The Maryland Health Department has convened an inter-agency task force aimed at reducing the COVID-19 positivity rate in Hispanic communities, Dr. Jinlene Chan, deputy secretary of public health services, told lawmakers Tuesday.
The Hispanic Outreach Task Force, spearheaded by the Department of Health, the Maryland Emergency Management Agency and the Department of Human Services in partnership with local organizations, is looking to provide support to Baltimore City to connect underserved Hispanic communities to social services, prevention tactics, isolation housing, educational materials and contact tracing.
Additionally, the task force is experimenting with an intervention program that would provide financial assistance, medical care, isolation, food and other services for families who have tested positive.
A pilot version of the program is set to serve 10 families. Based on its success, it may be expanded to other Hispanic communities in the coming months. The task force plans to first target its efforts in Baltimore City’s 21224 zip code ― a major hotspot.
“I think that, really from our perspective at the state level, it’s really diving in not just into that community, but then beginning to take the process and the lessons learned and working to expand that, certainly across the state, and working to engage many other partners to understand what the impact has been,” Chan told the Maryland House Public Health and Minority Health Disparities Subcommittee at a virtual briefing Tuesday.
The 21224 community has 1,980 cases ― 13% of the city’s total number of confirmed COVID-19 infections. That area has about 8% of the city’s overall population.
When looking at case rates, the Department of Health reported that the state’s Hispanic population leads both Black and white communities in infections, and trails behind the Black community in deaths.
According to the U.S. Census Bureau, 59% of Maryland’s population is white, 31.1% is Black and just 10.6% identify as Hispanic or Latino. Additionally, 6.7% identify as Asian, while 0.6% are American Indian or Alaska natives, and 0.1% identify as native Pacific islanders.
Dr. Sherita Hill Golden, vice president and chief diversity officer for Johns Hopkins Medicine, partnered with community leaders to have a testing site at Sacred Heart of Jesus Church in the 21224 neighborhood over the summer. She said that the zip code’s positivity rate had once been up to 40%, but recently has dropped as low as the mid-teens.
Golden explained to the subcommittee that Father Bruce Lewandowski and members of the Sacred Heart of Jesus congregation were trained to serve as bilingual contact tracers.
Contact tracing is a major issue among minority communities. Golden said that distrust of medical professionals among Black and Brown citizens has roots in medical experimentation practiced during the late 19th and early 20th centuries, paired with eugenics theories that have left many physicians with medical biases.
“What that’s resulted in is that, in the healthcare context, many of these communities have poor access to care,” Golden said. “They have a decreased quality of care. They have less participatory decision making in the patient-provider relationship and reduced health literacy that increases their risk for disease.”
Golden also pointed to social factors that play a major role in these health disparities, like redlining and predatory lending that have landed minorities in underserved communities with less access to transportation, healthful food and medical care; increased viral exposure via public transportation, essential or frontline jobs and mass-incarceration; and language barriers that make communicating with providers difficult.
She said that Johns Hopkins has supplied bilingual contact tracers to the Baltimore City Health Department, but that more are needed to build trust within these communities.
Additionally, she explained, Hispanic and immigrant individuals are afraid of family separation, making isolation and quarantine at government-designated hotels a difficult sell.
“I think that when you’re speaking to people in their language, it really is about the trust,” she explained. “One of the reasons that the Latinx community ― particularly immigrant members of that community ― they are very uncomfortable with the contact tracing concept, because they’re concerned that…you may actually use my information and turn me over to immigration.”
Dr. Nilesh Kalyanaraman, Anne Arundel County’s health officer, noted this fear of deportation and family separations as a problem in his jurisdiction, as well.
“We understand that we’re the county’s local health department and we don’t have any authority ― much less interest ― in doing anything related to immigration status or anything like that. But for communities that are scared of that, that doesn’t really matter, right?” he said. “So there’s a lot of those issues that go beyond simply what happens in the healthcare system or the public health system.”