Inequity Accounting for Hispanic COVID-19 Cases

by Carol J. Bova

Last week Del. Jennifer Carroll Foy, D-Prince William, wrote a letter to Governor Ralph Northam decrying the high rate of COVID-19 infection in Virginia’s Hispanic population. She blamed “longstanding and systemic factors, such as disparate access to information, testing, and treatment.” Jim Bacon responded that Virginia Department of Health (VDH) data did not support Foy’s assertion. But even Bacon took the VDH numbers as an accurate reflection of reality. In truth, VDH “confirmed cases” numbers, which suggest that Hispanics account for 43% of all COVID-19 cases in which race/ethnicity have been identified, are not reliable.

Originally, VDH number crunchers broke down confirmed cases as Black, White, Other, and Unknown. In mid-June they created Latino as a new demographic category, describing it as “Individuals of any race who identify as ‘Hispanic or Latino.’” To create the Latino category, VDH moved 11.3 percentage points from the White cases and 23.6 percentage points from Other and Unknown Race cases. The result: Hispanics accounted for 33.9% of all cases.

Ignoring 16,500 cases in the Unknown category increases the apparent proportion of Black and Latino cases and provides talking points for Del. Foy and the Governor that Latinos have 43% of all cases whose ethnicity was identified.

As can be seen by comparing the maps above and below, the distribution of the Hispanic population within the Commonwealth overlaps with COVID-19 hotspots, exposing more Hispanics to the virus. Also, heavier testing within those hotspots has identified more Hispanic cases. Unless randomized testing is conducted across all racial/ethnic categories using the same protocols, it is impossible to give an accurate estimate of the incidence of the virus within each group.

VDH said, “The percentage of the Hispanic/Latino population varies widely by county, from a low of 0.1% in Cumberland County to a high of 34% in Manassas Park City. … While Virginia’s proportion of Hispanics/Latinos is well under the national average of 17%, it represents a sizable population which is increasing and whose needs should be taken into account in the resource planning process.”

The 2014 Hispanic population was 687,000. In 2018, the number was estimated at almost 813,000, and it has increased since then. As an example, the Hispanic population in Fairfax increased 16.4% in 2019, so it is conceivable statewide the number is closer to or over a million in 2020.

 

The politics of ethnicity

Governor Northam held a COVID-19 Briefing in Fairfax on June 18, two days after the Virginia Department of Health announced the new breakdown of categories for reporting on COVID-19 which gave Hispanic ethnicity the same weight as race in reports. The briefing was targeted at Hispanics and included several persons who spoke in Spanish. The governor used the opportunity to make political points showing how Virginia and Prince William County are supporting undocumented Hispanics. He quoted a 10% Hispanic population number while he ignored the fact the Census classified Hispanics first within Black or White race numbers and added the Hispanic identification as additional information. With the VDH “Unknown” category hitting 16,500 on July 10, neither the governor nor anyone else can say what the true percentage of cases is for any VDH racial/ethnic category.

But the governor did say, “Clearly, Latino communities are disproportionately affected  by this virus. … Latino people are more likely to work in jobs that put them at high risk of contracting the virus. These risk factors are compounded within the Latino undocumented population.” He continued:

Our Medicaid program has worked to make it as easy as possible to enroll if you are eligible … and Medicaid is giving non-citizens extra time if needed to document immigration status when they apply for health coverage. For those who are not documented, but need testing or care, please be assured getting you tested and cared for is our priority. We’re not checking papers at these testing events or at clinics. We just want to help you and your families to be safe and healthy. I also want to acknowledge the action by Prince William county to end its 287-G program in which local law enforcement was collaborating with federal ICE officials and reporting the immigration status of people arrested. I hope this will set a new tone of trust and support with our Latino communities.

Heavy testing in Hispanic communities in Northern Virginia

Jeff McKay, Chairman of the Fairfax County Board of Supervisors at the June 18 briefing described the heavy testing there. “In Fairfax, we recognized this disproportionality from day one of this virus.” He said that the county had given over 69,000 tests already and was averaging over 9,200 tests per week in the Fairfax Health District, with more than 25 sites offering testing.

Fairfax Health District reported 98,282 PCR tests as of July 12, the highest number in the state, almost 42,000 more than Prince William, with the second highest number at 56,529. There probably have been many more cases in other races or ethnicities in other areas of the Commonwealth, but nowhere else has seen this level of testing to know for sure.

The actual numbers for the other health districts range from four districts with 37,000 to 41,000, ten districts with 22,000 to 28,000 tests and 19 districts with 4,527 to under 20,000 tests.

The VDH map of PCR tests highlights areas with 1000+ tests as the most heavily tested, and these areas also overlap the Hispanic population distribution map areas.

On June 14, the Black percentage of all cases was 14%, or 18.7% when omitting the Unknown cases — less than the 2019 census estimate that the Black population in Virginia is 19.9%. As of July 10, the numbers shifted slightly to 15.2% of all cases or 19.9% without the Unknown cases. Could it be that Black COVID-19 statistics no longer appeared disproportionate enough to single them out for press conference attention and the governor wanted to woo another segment of the population? VDH certainly managed to craft the Hispanic numbers for him to do so.

Carol J. Bova is a writer who lives in Mathews County.

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40 responses to “Inequity Accounting for Hispanic COVID-19 Cases

  1. Time to “23&Me” the bodies. All else is rubbish.

  2. I think it’s fair to point out that VDH has flaws in their data collection , many states do – but if one looks at the larger amount of data being collected overall by CDC – it has a consistent pattern on ethnicity.

    I give Carol credit. She is very thorough and precise and illustrates clear problems with VDH – no excuses – but the pandemic has pushed many agencies beyond what they are normally able to do nominally.

    The overall data nationally is no real surprise. Lower-income folks without health insurance who must work at in-person jobs, tend to not seek help until they have to and undocumented folks are afraid to get help at all given the current policies of the government to deport them.

    I still don’t understand why this is such a topic. It’s just the simple reality – and yes, some data collection is rough but overall the trend is what it is.

    • I agree with you, Larry. It is such a topic because some politicians are trying to exploit it for their own purposes. Jennifer Carroll Foy is in the middle of only her second term as a member of the House of Delegates who thinks that somehow makes her qualified to be governor. With nothing else in her resume, she has to make some headlines. It seems to me that she and other Democrats would be much better off saying exactly what you are saying: lower income folks, with little or no health insurance, who must work in jobs involving contact with the public, are much more vulnerable. That kind of narrative would cut across partisan lines.

      • ” …. Democrats would be much better off saying exactly what you are saying: lower income folks, with little or no health insurance, who must work in jobs involving contact with the public, are much more vulnerable.”

        I’m not sure how a lack of health insurance makes you more likely to catch COVID-19 but you are generally right. The only addition would be ” … in densely populated urban and suburban areas …”.

        I would bet that a statistical analysis would find that Virginians of Korean descent are more likely than average to catch COVID-19. Why? Because of systemic bias against Korean Americans? No. Because half of the Virginians of Korean descent living in Virginia live in Fairfax County and Fairfax County was a hotspot.

        • there’s less likely to get tested for the cost and less likely to consult a physician fearing they might have it and can’t afford it….

          The thing is – this pandemic never had to be about partisan idiocy.

          We’re about the only developed country where the pandemic is political… welcome to America…

  3. Did VDH say that, in order to create the Latino category, it had moved a proportionate number of cases otherwise reported as “white” or “other/unknown” to the new category, or are you assuming this based on the Latino category being populated from its establishment in mid-June?

    It makes sense that the Hispanic community is more vulnerable–poorer, less health care, multigenerational households, having to work in jobs that expose them, etc. It is too late now, but it would have been so much better to have collected other socioeconomic data such as income and employment status, so that we could have avoided this race/ethnicity-centered discussion.

  4. Politics is the ability to shamelessly argue from a position of absolute ignorance. Good politics is the ability to win that argument.

    • well.. how do you win if you are arguing ignorance, by the number who end up agreeing with you?

      Here we are in the middle of one of the most disruptive and damaging events in the history of our country that has affected every one of us – and we argue about data and whether it is correct or not and who we think or disbelieve is affected more…….. as a political calculation………..

      Look at us – compared to other countries now…. we align more with 3rd world countries than developed countries….

  5. The post here by Carol Bova and an earlier one by Jim Bacon miss the big picture. What you have is a politically ambitious freshman state delegate trying to make a point that she considers important and may help her politically. So what?
    Yet, the two blog posts go into excoriating detail about how many Hispanics in Virginia have been infected by COVID-19. The simple answer seems to be that data is shaky because the Health Department only recently began tracking it. Stating so should take no more than a couple of sentences, not blog posts that are hundreds of words long.
    More distressing is that these posts dismiss the incredible seriousness of the pandemic. Florida has just recorded a huge number of new infections. Numbers in Virginia still increase. It still takes far too long to get the results of a coronavirus test. Yet, the bloggers still try to knock down any suggestion that minority groups have over-sized levels of infection. That dodges the real issues.
    Another problem is the over reliance of numbers crunching. Neither blogger seems to have talked to a Hispanic individual, a member of the clergy, social workers or health workers who know first-hand about the Hispanic community. There is also a tendency here to paint all Hispanics as undocumented yard or poultry workers. Gee, my next door neighbor is a Colombian immigrant who has a PHD in psychology and works in mental health.
    I realize the time and money restraints in getting actual reporting, not numbers crunching. Bacon’s Rebellion does not support that since all contributions are for free. There is much criticism about the supposed flaws of the news media since funding cuts have made it hard for journalists to do their jobs. The same is true at BR.

    • The problem, as always, is Northam. Busy peddling systemic racism in atonement of his own vile racism as an adult. Facts, figures and reality don’t concern Northam when there is an opportunity to virtue signal. Here’s a game for you – find the Hispanic in Northam’s cabinet:

      https://www.governor.virginia.gov/the-administration/governors-cabinet/

    • “There is also a tendency here to paint all Hispanics as undocumented yard or poultry workers.”>/i>

      Prove it.

      • I can go and extract some quotes from BR itself – also with respect to blacks… but yes , no shortage of opinions about the perceived “characteristics” of black and brown folks…

    • If localities, most especially Fairfax County, enforced their occupancy ordinances, there would likely be less overcrowding and fewer cases of coronavirus among residents, most especially Hispanics. Occupancy laws have been justified to protect public health and safety.

      So why are businesses subject to occupancy regulation and people pushed to wear masks, but overcrowding in residences is ignored?

      Now if we still had real journalists, wouldn’t one of them ask Northam or McKay?

      • That might be part of it but also low-income folks tend to work a more than one job. They’ve seen that for instance with the staffing at nursing homes…

        and the more people you come into contact with – the higher your chances of getting infected… and it don’t matter your income or ethnicity – but it does matter if you are in the lower economic strata and work multiple jobs – especially what is known as day work.

  6. the infection rate more or less seems to correlate along these lines:

    People with low incomes and no health insurance – who earn a living in occupations that require contact with others – are logically going to be at greater risk – and the data pretty back backs that up… with the caveat that some states data collection is not top notch.

    The debate seems to focus more on what is or is not disparate impacts, and inequities – that seem to be associated with regard to ethnicity but the facts are the facts with regard to median income and race.

    And yes, note the line for Asians…

    • It’s more than just income. It’s income plus population density by race. Hispanics in Virginia disproportionately live in the cities and suburbs – generally where the outbreaks have been the worst. But, your logic is otherwise quite right.

  7. Consider this from VPM.
    (Who is VPM. “As Virginia’s home for public media, VPM connects nearly 2 million people across Central Virginia and the Shenandoah Valley to insightful programming in arts and culture, history, science, news and education. In addition to acclaimed series and documentaries, VPM produces compelling original content across platforms for local audiences and national distribution. From its Richmond-area newsroom, VPM News delivers award-winning coverage of statewide politics, local government, education and legal issues, as well as the news of the day from NPR. VPM Music is home to a 24/7 blend of classical, jazz and world music serving the Richmond region. A critical partner for parents, caregivers and teachers of the Commonwealth’s children, VPM offers free access to PBS KIDS content, bespoke educational content through the Science Matters initiative, plus local events and outreach.

    VPM operates public television stations VPM PBS, VPM Plus, VPM PBS KIDS, lifestyle channel VPM Create and international program channel VPM WORLD, as well as Richmond public radio stations VPM News (88.9 FM) and VPM Music (107.3 FM, 93.1 FM and 88.9-HD2). In the Northern Neck (89.1 FM) and Southside Virginia (90.1 FM), listeners receive a combination of news and music stations. Audiences can access VPM online at VPM.org, and on Facebook, Twitter, Instagram and YouTube.”

    Our Mission
    To use the power of media to educate, entertain, and inspire.

    Our Vision
    More connected, informed and empathetic Virginians.”) That is VPM by its own description.

    Here is VPM’s article on this subject:

    “Advocates, Lawmakers Call For Stronger Response to Coronavirus Impact on Latinos, dated July 9, 2020, by Alan Rodriguez Espinoza

    n a letter to Gov. Ralph Northam, the League of United Latin American Citizens is demanding that Virginia provide the community with more testing and free personal protective equipment, and hire more bilingual contact tracers and translators.

    The letter also calls for more Latino members in the state’s COVID-19 task force, and more bilingual and bicultural health officials: “The disproportionate and severe impact of COVID-19 on the Latino community demands greater precautions and immediate action of inclusion at decision-making levels.”

    Latinos make up ten percent of Virginia’s population, but nearly half of the state’s COVID-19 cases. Demographic data has also found Latinos in Richmond are disproportionately impacted by the virus.

    Five out of six Latinos work outside of the home, according to the Bureau of Labor Statistics, with many of them working essential jobs in agriculture, grocery stores and hospitals.

    “We are really the community that is keeping America going,” said Sindy Benavides, the league’s CEO. “It means that more than 85% of the Latino community has to leave their house every single day to work and get paid, which means that we are coming more in contact with COVID.”

    Del. Jennifer Carroll Foy — who’s also running for governor — voiced similar concerns in a letter of her own, and called for coronavirus relief funds for housing insecurity to be made available to undocumented immigrants.

    “The rates of infection are alarming, and magnify the inequities that are staring us in the face,” Carroll Foy said in an email. “They stem largely from longstanding and systemic factors, such as disparate access to information, testing, and treatment.”

    In her letter, she also calls on Northam to increase funding for outreach over Spanish-language media, which she said in her statement is “one of the most effective ways to disseminate resources.” Benavides says it’s a crucial way to get the word out.

    “Making sure that we have a public awareness campaign is key so that the community has this information both in English and in Spanish,” Benavides said.

    A spokesperson for Northam said in a statement the governor appreciates the input and has made health equity a top priority in the state response to the virus.

    “Virginia was one of the first states in the nation to form a health equity task force, and we have worked diligently to provide culturally-competent and translated resources, PPE, and no-cost testing to vulnerable communities across Virginia,” said Alena Yarmosky, the governor’s press secretary.

    *Editor’s note: After publication of this story, Yarmosky emailed VPM to highlight a bilingual press conference organized by the state as an example of the ongoing work they are doing to create public awareness. “

  8. “With little education, most immigrants sought jobs requiring manual skills.” Is that proof?

    • Really, Peter, do you dispute the fact that on average Latino immigrants have a lower level of education than native-born Americans? Do you dispute that Latinos on average have gravitated toward occupations requiring manual skills?

  9. Dick Sizemore, you asked: Did VDH say that, in order to create the Latino category, it had moved a proportionate number of cases otherwise reported as “white” or “other/unknown” to the new category, or are you assuming this based on the Latino category being populated from its establishment in mid-June?

    Quoting percentages moved and added was a more direct way of describing what happened with the case numbers.

    VDH moved case numbers from White, Other and Unknown to create Asian/Pacific Islander, Native American, Two or more races and Latino.
    If the first three were identified to begin with, logic says they came from Other and not White or Unknown. 1,862 Asian, 65 Native American, 138 Two or more =2065. The remaining 8,932 in Other went into Latino.
    White was reduced 6,051, so they went into Latino.
    Unknown was reduced 3245. They would have been cases labeled Latino, without a race, so they went into Latino.
    380 cases were added that day with Black increased from the day before by 28. The remaining 352 ended up in Latino, either by some being added to White and an equal number moved to Latino to result in the net White reduction of 6051, or being directly added to Latino.

  10. Bacon. You are a hoot! Where is your evidence that the “average” Latino is uneducated?

  11. First of all, Peter, I didn’t say that the “average” Latino is “uneducated.” I said that Latinos on average have less education than the average Virginia. That’s an important distinction, and if you fail to grasp it, I would not advise taking the SAT test any time soon!

    I just pulled this off The Excelencia in Education website: https://www.edexcelencia.org/research/latino-college-completion/virginia. 30% of Latino adults have earned an associate degree or higher, compared to 44% of all adults.

    Latinos have a higher dropout rate than whites and Asians. Latinos have lower SOL pass rates than whites and Asians. This is all well known and to question it is pure obstructionism.

    • This is a decent poster the Census produced for a conference several years ago comparing immigrants from China, India and Mexico:https://www.census.gov/content/dam/Census/library/working-papers/2016/demo/knapp-jenson-gryn-paa.pdf

      Most Hispanic immigrants in Virginia are not from Mexico but their educational attainment levels are similar on average.

      • Hamilton –

        That chart you linked into your comment is highly informative, useful and compelling. It explains vividly in graphic detail the various paths to success for our major immigrant communities, Chinese, Indian, and Mexican, despite their great differences, including the powerful link between high work ethic, and high community / family, and relation ethic, how these mix and combine for exponential results.

        Can we find a chart that includes and places whites and blacks (or some portion thereof) within these very same matrices? I suspect that such a chart would be quite compelling. And highly informative and useful.

        See Chart that Hamilton linked in:
        https://www.census.gov/content/dam/Census/library/working-papers/2016/demo/knapp-jenson-gryn-paa.pdf

        • I’m glad the chart was informative. I have not seen a similar chart comparing whites and blacks.

          The categories are so large I think a lot of distinctive trends would average out. For example, black immigrants have considerably higher income and educational attainment levels than native blacks and very different household structures. By the mid-2040s, most black Americans will be 1st or 2nd generation immigrants, Hispanic or multiracial, so it valuable to look at the population in segments. Sort of the way VDH is when they seperate white Hispanics from Virginia’s white population.

          Though Hispanics in Virginia’s workforce are still mostly immigrants their children have much higher educational attainment rates and native born Hispanics in Virginia earn more than Hispanic immigrants by a wide margin.

      • here’s another chart that is somewhat similar in pointing out the various education levels of immigrants:

  12. If we look at the Fairfax Co. daily COVID dashboard, which shows extraordinary impact on the Hispanic community, only 15% of the cases are reportedly unknown with respect to ethnicity.

    From that I would hypothesize, if we were able to normalize the data by removing the nursing home deaths, the community spread is almost totally and only in the Hispanic community.

    The other possibility, since Supervisor McKay advises the Fairfax Hispanic community has been a major focus (eg; on testing) from the beginning (due to the trends), that we may have over tested that community.

    https://www.fairfaxcounty.gov/covid19/case-information

  13. I’m not sure what “over-testing” means if the more you test, the more you know what the positivity rate is but if we’re going to make that argument – then should we also break down ethnicity in the testing? (or maybe they do?).

  14. Testing in Virginia was not randomized, nor has it been representative of the entire population. The more tests you do in COVID-19 hot spots in dense urban settings and in poor neighborhoods, the more cases you’ll find. But that doesn’t eliminate cases in other groups in other areas–it just doesn’t address those.

    What happened to the “disparate” numbers for Blacks after more testing in poor Black neighborhoods in April and May? The numbers dropped to more closely reflect the population number. So in June, VDH rearranges the numbers to show the Hispanics are really the ones impacted. And throughout all of this, the Unknown race number was 32% April 29, 33% May 29, and after creating the Latino group, unknown dropped to 25% June 29.
    I’m not faulting Delegate Foy for using the numbers. I am faulting the governor for his failure to follow through on getting the unknown numbers reduced as he said he would in April. I am faulting VDH for not doing that, for waiting weeks, if not months, to input negative test results received by fax, and for playing political shuffleboard with numbers that impact people’s lives.

    Peter Galuszka, VDH has tracked all this from the beginning, and botched the reporting all along. There is nothing in what I said here that detracts from the seriousness of the pandemic. How can the state adequately address the virus with 3/4s of the information? If VDH could distribute the 17,321 Unknown race cases today, that could radically change the picture for any group in the VDH listings. It could more than double the White cases, Black and other groups’ cases or add to the Hispanic impact. Why hasn’t contact tracing filled in some of the unknown race data? Even though they’ve only contacted 85%, that’s a lot more than they have now.

  15. do we know WHERE VDH is doing testing? Do we KNOW it is “targeted” by demographics?

    If that is what VDH is doing – rather than true randomizing… doesn’t look good.

    But I’m still hearing that you cannot get a test just because you want one – even in drive through –

    perhaps I’m wrong but I’m not really hearing that we’re doing randomized testing….

    At any rate – I’m still skeptical of the idea that the more you test the more you will find.

    to a point, yes… but you also start to understand positivity… i.e. how much virus is in the population.

    Don’t you need to know that? Wouldn’t you want to know that?

    I don’t need to be convinced that VDH has some issues – but when we see national numbers – should we assume those most states are doing right but Virginia not – or what?

    I think we’re into a little bit of instant gratification on the numbers.

    No health department in the country has been used to doing testing and collecting data on this scale.

    When I see data from Florida, Arizona, Texas – do we think their data is better , more accurate, more reliable than Virginia?

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