Here's Why That's Important
The disproportionate effect of COVID-19 on their community in the early days of the pandemic forced many older California Latinos to do something they normally avoid: Call 911 and ask for help.
It was, statistically, a turnaround. In the first six months of 2019, before the virus hit, white Californians age 50-plus with a respiratory issue were 28% more likely to call Emergency Medical Services (EMS) than were Latinos of the same age group. But in the first six months of 2020, as COVID cases ravaged their neighborhoods, Latinos were 10% more likely than whites in the demographic to use EMS when they felt respiratory distress.
That transformation in usage provides a critical opportunity to reconsider how the state’s EMS system is deployed and who works within it, say the authors of a new study conducted by the UCLA Latino Policy and Politics Initiative — and it can be a springboard to create more efficient local EMS agencies in areas like Los Angeles County, where nearly 50% of the population is Latino.
Ironically, L.A. County was the only one of the state’s 33 local EMS agencies not to be included in the UCLA report. The California Emergency Medical Services Information System omitted L.A. because its EMS reporting program is in the testing phase, the authors wrote.
Emergency medical services are integral to the state’s health system. Making it more accessible is a simple advancement of a common good.
“Although the study doesn’t directly account for about 30% of California’s Latinos who live in Los Angeles, other studies on the impact of COVID-19 on Latinos in L.A. would suggest that the same phenomenon would hold true in Los Angeles,” said Esmeralda Melgoza, a co-author of the UCLA report.
The virus’s impact upon Latinos in California was a driving force for the study. According to the Kaiser Family Foundation, Latinos account for 40% of California’s population, but represent 61% of its COVID cases and 47% of its deaths. Nationally, Latinos comprise 18.45% of the population but account for 26.2% of all COVID cases, per the Centers for Disease Control and Prevention.
In the early days of the pandemic, a combination of conditions pushed Latino COVID rates beyond the expected norm in California. First, Latino workers were heavily represented in front-facing and essential jobs: in transportation, food preparation and service, warehousing, etc. As the UCLA authors note, they also were more likely than white Californians to live in crowded, often multigenerational housing conditions that increased their odds of getting or spreading the virus.
Latinos tended to have more preexisting medical conditions, like heart disease, obesity or diabetes, that would impair their ability to fight off the worst effects of the virus. And both poverty and inadequate access to regular health care, a reality for many Latinos in the state, also factor into the equation.
While the data collected does not prove conclusively that the virus was the reason for the heightened use of emergency services by Latinos, the numbers are “suggestive that this shift in EMS use is driven by COVID-related symptoms among Latinos,” co-author Arturo Vargas Bustamante told Capital & Main.
It all came to a head during the first half of 2020, prompting a significant uptick in the percentage of EMS calls that went to older Latino patients. But the UCLA study suggests that inherent concerns about the EMS system likely have discouraged Latinos in California from requesting emergency help in years past.
What Melgoza, Bustamante and co-author Hiram Beltran-Sanchez found was that, prior to the pandemic, Latinos age 50 and older were far less likely to call EMS than white Californians. They noted several contributing factors: general distrust of the 911 system; fears related to immigration status; concerns over the cost of emergency services, such as ambulance transport; and lack of health insurance.
None of that necessarily improved during a pandemic in which emergency services were often stretched to breaking points across the state. But the UCLA study’s authors suggest that, with little alternative during those virus-related emergencies, Latino individuals and families may have become more familiar and comfortable with EMS. That opens the door to looking closely at changes that might make the services more accessible to the growing Latino population in the state.
Among the authors’ suggestions:
- Initiate EMS outreach to the Latino community, both to raise awareness of the role EMS can play in safeguarding the health of individuals and to build trust in the health care system overall. This, the authors say, could lead to more Latinos seeking everyday and preventive care, “which may alleviate some of the non-emergency call volume that often saturates the EMS system.”
- Increase the number of EMS workers who speak Spanish and other languages besides English. Past research indicates that language barriers are often cited as a concern for Latinos and members of other ethnic groups who call for emergency help.
- Diversify the EMS workforce in general, which may require a reevaluation of how EMS agencies recruit, hire and train their employees.
- Prioritize the centralization of data collection in the state. This would mean including Los Angeles County’s considerable amounts of information on EMS calls in its vast area.
Emergency medical services are an integral component of the state’s health system, the authors note. Making it more accessible to more residents is a simple advancement of a common good.
“The pandemic made it clear which demographic groups face the worst outcomes during a public health crisis,” Bustamante said. “We have a unique opportunity to use those lessons to ensure that our medical services are better prepared to serve those populations in the future.”
Capital & Main