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With the COVID-19 vaccine becoming available, many of us, especially parents, were hopeful that we were seeing the light at the end of the tunnel and would be able to begin the school year with the pandemic in the rearview mirror. However, the surge of COVID-19 cases in children and adolescents has intensified concern among parents and public health leaders alike. And as the pandemic continues, so do existing health disparities and inequalities.
Compared with the beginning of the pandemic in 2020, we now understand how racial and ethnic minorities – and Latino communities in particular – have been affected by the COVID-19 pandemic. The Hispanic population accounts for 19% of deaths associated with COVID-19 and is experiencing the highest rate of COVID-19 deaths (36%) among children (0-4 years of age) and adolescents (5-18 years of age).
According to a Pew Research Center report, many Latinos feel confident that the worst periods of the pandemic are in the past. However, the optimism of our communities toward the COVID-19 pandemic cannot become a deterrent from getting vaccinated and continuing to wear a mask in public indoor settings, even for those who are vaccinated. Instead, it should catalyze the adoption of these COVID-19 preventive measures to protect our children and rebuild our communities post-pandemic. The vaccines are free and available to everyone aged 12 years or older living in the U.S., regardless of immigration or health insurance status.
Notably, public health agencies and community organizations continue to work together to create culturally and linguistically appropriate approaches to help mitigate the impact of COVID-19. In alignment with the Executive Order (E.O.) 13995, - “Ensuring an Equitable Pandemic Response and Recovery,” signed on January 21, 2021, public health agencies and community organizations continue to work together to create culturally and linguistically appropriate approaches to help mitigate the impact of COVID-19. Section 3 of the E.O. calls for the need to conduct “an outreach campaign to promote vaccine trust and uptake among communities of color and other underserved populations.” The U.S. Department of Health and Human Services’ (HHS) national campaign, “Juntos Sí Podemos,” provides multiple resources in both English and Spanish to educate people about effective ways to prevent and stop COVID-19 in Hispanic communities. Through the “Alianza Comunitaria Contra el COVID-19,” and the Community Engagement Alliance Against COVID-19 Disparities, community members are reinforcing their role as key trusted allies. Thus, community members spread timely and accurate information to family, friends, and neighbors. Additionally, the CDC has COVID-19 guidance to protect students, teachers, staff, and communities, including child care programs. Through these efforts, Hispanic communities can be made more aware of the risk of misinformation regarding COVID-19. They can be encouraged to get vaccinated to protect themselves, their loved ones, and their community. HHS has made available resources to ensure our communities get access to accurate information about the COVID-19 vaccination and address misinformation. We should empower our Latino communities with the tools to help close the gaps in information, and confront misinformation with evidence-based messaging from credible sources.
Despite these efforts and many others at regional and local levels, Latinos account for only 17% of those fully vaccinated in the United States. For that reason, we must work closely with the Hispanic communities hit hardest by COVID-19, providing accurate information and encouraging people to get informed, get vaccinated, wear a mask and take steps to overcome COVID-19.
This Hispanic Heritage Month, we can commit to protecting our children and communities by getting vaccinated and following CDC recommendations. Mask use is especially important in school settings where the children are unable to be vaccinated. And, we must continue following the science, applying preventive measures, and working together so we can once again join together as a community and gather with family and friends.
Be sure to visit the OMH Hispanic Heritage Month website to access resources in English and Spanish from other HHS agencies and stakeholders to help provide Hispanics and Latinos with relevant information related to COVID-19.
Publicado el 29 de septiembre de 2021 por Alexander Vigo-Valentín, Ph.D. Asesor de Salud Pública, Líder de Políticas de Salud para los Hispanos/Latinos, División de Políticas y Datos de la Oficina de Salud de las Minorías, Departamento de Salud y Servicios Humanos de los EE. UU.
Con la disponibilidad de la vacuna contra el COVID-19 desde el año pasado, muchos de nosotros, especialmente los padres, teníamos la esperanza de ver la luz al final del túnel y poder comenzar el año escolar con la pandemia ya en el pasado. Sin embargo, el aumento de los casos del COVID-19 en niños y adolescentes ha intensificado la preocupación tanto de los padres como de los responsables de la salud pública. Y a medida que la pandemia continúa, también lo hacen las disparidades y desigualdades de salud existentes.
En comparación con el inicio de la pandemia en 2020, ahora tenemos un mejor conocimiento de cómo las minorías raciales y étnicas, y las comunidades latinas en particular, han sido afectadas por la pandemia del COVID-19. La población hispana representa el 19% de las muertes asociadas con el COVID-19 y está experimentando la tasa más alta de muertes por COVID-19 (36%) entre los niños (de 0 a 4 años) y los adolescentes (de 5 a18 años).
Según un informe del Centro de Investigaciones Pew, muchos latinos sienten que los peores periodos de la pandemia son cosa del pasado. Sin embargo, el optimismo de nuestras comunidades frente a la pandemia del COVID-19 no puede convertirse en un elemento que desanime a vacunarse y a seguir usando mascarillas en lugares públicos cerrados, incluso para quienes están vacunados. Por el contrario, debería impulsar la adopción de estas medidas preventivas contra el COVID-19 para proteger a nuestros niños y reconstruir nuestras comunidades después de la pandemia. Las vacunas son gratis y están disponibles para todas las personas mayores de 12 años que viven en los EE. UU., independientemente de su estatus migratorio o seguro médico.
En particular, las agencias de salud pública y las organizaciones comunitarias continúan trabajando juntas para crear enfoques cultural y lingüísticamente apropiados para ayudar a mitigar el impacto del COVID-19. Conforme con la Orden Ejecutiva (E.O., por sus siglas en inglés) 13995, "Garantizar una respuesta y recuperación equitativas ante la pandemia", firmada el 21 de enero de 2021, las agencias de salud pública y las organizaciones comunitarias continúan trabajando juntas para crear enfoques cultural y lingüísticamente apropiados para ayudar a mitigar el impacto del COVID-19. La sección 3 de la E.O. hace referencia a la necesidad de llevar a cabo "una campaña de divulgación para promover la confianza y la aceptación de la vacuna entre las comunidades de color y otras poblaciones desatendidas". La campaña nacional del Departamento de Salud y Servicios Humanos de los EE. UU. (HHS, por sus siglas en inglés), “Juntos Sí Podemos,” ofrece múltiples recursos tanto en inglés como en español para educar a las personas sobre las formas eficaces de prevenir y detener el COVID-19 en las comunidades latinas. Además, como parte de la “Alianza Comunitaria Contra el COVID-19,” y La Alianza de Participación Comunitaria contra las disparidades del COVID-19, o CEAL, de los Institutos Nacionales de Salud (NIH, por sus siglas en inglés), los miembros de la comunidad están reforzando su rol como aliados y mensajeros de confianza que ayudan a dar forma a los enfoques y a difundir información oportuna y precisa a familiares, amigos y vecinos. Además, los CDC cuentan con guías sobre el COVID-19 para proteger a los estudiantes, los maestros, el personal y las comunidades, incluidos los programas de cuidado infantil. A través de estos esfuerzos, las personas de las comunidades latinas pueden ser más conscientes del riesgo de la desinformación cuando se trata del COVID-19, y pueden ser alentados a vacunarse para protegerse a sí mismos, a sus seres queridos y a su comunidad.
Las agencias de HHS y otras organizaciones nacionales y estatales han desarrollado recursos para asegurar que nuestras comunidades tengan acceso a información precisa sobre las vacunas del COVID-19. Esta información brinda las herramientas para eliminar las lagunas de información, derribar mitos y confrontar la desinformación con mensajes de fuentes confiables basados en la evidencia científica. A pesar de estos esfuerzos y de muchos otros a nivel regional y local, según los CDC los latinos sólo representan el 17% de las personas que han sido completamente vacunadas en los Estados Unidos. Por esa razón, debemos trabajar estrechamente con las comunidades hispanas más afectadas por el COVID-19, facilitando información precisa y animando a todos a informarse, vacunarse, usar una mascarilla y tomar medidas para superar el COVID-19.
En este Mes de la Herencia Hispana, podemos comprometernos a proteger a nuestros niños y comunidades vacunándonos y siguiendo las recomendaciones de los CDC. El uso de la mascarilla es especialmente importante en los entornos escolares donde los niños no pueden ser vacunados. Y debemos continuar siguiendo la ciencia, aplicando medidas preventivas, y trabajando juntos para que podamos una vez más unirnos como comunidad y reunirnos con familiares y amigos.
No olvide visitar el sitio web del Mes de la Herencia Hispana de OMH para acceder recursos en inglés y español de otras agencias de HHS y aliados para ayudar a proporcionar a los hispanos y latinos información relevante relacionada con el COVID-19.
During public health crises such as the COVID-19 pandemic, racial and ethnic minority groups disproportionately experience adverse outcomes like high hospitalization and mortality rates as a result of a variety of factors, including social determinants of health (SDOH).1,2 SDOH are conditions in the places where people live, learn, work, and play that affect a wide range of health and quality-of-life outcomes and risks. Examples of SDOH include healthcare access and quality, education, racism and discrimination, economic stability, housing, and environmental conditions. The Minority Health Social Vulnerability Index (Minority Health SVI) is a new database developed by the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) and the Centers for Disease Control and Prevention (CDC). This database integrates SDOH and other vulnerability-associated data to support the identification of communities at risk for disproportionate impact from COVID-19 and other public health crises.
The Minority Health SVI:
In light of the disproportionate impact of COVID-19 and longstanding structural inequities experienced by racial and ethnic minority populations, the Minority Health SVI is an invaluable resource that improves access to local data. This data will allow users to better understand racial/ethnic groups, language preferences, and factors associated with racial and ethnic health disparities in each community. The Minority Health SVI also allows users to more deeply comprehend the social vulnerability of specific racial and ethnic minority communities and better allocate public health resources.
OMH is using the Minority Health SVI’s comprehensive data to promote equity in its policy and program efforts. The Minority Health SVI is an important tool available to awardees to support these efforts.
1 Introduction to COVID-19 Racial and Ethnic Health Disparities. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/index.html. Accessed on July 29, 2021. 2 At A Glance: CDC/ATSDR Social Vulnerability Index. https://www.atsdr.cdc.gov/placeandhealth/svi/at-a-glance_svi.html. Accessed on July 29, 2021.
Growing up in Tonga, it was all but impossible not to recognize a lack of access to education, health, and economic opportunities within my Pacific Islander family and community. These experiences have inspired me to support and promote health equity in vulnerable groups as part of my professional career and personal interests.
As we celebrate Asian American and Pacific Islander Heritage Month this May, it is useful to take a look back. Historically, the U.S. Census Bureau grouped persons of Asian ancestry into the category "Asian Pacific Islander." During the 1990 census, the standards for collecting race/ethnicity data were under scrutiny because the categories outlined in the federal Office of Management and Budget (OMB) Directive No. 15 did not reflect the nation's changing demographics. In 1997, OMB issued a federal register notice, Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity, which separated the Asian and Native Hawaiian or Other Pacific Islander (NHOPI) ethnicities into their own separate categories. As a result of this distinction, public health practitioners would better understand risk factors, disease prevalence, and lived experiences for each group. The revised OMB directive defines the two ethnic groups as follows:
Although OMB released these data standards, it is important to note that some entities continue to lump the two ethnic groups under “Asian Pacific Islander.” During the COVID-19 pandemic, UCLA data researchers found that only 20 states provided COVID-19 data about NHOPIs . This is a serious problem as it is difficult to understand and justify the need to intervene and/or allocate resources for specific groups during public health crises.
In President Biden’s Proclamation on Asian American and Native Hawaiian/Pacific Islander Heritage Month, 2021, he noted that AAHOPI “communities face systemic barriers to economic justice, health equity, educational attainment, and personal safety. These challenges are compounded by stark gaps in Federal data, which too often fails to reflect the diversity of AAHOPI communities and the particular barriers that Native Hawaiian, Pacific Islander, Southeast Asian, and South Asian communities in the United States continue to face.”
As seen in the figures below, when available data among ethnic groups are considered separately, we see stark differences in risk factors between AAs and NHOPIs.
Snapshot of Health Profile Measures
Adapted from the Office of Minority Health, Policy and Data, Health Profiles by Population.
As we continue to advance cultural competency under the Biden Administration’s Executive Order on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government, I present three important considerations for public health colleagues and researchers working/partnering to improve health in AAHOPI communities:
For more information about Asian American and Pacific Islander Heritage Month, please visit the OMH observance page.
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Each year in the U.S., approximately 700 women die from pregnancy-related complications and more than 25,000 women suffer unintended outcomes of labor and delivery that can result in significant short- or long-term consequences to their health. Black women in the U.S. are three to four times more likely than white women to die in pregnancy or childbirth. American Indian/Alaska Native women are two to three times more likely to die. More women of color than white women report feeling mistreated, ignored, or dismissed by their maternal health providers.
Simone Landrum, a Black woman in New Orleans, Louisiana, is one of the faces of this crucial public health issue. During pregnancy, she complained repeatedly to her physician about headaches, sensitivity to light, swelling, and fatigue. Her physician told her to calm down and take Tylenol. At 34 weeks, she suffered a placental abruption due to high blood pressure, and her stillborn baby was delivered via C-section. Her story, as reported by the New York Times , sheds light on the sharp contrast between pregnancy as a source of new life and also a possible cause of death for so many Black women.
The reasons for Simone’s – and for many women of color – tragic pregnancy and childbirth experiences are complex and deeply rooted in the harmful effects of social determinants of health, chronic stress, and poor quality of care. What role can maternal health providers play in preventing maternal mortality and morbidity? One vital strategy is to improve quality of care by providing culturally and linguistically appropriate services (CLAS) – in other words, understanding, respecting, and responding to a patient’s experiences, values, and beliefs.
In December 2020, HHS released the Action Plan to Improve Maternal Health in America and the Surgeon General’s Call to Action to Improve Maternal Health, that sets an ambitious goal of reducing the maternal mortality rate in the U.S. by 50 percent by 2025.
To help lead the nation toward meeting the Action Plan’s goal, I am pleased to announce that the HHS Office of Minority Health has launched an e-learning program that builds maternal healthcare providers’ knowledge and skills related to cultural competency and cultural humility. This free e-learning program – Culturally and Linguistically Appropriate Services (CLAS) in Maternal Health Care – supports the Action Plan’s call to healthcare providers to deliver services that respect and respond to patients’ culture and language preferences, to bring about positive health outcomes for diverse populations.
Culturally and Linguistically Appropriate Services (CLAS) in Maternal Health Care is offered at no cost and accredited for two continuing education hours for physicians, physician assistants, nurses, nurse practitioners, certified nurse midwives, and certified midwives. The program offers case studies, self-reflection questions, and a Resource Library.
We must ensure that maternal healthcare providers are equipped to deliver respectful, compassionate, high quality care. It is a matter of life and death. If you are a maternal health care provider, the change starts with you. Make a commitment today to complete this Maternal Health Care program and share this new resource with your colleagues.
Maybe you’ve seen the videos on social media. A 52-year-old Chinese American woman assaulted in New York City. An 84-year-old Thai American man pushed to the ground so violently in San Francisco that he dies from his injuries. Both incidents in recent weeks are part of an alarming increase of attacks on Asian Americans and Pacific Islanders (AAPIs) in the United States since the beginning of the COVID-19 pandemic last year.
Renowned civil rights lawyer Bryan Stevenson says that to address racial inequality, we have to confront our history. In the context of health inequities, we should acknowledge that hate, stigma, racism, discrimination, conscious and implicit bias, and microaggressions have played—and continue to play—a role in contributing to poor health and health outcomes for racial and ethnic minority populations, and in exacerbating health disparities.
While the nation battles the COVID-19 pandemic, disturbing reports of attacks, harassment and hate-motivated incidents are forcing AAPI communities to battle racism and bigotry that threaten their physical safety and mental wellbeing.
This is not the first time the AAPI community has experienced racism during a public health crisis. The 2003 SARS outbreak saw a rise in anti-Asian rhetoric and action, driven by similar myths and misdirection of blame toward AAPIs as are being perpetuated now. These are just a few examples of the violence and abuse against racial and ethnic minority and other marginalized groups that have persisted throughout our country’s history. Not only are actions motivated by intolerance inherently wrong, but there is also evidence that suggests that they can affect the health and mental health of individuals and their communities.
On January 26, President Biden issued the Memorandum Condemning and Combating Racism, Xenophobia, and Intolerance against Asian Americans and Pacific Islanders in the United States. The memorandum calls for federal government to combat and prevent racism, xenophobia, and intolerance against AAPIs. The memorandum includes a directive for the Secretary of Health and Human Services, in coordination with the COVID-19 Health Equity Task Force, to consider issuing best practices for advancing cultural competency, language access and sensitivity toward AAPIs in the context of the federal COVID-19 response. On January 20, the Administration also issued the Executive Order on Advancing Racial Equity and Support for Underserved Communities Through the Federal Government. This executive order calls for a comprehensive federal approach to advancing equity for all, including people of color and others who have been historically underserved, marginalized, and adversely affected by persistent poverty and inequality.
Federal activities aligned with the memorandum and executive order will not only address immediate equity needs related to COVID-19 response and recovery efforts, but also will have the great potential to support sustained federal efforts beyond the pandemic to combat interpersonal and structural racism and to advance inclusion for people of all races, national origins, and ethnicities. Of critical importance to the Office of Minority Health (OMH) at the U.S. Department of Health and Human Services, another promising outcome will be the advancement of health equity, as the federal government works to improve cultural competence, improve access to quality health care, and mitigate the adverse effects of racism on health and wellbeing. OMH calls on everyone in the nation to join the federal government in condemning and combating racism—it is the right thing to do as a nation, and for our health.
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