When the Orange County Health Care Agency (OCHCA) began publishing COVID-19 case data on their website, I would scroll through several times a week, crossing my fingers in my mind, and hoping for better news than my previous visit. I focused most of my attention on the data reports outlining the total number of cases and deaths by race/ethnicity, as well as by city. As a future Latino public health professional and born-and-raised Santanero, this was as much of a personal effort as it was a professional one.
As the weeks, and eventually months, went on, one race/ethnicity category saw aggravatingly steady increases in case numbers: “Hispanic or Latino.” Slowly but surely, Latinos have claimed the highest number of both COVID-19 related cases and deaths, grim top prizes that show no sign of being handed over to another group anytime soon. As of July 21, 2020, Latinos make up 43% of all reported cases in Orange County (OC), and 39% of deaths. Latinos are currently the only racial/ethnic group for which its number of COVID-19 cases is more than its percentage of the total OC population (35%).
The OCHCA began collecting race/ethnicity data early on in the COVID-19 emergency, but shamefully committed an important public health mistake: documenting race-associated differences without further action. According to public health leader Dr. Camara Jones, having no action plan for race/ethnicity data can limit efforts at disease prevention by narrowing the focus to medical screening and treatment, as opposed to addressing the root social causes of disease. These social causes account for 80 to 90 percent of a population’s health, and yet have not received adequate focus by OC leadership.
More than five months after COVID-19 first appeared in OC, the OCHCA launched the COVID-19 Latino Health Equity Initiative on July 1, 2020. For five months, OC leadership sat on numbers, figures and pie charts showing that Latino residents were being severely impacted by COVID-19, yet implemented no large-scale targeted response. The new Equity Initiative, which is heavily focused on access to testing and educational outreach, does not focus nearly enough on the root social causes of COVID-19 vulnerability.
In order to ‘flatten the COVID-19 curve’ for OC Latinos, particular emphasis should be placed on the social curves that structural racism has been creating for generations. Housing affordability, access to green space, unbiased and culturally sensitive medical care, workplace protections, high-quality public schools, rental assistance: these are all preventative health tools as worthy of government investment as any medical test or treatment. For us Latinos that have called OC home, especially in Santa Ana, governmental inaction on these social factors is nothing new.
Purposeful ignorance of the social and health disparities that have long been affecting OC’s Latino community extends the county’s long history of racial injustice. The landmark 1947 legal case Mendez v. Westminster highlighted the local issue of economic disinvestment in and forced segregation of Mexican American schoolchildren. In the 1960s, as Santa Ana’s Latino population began to dramatically increase, White residents began to move out to surrounding cities, leaving behind a legacy of residential segregation and long-term disinvestment. In the 21st century, gentrifying development projects in both Santa Ana and Anaheim, which are primarily marketed towards young, middle-class Whites, have pushed Latino residents into severely low-income, overcrowded neighborhoods.
In the era of COVID-19, the consequences of this racist history on Latino health are only magnified, and serve as a dramatic call for change. 92704, the Santa Ana zip code with the highest number of COVID-19 cases in all of OC, has areas in which 48% of households are overcrowded, 45% of adults are uninsured, and 61% of adults live below the federal poverty level. 92804, the Anaheim zip code with the highest number of COVID-19 cases in the city, has areas in which 36% of residents pay more than half of their income on rent, 96% of residents live more than ½ mile from a supermarket, and 52% of adults live below the federal poverty level. It is no coincidence that 92704 and 92804 are 74% and 49% Latino, respectively.
Being the strong-willed and outspoken community that we are, OC Latinos have learned to not wait around for county leadership to save the day. Community-based organizations such as Latino Health Access, Santa Ana Building Healthy Communities and Chispa empower Latino residents to use their knowledge and voice to create community change. Local Latino youth have mobilized as a powerful political force, as demonstrated by the surging movement against unrestricted city police spending. In what is expected to be a critical local election year, the Latino vote will be more important than ever in deciding Orange County’s future. Even in the face of seemingly impassable barriers, OC Latinos possess an unmatched collective strength, and it is this strength that will continue to carry us up and up.
Juan González is a born-and-raised Santanero, and a graduate student at the University of California, Berkeley studying public health and city planning, with focuses on environmental health, housing, community and economic development.
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