; and provide low priced inhalers, insulin, diabetes and hypertension medications, along with free testing, masks, and vaccines. At the same time, leaders in the public and in the private sector — philanthropy, corporations and institutions — should support nonprofit organizations to provide food and other basics for our families and mentor our students to attend college and become doctors and nurses. We invite all the leaders in our communities to work with the National Hispanic Medical Association and our network of physicians for leadership development training to improve the health of our communities.