Leading Indicators

The Impact of COVID-19 on Philly’s Latinx/Hispanic Community

The Impact of COVID-19 on Philly’s Latinx Community 

In a previous Leading Indicator, we examined the social determinants of health that have disproportionately positioned Philadelphia’s African American/Black communities on the frontlines of the COVID-19 pandemic. In this brief we continue our discussion of the social determinants of health and how the pandemic is exacerbating local health inequalities - this time among Philadelphia’s Latinx/Hispanic communities. 

 

Key Takeaways 

  • Philadelphia’s Latinx/Hispanic population has almost doubled in size between 2000 and 2018. 
  • As of 2018, 38 percent of the city’s Latinx/Hispanic population were living in poverty - the highest of any demographic group. 
  • Approximately 13 percent of the city’s Latinx/Hispanic population had no health insurance coverage in 2018 – compared to 5 percent of the Non-Hispanic White population and 7 percent of the African American/Black population. 
  • The city’s Latinx/Hispanic population faces a disproportionate risk of contracting the COVID-19 virus because of underlying health inequalities related to poverty and barriers to access to the healthcare system, as well as overrepresentation in “essential” occupations. 

Philadelphia’s Latinx/Hispanic Population 

Philadelphia has a large and rapidly growing Latinx/Hispanic population that nearly doubled in size between 2000 and 2018 - from 8.5 to 14.5 percent [1]. The Latinx/Hispanic population is diverse and comprises distinct communities with unique origins. Figure 1 compares place of descent or origin for Philadelphia’s Latinx/Hispanic population with the total U.S. Latinx/Hispanic population.  

 

FIGURE 1

Percentage of Latine/Hispanic descent

NOTE: Data for this table were obtained from the U.S. Census’ 2018 American Community Survey Five-Year Estimates.

 

The majority of Philadelphia’s Latinx residents are of Puerto Rican origin or descent at 60.5 percent. This far outpaces national estimates and is largely the result of mass economic migrations from the island in the 1950s and 1960s - with Philadelphia’s then-robust textile industry acting as a major draw [2]. Since the 1990s, Philadelphia has seen a rapid influx of Dominicans who are currently the second most prevalent Latinx/Hispanic concentration at 11.8 percent. Interestingly, many of Philadelphia’s Dominican residents are recent transplants from New York City who left to find more affordable housing and new employment [3].  

 

Barriers to Equitable Health 

Like the city’s African American population, Philadelphia’s Latinx/Hispanic population has faced systemic discrimination in employment and housing that has hindered wealth creation and kept many Latinx communities living in poverty [4]. As of 2018, 38 percent of the city’s Latinx residents were living in poverty which is the highest proportion of any major racial or ethnic group in the city [1]. As discussed in our previous brief, poverty is highly correlated with adverse health outcomes. Poverty creates a vicious downward cycle where a lack of financial resources to fully participate in the costly U.S. healthcare system means that individuals living in poverty often forego seeking treatment. They, therefore, have increased risk of developing chronic diseases and mental illnesses, higher mortality rates, and lower life expectancies [5].

 

Philadelphia’s Latinx/Hispanic population has reported some of the highest cases of chronic disease and adverse health outcomes in the city relative to other racial and ethnic groups. According to the 2019 Health of the City report, 38 percent of Latinx/Hispanic residents surveyed rated their health as poor or fair compared to 25 percent of Non-Hispanic Black residents and 20 percent of Non-Hispanic White residents. The self-reported data correlate with a series of objective measures—such as obesity, adult-onset asthma, diagnosed depression, and new HIV diagnoses—where prevalence among the Latinx/Hispanic population outpaced any other racial or ethnic group in the city. In addition, urban Latinx/Hispanic residents are more likely to live in densely populated neighborhoods with substandard housing conditions [6]. This, coupled with a higher prevalence of multigenerational households, allows infectious diseases to spread quickly within the community.

 

Research suggests that the largest health barrier faced by Latinx/Hispanic populations is the access to care. Acculturation and language barriers, citizenship status, higher unemployment rates, and lack of insurance coverage have prevented many Latinx residents from seeking medical care [7]. In fact, despite the Affordable Care Act’s significant expansion of coverage and patient protection, 13 percent of the city’s Latinx/Hispanic population remained without health insurance in 2018 – compared to 5 percent of the Non-Hispanic White population and 7 percent of the African American/Black population [1]. 

 

The poor health conditions and barriers to care positions Philadelphia’s Latinx/Hispanic community at an elevated risk of contracting and spreading the COVID-19 virus. Figure 2 illustrates this relationship by showing the spatial correlation between the concentration of Latinx/Hispanic residents and pertinent health indicators related to the COVID-19 virus. It shows that many Latinx/Hispanic neighborhoods in Philadelphia face higher risk of COVID-19 contraction due to existing health inequalities. 

 

FIGURE 2

NOTE: Data for these maps were obtained from U.S. Census’ 2014-2018 American Community Survey Five-Year Estimates, the National Center of Health Statistics' U.S. Small-Area Life Expectancy Estimates Project's 2010-2015 estimates, the CDC’s 500 Cities Project, and the Social Progress Imperative’s COVID-19 Vulnerability Index. The Social Progress Imperative also lists the detailed curation of their data.

 

Essential Workers or Waiting Without Benefits 

While some Latinx/Hispanic Philadelphians face greater risk of contracting and spreading the COVID-19 virus because they work in state-defined “essential” occupations, the majority work in “non-essential” occupations that have been effectively shut down by the government in response to the pandemic. This increases risk for Latinx/Hispanic communities since permanent separation from employment could lead to even larger numbers of community members without access to medical benefits.

 

Figure 3 shows the 2018 occupational concentrations with higher than average Latinx/Hispanic representation in Philadelphia’s salaried workforce. As with Philadelphia’s African American/Black population, many Latinx individuals work in “essential” occupations that increases their risk of exposure to the virus – specifically, Material Moving Occupations (e.g. trucking, delivery drivers, and hand laborers), Production Occupations (e.g. assemblers, bakers, butchers, welders, woodworkers, etc.), Law Enforcement Workers (police, security guards, etc.), and Healthcare Support Occupations (e.g. nursing assistants, orderlies, home health aides, community and public health workers, etc.). All of these positions are on the frontlines of this pandemic and run a greater risk of infection. 

 

FIGURE 3

NOTE: Data for this graph were obtained from the U.S. Census’ 2018 American Community Survey One-Year Estimates.

 

Although many Latinx/Hispanic residents are employed as essential workers during the pandemic, the abrupt termination of public and private construction across the Commonwealth posed a greater risk for Latinx/Hispanic populations. Philadelphia’s Latinx/Hispanic population constitutes 12.6 percent of the city’s total workforce, but roughly 32 percent of Construction and Extraction Occupations and over 20 percent of Installation, Maintenance, and Repair Occupations. These occupational categories comprise all manner of skill and unskilled laborers that include carpenters, electricians, insulation workers, masons, roofers, painters, plumbers, mechanics, HVAC mechanics and installers, and medical equipment repairers. With the closure of construction across the state, many firms had to layoff workers since labor accounts for roughly 20 to 40 percent of any construction project. For many workers, this could mean termination of employer-provided medical benefits, further exacerbating lack of access to medical care if they were to contract the virus. In sum, the “essential” Latinx/Hispanic worker faces greater risk of infection while the “non-essential” worker faces a greater risk of losing access to care. 

 

Reducing Barriers to Health 

The COVID-19 pandemic is amplifying existing health inequalities and disproportionately impacting communities of color. This is evident among the city’s Latinx/Hispanic population who—like the city’s African American/Black communities—face a disproportionate risk of contracting the COVID-19 virus because of underlying health inequalities related to poverty and their overrepresentation in “essential” occupations. However, the Latinx/Hispanic community faces the additional challenge of accessing a healthcare system that has historically erected significant barriers to entry. Public health crises like the COVID-19 pandemic will continue to disproportionately impact communities of color until the underlying structural inequities are addressed.

 

Latinx/Hispanic individuals already face numerous obstacles when accessing healthcare in the United States. Poverty, language and cultural barriers, underrepresentation in the medical field, and lack of insurance have over-burdened many Latinx/Hispanic communities with physical and mental illnesses and chronic diseases. These factors have also contributed to significantly higher prevalence of the COVID-19 virus in Latinx/Hispanic communities when compared with Non-Hispanic White populations. 

 

Addressing Latinx/Hispanic health disparities are central to an equitable response and recovery strategy. In the immediate crisis, increased targeted outreach in Latinx/Hispanic communities can ensure that residents have good information on the ever-changing risks and prevention guidelines related to COVID-19. Information written in Spanish via handouts and webpages are a start, but greater successes will come from tight coordination with Latinx/Hispanic community organizations and civic leaders who are best positioned to disseminate information in their communities [8]. Third (and as previously suggested with the African American/Black population), COVID-19 testing should be concentrated in poorer communities with higher prevalence of chronic disease. And finally, the publicly-released COVID-19 data needs to include racial and ethnic identifiers for both positive and negative cases to better monitor the spread of the disease throughout the city’s communities. Data reflecting higher incidences in one community would allow officials to more directly target interventions and better allocate resources.  

 

Philadelphia’s Latinx/Hispanic population is the fastest growing demographic group in the city. We need culturally informed and competent strategies to address health crises like the COVID-19 pandemic, otherwise we will continue to see major disparities.

 

Author's Note: Special thanks to our colleagues at the Social Progress Imperative for access to their curated data

 

Works Cited 

[1] U.S. Census Bureau. 2019. 2014-2018 American Community Survey 5-Year Estimates. Retrieved from: (https://www.census.gov/data.html). 

 

[2] Riberio, Alyssa. 2016. “Puerto Rican Migration”. The Encyclopedia of Greater Philadelphia. Retrieved from: (https://philadelphiaencyclopedia.org/archive/puerto-rican-migration/). 

 

[3] Sadurní, Luis Ferré. 2017. “Dominican population continues to soar in Philadelphia”. The Philadelphia Inquirer, February 27. Retrieved from: (https://www.inquirer.com/philly/news/Dominican-population-continues-to-soar-in-Philadelphia.html). 

 

[4] Harvard T.H. Chan School of Public Health, Robert Wood Johnson Foundation, and National Public Radio (NPR). 2017. Discrimination in America: Experience and Views of Latinos. Retrieved from: (https://www.rwjf.org/en/library/research/2017/10/discrimination-in-america--experiences-and-views.html). 

 

[5] Healthy People 2020. N.d. “Poverty.” Office of Disease Prevention and Health Promotion. Retrieved from: (https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/poverty). 

 

[6] Population Reference Bureau. 2007. Hispanic Gains Minimize Population Losses in Rural America. Retrieved from: (https://www.prb.org/hispanicgains/). 

 

[7] Velasco-Mondragon, Eduardo; Angela Jimenez; Anna G. Palladino-Davis; Dawn Davis; & Jose A. Escamilla-Cejudo. 2016. “Hispanic Health in the USA: A Scoping Review of the Literature.” Public Health Reviews, (37). Retrieved from: (https://publichealthreviews.biomedcentral.com/articles/10.1186/s40985-016-0043-2). 

 

[8] Galvan, Astrid & Regina Garcia Cano. 2020. "Getting Coronavirus Updates in Spanish Is a Mixed Bag in US." NBC10 Philadelphia, March 19. Retrieved from: (https://www.nbcphiladelphia.com/news/coronavirus/getting-coronavirus-updates-in-spanish-is-a-mixed-bag-in-us/2332597/).