On a snowy January morning, Luis Portillo stood in line with about 200 other people at the side of a busy street in Silver Spring, Maryland — a suburb just north of Washington, DC — waiting for his turn to test for Covid-19. 19 to be tested at Mary’s Center, a state-approved health center. Portillo, a 65-year-old bakery worker originally from El Salvador, shoved his hands in his coat pockets and shivered in the 25-degree weather.
Although Portillo isn’t particularly concerned about Covid – he’s vaccinated and boosted and had a mild case last year – he came out because it’s necessary to “take care of yourself as best you can” to prevent others who are are more likely to be infected, he said in Spanish. After developing symptoms after a Christmas party and finding out another partygoer had tested positive, Portillo decided he needed a test. He was concerned about exposing employees or his four roommates who have remained symptom-free.
Similarly, Andres Bueno, 40, a Colombian construction worker who is waiting in line, said he and many others are “a little more confident now that we know more about the virus” but still “concern it will affect other people” . I think that worries you more,” he said in Spanish. Bueno, who is vaccinated and wants a booster shot, has also been in contact with someone who has tested positive.
The testing rush at Mary’s Center reflected some of the unique needs of its large population of Hispanic patients, many of whom work in public-facing jobs without paid sick leave or live in it multi-generational households in older people at higher risk of serious illness.
It also indicated a broad sense of collectivism, or a belief in the importance of taking care of others in the community, which public health experts have noted helps to promote health behavior among some groups of Latino immigrants. That attitude may have helped motivate these patients to get tested, said Marvin Ruiz-Chávez, who manages Covid testing and immunizations at the Silver Spring site.
Community concerns – compounded by strong outreach – also likely played a role in the rise in vaccination rates for Hispanics in recent months, now matching those of non-Hispanic whites in the United States Sixty percent of each group received at least one dose.
Three-fourths of the patients at Mary’s Center, which has five clinic sites and several school-based health centers in the Washington area, are Hispanic, and 65% earn less than the federal poverty line, according to data from the federal Health Resources and Services Administration, the agency that qualifies the state Health centers supervised. When the omicron variant caught on, the demand for testing at the center skyrocketed.
For many of those who waited hours in testing lines last month, Mary’s Center offers safe and convenient access to care. Many of his patients are undocumented, have limited English skills and lack health insurance, which largely excludes them from the general healthcare system. However, Mary’s Center staff is bilingual in Spanish, patients can get tested for free with minimal red tape, and patients are not required to provide information about their citizenship status.
Before the Omicron surge, the Silver Spring site was testing an average of 70 people per day, Ruiz-Chávez said. Hundreds showed up by mid-December, forcing the center to limit daily testing to about 200 people due to limited supplies, staff and time.
Testing sites across the country, serving a variety of groups, saw a similar increase in volume as Covid cases surged. Nonetheless, Ruiz-Chávez cited a common cultural emphasis on living in harmony with others—called convivir in Spanish – as the main motivator for Latino test seekers, many of whom mentioned the need to take care of their own health to protect others from the virus.
Honduran immigrant Carla Velazquez, 27, reiterated that sense of responsibility: “We don’t want to be transport companies,” she said in Spanish while standing in line wrapped in a large blanket. Velazquez and her husband, both of whom had been vaccinated, were exposed to a relative with Covid and felt a duty to protect others who attend their church or gather in other shared spaces.
The vaccination coverage gap began to narrow in earnest over the summer, largely credited to the Biden administration efforts to rise access to immunizations in underserved communities and the local people who are on the ground outreach work conducted by culturally credible local organizations and facilitated by federal dollars.
Undoubtedly, access has had a major impact on vaccine uptake in the Hispanic community, particularly among immigrants, said Sandra Echeverría, associate professor of public health education at the University of North Carolina-Greensboro, due to widespread social disadvantages, including language barriers, lack of familiarity with the Health care system, inability to take time off work and fear of immigration enforcement.
But how much has the collectivism embedded in Hispanic culture—particularly among immigrants and their families—also helped close the vaccine gap and encourage people to get tested? “There might be an association there, we just don’t know,” said Frank Penedo, a professor of psychology and medicine at the University of Miami, due to a lack of data and the difficulty of measuring a hard-to-define concept.
“I think access was key, and let’s not forget that,” Echeverría said, “but also that cultural orientation, that sense of community, doing for yourself and for others, is there,” and no doubt plays a role.
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