Miller Report, July 20

Ethnic Disparity in Mendocino COVID Reflects National Trends

by William Miller, MD – Chief of Staff at Adventist Health – Mendocino Coast Hospital

This week, Mendocino County broke 200 in the number of COVID positive test results since the pandemic began in March.  Currently, there have been three COVID related deaths, two of whom were residents here in Sherwood Oaks nursing facility.  Currently, there are 9 hospitalized persons, four in Ukiah, three in Willits and two here.  The majority of these 200 cases are doing well and are expected to have only mild to moderate symptoms and recover without any need for hospitalization.

The demographic breakdown of these 200 cases shows that 10%, or about 20 people, have been on the Coast, while two thirds of the cases (144) are inland in the Ukiah Valley.  A concerning statistic is that about 60% (122) are identified as Latinx/Hispanic.  The Latinx population comprises 26% of the residents of Mendocino County according to the US Census estimate of 2019.  We have seen similar disparities throughout the US in terms of Latinx and African-American populations making up a disproportionate number of COVID cases elsewhere.  Additionally, the mortality rate in these populations may be higher if they get COVID because there is also a disproportionately higher rate of diabetes, obesity and heart disease.  These three factors seem to be the highest risk factors for a poor outcome in COVID.

According to a NY Times article from May 7^th, “Latinos may be more vulnerable to the virus as a result of the same factors that have put minorities at risk across the country. Many have low-paying service jobs that require them to work through the pandemic, interacting with the public. A large number also lack access to health care, which contributes to higher rates of diabetes and other conditions that can worsen infections.”

I feel that we must avoid being judgmental of any group when it comes to health.  Instead, we should recognize where these disparities exist and explore them to find out why they are happening to better support our fellow community members.  In reality, the dynamics of how any large health issue effects a particular group of people is often very complex.  

According to Lucresha Renteria, CEO of Mendocino Coast Clinics, “Many Hispanic people live in homes with multiple families, certainly multiple different generations.  Much of the culture is based on large family interactions.”  She also went on to point out that many of these same people work low income jobs where they get paid on a day to day basis.  They simply cannot afford to take off 14 days to self-isolate.  “It isn’t just that the person cannot afford the loss of two weeks of income, it is also that when they try to go back to that job they are likely to find that it has been filled by someone else in the interim,” she said.  “So taking time off from work could mean loosing the job all together.”

Lucresha and I are reaching out to the County Health Department to explore ways that our two organizations can work with health officials in developing more effective strategies to reach out to this population.  Simply translating a flyer into Spanish isn’t likely to be enough.