The mounting evidence highlighting the disproportionate impact of the COVID-19 pandemic in ethnic minority communities underscores the need to understand how distress and healthcare access impacts the well-being of undocumented Latino/a immigrants (ULIs), one of the most marginalized and vulnerable ethnic minority communities in the U.S. We used existing data from a cross sectional study (Proyecto Voces) of 252 ULIs to conduct path analyses that explored the relations among distress due to immigration legal status, healthcare access difficulties, and the health of ULIs. Results demonstrated that distress due to immigration legal status is related to the physical and mental health of ULIs, and that difficulties in accessing healthcare explained these relations. These data support the importance of immediate, targeted efforts for increasing access to healthcare among undocumented immigrants and highlight the long-term importance of a much-needed healthcare reform for improving access to marginalized populations.
A critical step to reduce the spread of COVID-19 is vaccination. We conducted a mixed methods project that used online surveys and focus groups with 64 Community Health Workers and Promotor/as (CHW/Ps) located near the U.S.-Mexico border to identify barriers and facilitators to COVID-19 vaccination among Latino communities that have been historically underrepresented and medically underserved. Overall, personal barriers to vaccination included mistrust of manufacturers and administrators as well as fear of: becoming infected from the vaccine, discrimination/stigmatization from healthcare professionals administering the vaccine, exploitation/manipulation by the government or health authorities, and having personal information mishandled. Environmental and community barriers included being undocumented and fear-inducing myths and beliefs. Additional barriers included limited information and logistics pertaining to vaccination access. Targeted efforts are needed to overcome barriers in a culturally and contextually sensitive manner to prevent harm and reduce risk of infection among communities that have been historically underrepresented.
Background As the COVID-19 pandemic evolves, more information is needed on its long-term impacts on health-related quality of life (HRQoL) and social determinants of health (SDoH). The aim of the study was to assess HRQoL and SDoH among a predominantly Latino population of COVID-19 survivors and to compare effects in Latinos versus non-Latinos. Methods This cross-sectional study consisted of a survey (in English and Spanish) of COVID-19 survivors from December 2020 to July 2021. The study assessed sociodemographic data, clinical characteristics, and SDoH, consisting of 10 COVID-19—related concerns. The PROMIS-29 + 2 (PROPr) measure, which captures 8 HRQoL domains and a preference-based health utility, was used to assess HRQoL. Bivariate analyses included chi-square tests and t-tests. Generalized linear models were conducted for multivariable analyses. Results Of 230 respondents (6.3% response rate), the mean [SD] age was 43.1 [14.3] years; 83.0% were Latino; the mean [SD] time since diagnosis was 8.1 [3.2] months; and 12.6% had a history of hospitalization with COVID-19. HRQoL scores were slightly worse than population norms on all domains, especially anxiety; the mean [SD] PROPr health utility was 0.36 [0.25]. Domain scores were similar by ethnicity except for cognitive function—abilities, where scores were lower in Latinos. Multivariable analyses revealed that: (1) financial concerns were associated with worse health utility, as well as worse scores on all 8 PROMIS domains; (2) interpersonal conflict was associated with worse health utility and worse scores on 6 of the 8 PROMIS domains (anxiety, depression, fatigue, sleep disturbance, social function, and pain interference); and (3) Latino ethnicity was only associated with 1 PROMIS domain (cognitive function—abilities) after controlling for covariates. Conclusion COVID-19 infection is associated with HRQoL decrements long after the acute infection, and financial concerns and interpersonal conflict are particularly associated with worse HRQoL.
In the U.S., Latinos are disproportionately affected by the COVID‐19 pandemic. A critical step to reduce the spread of COVID‐19 is diagnostic testing. Yet, for testing to be effective, barriers must be reduced or eliminated and facilitators promoted. Guided by principles of community‐based participatory research, we collected data from 64 community health workers and Promotor/as (CHW/Ps) in Texas to identify relevant personal, community‐level, and testing‐related barriers and facilitators to diagnostic testing for COVID‐19 among underserved Latino communities. Data were collected through an online survey and focus groups. A large majority of CHW/Ps (90.6%) reported that they perceived diagnostic testing to be important for their communities; however, only 42.2% believed that their communities understand the use of testing. Personal barriers to diagnostic testing included mistrust and fear, including fear of: becoming infected and infecting others, job/income loss, discrimination/stigmatisation, uncovering other diseases, and mishandling of personal information. Community‐level barriers to testing included fear‐inducing myths and beliefs. Test‐related factors included cost and accuracy of testing, testing procedures, inadequate and insufficient information, and logistics pertaining to testing sites. Facilitators to testing included building trust between communities and those administering testing, along with receiving culturally and contextually appropriate testing information. Diagnostic testing for COVID‐19 among underserved Latino communities is complex and suboptimal. Targeted efforts are needed to overcome personal, community and test‐related barriers in a culturally and contextually sensitive manner in order to prevent harm and to reduce further risk among underserved communities.
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