Coronavirus Disease 2019 and the Case to Cover Undocumented Immigrants in California

Torres-Pinzon, Diana L; Solorzano, Walter; Kim, Sue E.; Cousineau, Michael R.

doi:10.1089/heq.2020.0049

Cited by 5 publications

(3 citation statements)

References 4 publications

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“…Including immigrant families in financial relief could enable more workers to refuse to work in unsafe settings, which might interrupt transmission and reduce mortality. Third, an immediate step that could improve access to medical care is extending emergency Medicaid coverage to all individuals with COVID-19 regardless of immigration status ( Torres-Pinzon et al, 2020 ). Finally, as California moves toward complete reopening, it is critical that the vulnerable subgroups highlighted in our study receive extra support to access COVID -19 vaccination.…”

Section: Discussionmentioning

confidence: 99%

Excess mortality among Latino people in California during the COVID-19 pandemic

Riley

Chen

Matthay

et al. 2021

SSM - Population Health

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Latino people in the US are experiencing higher excess deaths during the COVID-19 pandemic than any other racial/ethnic group, but it is unclear which sociodemographic subgroups within this diverse population are most affected. Such information is necessary to target policies that prevent further excess mortality and reduce inequities. Using death certificate data for January 1, 2016 through February 29, 2020 and time-series models, we estimated the expected weekly deaths among Latino people in California from March 1 through October 3, 2020. We quantified excess mortality as observed minus expected deaths and risk ratios (RR) as the ratio of observed to expected deaths. We considered subgroups categorized by age, sex, nativity, country of birth, educational attainment, occupation, and combinations of these factors. Our results indicate that during the first seven months of the pandemic, Latino deaths in California exceeded expected deaths by 10,316, a 31% increase. Excess death rates were greatest for individuals born in Mexico (RR 1.44; 95% PI, 1.41, 1.48) or a Central American country (RR 1.49; 95% PI, 1.37, 1.64), with less than a high school degree (RR 1.41; 95% PI, 1.35, 1.46), or in food-and-agriculture (RR 1.60; 95% PI, 1.48, 1.74) or manufacturing occupations (RR 1.59; 95% PI, 1.50, 1.69). Immigrant disadvantages in excess death were magnified among working-age Latinos in essential occupations. In sum, the COVID-19 pandemic has disproportionately impacted mortality among Latino immigrants, especially those in unprotected essential jobs. Interventions to reduce these inequities should include targeted vaccination, workplace safety enforcement, and expanded access to medical care and economic support.

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Section: Discussionmentioning

confidence: 99%

Excess mortality among Latino people in California during the COVID-19 pandemic

Riley

Chen

Matthay

et al. 2021

SSM - Population Health

View full text Add to dashboard Cite

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“…Including immigrant families in financial relief could enable more workers to refuse to work in unsafe settings, which might interrupt transmission and reduce mortality. Third, an immediate step that could improve access to medical care is extending emergency Medicaid coverage to all individuals with COVID-19 regardless of immigration status 29 . Finally, pandemic disparities are likely to widen in the U.S. and similar contexts unless action is taken to prioritize marginalized populations, including unauthorized immigrants and those without health insurance, for access to COVID-19 vaccination.…”

Section: Discussionmentioning

confidence: 99%

Excess death among Latino people in California during the COVID-19 pandemic

Riley¹,

Chen

Matthay³

et al. 2020

Preprint

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BackgroundLatino people in the US are experiencing higher excess deaths during the COVID-19 pandemic than any other racial/ethnic group, but it is unclear which subgroups within this diverse population are most affected. Such information is necessary to target policies that prevent further excess mortality and reduce inequities.MethodsUsing death certificate data for January 1, 2016 through February 29, 2020 and time-series models, we estimated the expected weekly deaths among Latino people in California from March 1 through October 3, 2020. We quantified excess mortality as observed minus expected deaths and risk ratios (RR) as the ratio of observed to expected deaths. We considered subgroups defined by age, sex, place of birth, education, occupation, and combinations of these factors.FindingsDuring the first seven months of the pandemic, Latino deaths in California exceeded expected deaths by 10,316, a 31% increase. Excess death rates were greatest for individuals born in Mexico (RR 1.44; 95% PI, 1.41, 1.48) or Central America (RR 1.49; 95% PI, 1.37, 1.64), with less than a high school degree (RR 1.41; 95% PI, 1.35, 1.46), or in food-and-agriculture (RR 1.60; 95% PI, 1.48, 1.74) or manufacturing occupations (RR 1.59; 95% PI, 1.50, 1.69). Immigrant disadvantages in excess death were magnified among working-age Latinos in essential occupations.InterpretationThe pandemic has disproportionately impacted mortality among Latino immigrants and Latinos in unprotected essential jobs; Interventions to reduce these disparities should include early vaccination, workplace safety enforcement, and expanded access to medical care.FundingNational Institute on Aging; UCSFRESEARCH IN CONTEXTEvidence before this studySeveral articles have suggested all-cause excess mortality estimates are superior to official COVID-19 counts for assessing the impact of the pandemic on marginalized populations that lack access to testing and healthcare. We searched PubMed, Google scholar, and the medRxiv preprint database through December 22, 2020 for studies of (“excess mortality” or “excess death”) AND (“COVID-19” or “coronavirus”) set in the United States and we identified two empirical studies with estimates of excess mortality among Latinos during the pandemic. The study set in California (from our research team) found per capita excess mortality was highest among Black and Latino people. The national study found percent excess mortality was significantly higher among Latino people than any other racial/ethnic group. Neither study further disaggregated the diverse Latino population or provided subgroup estimates to clarify why excess pandemic mortality is so high in this population. In the U.S., official COVID-19 statistics are rarely disaggregated by place of birth, education, or occupation which has resulted in a lack of evidence of how these factors have impacted mortality during the pandemic. No study to date of excess mortality in the U.S. has provided estimates for immigrant or occupational subgroups.Added value of this studyOur population-based observational study of all-cause mortality during the COVID-19 pandemic provides the first estimates of within-group heterogeneity among the Latino population in California – one of the populations hardest hit by COVID-19 in the U.S. We provide the first subgroup estimates by place of birth and occupational sector, in addition to combined estimates by foreign-birth and participation in an essential job and education. In doing so, we reveal that Latino immigrants in essential occupations have the highest risk of excess death during the pandemic among working-age Latinos. We highlight the heightened risk of excess mortality associated with food/agriculture and manufacturing occupational sectors, essential sectors in which workers may lack COVID-19 protections.Implications of all the available evidenceOur study revealed stark disparities in excess mortality during the COVID-19 pandemic among Latinos, pointing to the particularly high vulnerability of Latino immigrants and Latinos in essential jobs. These findings may offer insight into the disproportionate COVID-19 mortality experienced by immigrants or similarly marginalized groups in other contexts. Interventions to reduce these disparities should include policies enforcing occupational safety, especially for immigrant workers, early vaccination, and expanded access to medical care.

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“…Eligibility and access to health insurance among the Latino population is also influenced by immigration status, English language proficiency, and place of birth ( 10 , 11 ). Uninsured and underinsured individuals are less likely to have a regular source of health care and are more likely to delay seeking health care services, which may lead to negative health consequences ( 10 , 12 ). All of these factors increase the risk of COVID-19 infection and death among Latinos, especially individuals aged 50 and older ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Emergency Medical Service Use Among Latinos Aged 50 and Older in California Counties, Except Los Angeles, During the Early COVID-19 Pandemic Period

Melgoza

Beltrán‐Sánchez

Bustamante

2021

Front. Public Health

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The COVID-19 pandemic has disproportionately affected Latino adults aged 50 and older in California. Among adults aged 50–64, Latinos constitute approximately one-third (32%) of the population, but over half (52%) of COVID-19 cases, and more than two-thirds (64%) of COVID-related deaths as of June 2, 2021. These health disparities are also prevalent among Latinos 65 years and older who constitute 22% of the population, but 40% of confirmed COVID-19 cases and 50% of COVID-related deaths. Emergency medical services (EMS) are an essential component of the United States healthcare system and a vital sector in COVID-19 response efforts. Using data from the California Emergency Medical Services Information System (CEMSIS), this study examines racial and ethnic differences in respiratory distress related EMS calls among adults aged 50 and older in all counties except Los Angeles. This study compares the early pandemic period, January to June 2020, to the same time period in 2019. Between January and June 2019, Latinos aged 50 and older had statistically significantly lower odds of respiratory distress related EMS calls compared to Blacks, Asians, and Whites. During the early pandemic period, January to June 2020, Latinos aged 50 and older had statistically significantly lower odds of respiratory distress related EMS calls compared to Blacks but slightly higher odds compared to Whites. Differences by race/ethnicity and region were statistically significant. Understanding EMS health disparities is crucial to inform policies that create a more equitable prehospital care system for the heterogeneous population of middle aged and older adults.

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Coronavirus Disease 2019 and the Case to Cover Undocumented Immigrants in California

Cited by 5 publications

References 4 publications

Excess mortality among Latino people in California during the COVID-19 pandemic

Excess mortality among Latino people in California during the COVID-19 pandemic

Excess death among Latino people in California during the COVID-19 pandemic

Emergency Medical Service Use Among Latinos Aged 50 and Older in California Counties, Except Los Angeles, During the Early COVID-19 Pandemic Period

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