The Weekly Issue/El Semanario Advisory Board
Dear Reader: If you were offered a COVID-19 vaccine today, would you take it? Why, or why not? Consider the intersectionalities of decision making that led you to your resolution to be vaccinated, or not. How will the Latinx communities make their similar determinations?
As our Advisory Board for The Weekly Issue/ El Semanario argued in last week’s edition, we are deeply concerned that members of the American workforce labeled “Essential Workers” will not be considered so essential once the vaccine becomes available. This is an imperative issue because members of the Latinx, African American, and Native American communities are approximately 4 times more likely to be hospitalized with COVID-19 than White communities (El Semanario, Nov. 26, 2020).
We are now concerned with the flip side of that issue: Will these communities agree to receive vaccinations? Among other sources, answers to that question are provided in a significant new study, “COVID Collaborative Survey: Coronavirus Vaccination Hesitancy in the Black and Latinx Communities” (by the COVID Collaborative, Langer Research, UnidosUS and the NAACP). The full report, including results of widespread surveys among Blacks and, to a lesser extent, Latinx communities, indicate significant challenges for the potential efficacy of the forthcoming COVID-19 vaccine in the Latinx and Black American communities.
Among Black Americans, 55% “Know someone who has been diagnosed with COVID-19,” and 48% know someone who was hospitalized or who died from the disease. The figures for Latinx Americans are even higher, with 73% knowing someone so diagnosed, and 52% someone “who has been hospitalized with or died from COVID-19.” These stark figures seem to belie the flip side of the issue: Among Blacks, only 14% “Mostly or completely trust that a vaccine will be safe,” with 34% among Latinx Americans, still a low figure. These numbers bode ill for widespread vaccinations among these groups.
How can both sides of this issue apply? If the disease is so prevalent among personal experiences and knowledge among these two groups, why are they reluctant or even averse to take the vaccine?
The answer to this seeming conundrum is the vital matter of trust “in the people and institutions responsible for developing and delivering a vaccine,” as the report says. The survey respondents indicated that only 4% of Black Americans trust “The Trump Administration,” higher among Latinx Americans but still low at 18%, and for other institutions, only 19% of Black Americans and 27% of Latinx Americans trust “Drug Companies.” The highest number trust the vaunted, renowned Dr. Fauci, but still at only a bare majority of 53% of Black Americans and 50% of Latinx Americans.
The readership of The Weekly Issue/El Semanario in the various states we reach would be well advised to reflect on these and other numerous findings of this report. A key finding places the situation in stark terms:
Confirming previous findings, fewer than half of Black adults, 48 percent, say they probably or definitely would get a coronavirus vaccine if it were available for free – including just 18 percent who definitely would get vaccinated. Among Latinx adults, interviewed for comparison, more likely would get vaccinated, 66 percent, including 31 percent definitely (page 2, Full Report).
So only 18% of Black Americans and 31% of Latinx Americans “definitely would get vaccinated,” leaving the vast majority still vulnerable to widespread infection.
For Black Americans, as the Report states (page 9), knowledge of the horrific Tuskegee Syphilis Study inflicted upon Black males—a euphemistically-entitled “study”—is a “negative predictor” for Black Americans to receive the COVID-19 vaccination. The article “Racism and Research: The Case of the Tuskegee Syphilis Study,” by Allan M. Brandt (1978), includes the following as introduction, implicating the U.S. Public Health Service and the currently-celebrated Centers for Disease Control:
“In 1932 the U.S. Public Health Service (USPHS) initiated an experiment in Macon County, Alabama, to determine the natural course of untreated, latent syphilis in black males. The test comprised 400 syphilitic men, as well as 200 uninfected men who served as controls. The first published report of the study appeared in 1936 with subsequent papers issued every four to six years, through the 1960s. When penicillin became widely available by the early 1950s as the preferred treatment for syphilis, the men did not receive therapy. In fact on several occasions, the USPHS actually sought to prevent treatment. Moreover, a committee at the federally operated Center for Disease Control decided in 1969 that the study should be continued. Only in 1972, when accounts of the study first appeared in the national press, did the Department of Health, Education and Welfare halt the experiment.”
We still experience extreme hardships. As a recent article in The Atlantic reveals, essential workers who are Latinx experience various social intersectionalities: employment requiring constant social interactions; low-wage jobs and resultant low median wealth; in many cases, lack of health insurance, especially undocumented immigrants; in some cases, “a cultural uneasiness with the American style of healthcare… [and] preferring non-Western medicine.” As a result, “Latinos are the racial and ethnic group least likely to visit the doctor. More than one-fourth of Latino adults in the United States lack a usual healthcare provider and almost half of Latinos never visit a medical professional during the course of the year.”
Given the above, the Latinx community finds itself in an infuriating situation facing the upcoming COVID-19 vaccinations. According to a New York Times article, “Who Will Get the Coronavirus Vaccine First?” (Nov. 30, 2020), CDC’s decision is imminent as to “which Americans it will recommend to get the coronavirus vaccine first,” with the nation’s “21 million health care workers” first, a necessary decision, followed by residents in nursing homes. CDC will decide soon on following recipients, including “essential workers.”
Our Advisory Board asserts that federal, state and local administrators must immediately work with local and informal leaders to access Latinx communities to ensure equitable and fair distribution. However, during the Trump Administration, one of the fundamental aspects of human relationships has been destroyed — namely, trusting the system. Rebuilding this aspect of the human condition will require culturally responsive intervention strategies. In 1986, following the passage of IRCA, Dr. Ramón Del Castillo, then Director of El Centro de las Familias, a mental health clinic in Denver, CO, was contacted by the State Department of Substance Abuse and Mental Health and asked to develop a culturally competent program to serve the needs of this specialized population. Many lessons were learned during this process. One of the distinctions between then and now is the use of social media and technology, aspects of communication which would have to be taken into consideration.
A foremost lesson learned is the need to hire outreach workers that are bilingual and bicultural to earn the trust of the many Latino communities. Entrance into Latino communities that are tight knit can be challenging due to the pervasive fear by some of deportation, leading to further suspicion and an unwillingness to interact with perceived outsiders — including for children born in the U.S. of immigrant parents.
Outreach workers can become “boundary spanners,” with a deep understanding of intricate Latino cultural belief systems, behaviors, attitudes and values. They have knowledge of the communities they serve and how to develop trusting relationships — they act as ambassadors of good will for those respective communities. Connection with the many nonprofit organizations such as health and mental health facilities that have gained the trust of the Latino community and cater to this population is an integral part of the process. Addition of an educational component about the vaccine is critical as outreach workers create pathways into Latino communities. Dispensing this information in Spanish is essential, with dialogue concerning all of the important aspects of the vaccine, including side effects.
Partly due to lack of insurance, Latinos many times have not visited with Western-medicine doctors and may depend on botanicas that function as dispensaries of medicinal herbs. A visit to the local botanica by outreach workers can become a creative pathway into the Latino community. Additionally, familiarity with local healers, Medicine People, or Curanderas/os that may be working in the community can be an asset as they have ultimate trust with those they serve and can act as a conduit for patients.
Finally, the innovation of integrated health care facilities is of critical importance in caring for our communities. Integrated healthcare was developed as a response to patients going to medical offices exhibiting symptoms of psychological and emotional challenges. Integrated health care is defined as, “An approach characterized by a high degree of collaboration and communication among health professionals” (apa.org) They consist of culturally competent staff who become ambassadors for their communities, a quasi-holistic approach beneficial to underserved populations.
We assert that each member of the Latinx communities, and all others, must be given an equitable opportunity to choose to take the vaccine. In that way, the U.S. can begin a new path to gain the trust of these essential communities.
Members of The Weekly Issue/El Semanario Advisory Board: Ramón Del Castillo, Ph.D.; Ray Ayón, retired Denver Police Detective; Steve Del Castillo, Ph.D.; and Luis Torres, Ph.D.
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