Monday, November 9, 2009
California Health officials say low-income Latino immigrants and migrant workers are a high risk group when it comes to swine flu.
California health officials say in all the discussion about the H1N1 pandemic, two groups haven’t been getting enough attention: low-income Latino immigrants and migrant workers. They’re considered high risk groups when it comes to swine flu because they often lack health insurance, have high rates of chronic diseases and have difficult jobs.
Let’s start with one of the biggest concerns for this group, working while they’re sick. It’s an ongoing issue for anyone who has a job, call in sick or tough it out?
David Katz, a physician at the Davis Community Clinic, in Yolo County, just west of Sacramento. He said this is a big issue for his patients.
“It’s a conundrum for the Latino worker, the low-income family because they won’t get sick days and they won’t get paid during the days that they miss," Katz said.
This was the case for one Latino patient he just saw in the clinic.
“They probably did have the flu initially a month ago and now they came in with this prolonged cough, and very sick, and it turned out they had pneumonia," Katz said. "That’s a very typical story for someone who is trying to just, so to speak, muscle their way through the illness."
And as they get sicker, Katz said, the public health threat increases. He said typically many low-income Latinos squeeze together in small living quarters because of tight budgets.
“When we have a pandemic situation there’s a concern that there will be more spread of airborne viruses because multiple families may be in one apartment, because there may not be anywhere else to isolate a person who is sick with a respiratory illness including H1N1 flu,” he said.
A patient leaving the health clinic, Antonio Magallanes, doesn’t hesitate when asked about what he’s done when he’s had the flu.
“I used to just make up some kind of tea or something and go to work,” said Magallanes.
Magallanes moved to the United States from Mexico. He’s 65 now and retired but he used to work in the fields and as a landscaper. He said it wasn’t his boss who pressured him to work, it was the nine hungry children he had to take care of.
“I couldn’t stay home because I need the money to feed my kids," he said.
The economic pressures are real but employers don’t want sick people in their fields. Hank Giclas, who is with the farm trade group Western Growers Association, said convincing workers of this is always a struggle.
“If workers are sick we would encourage people to go home and get well, but there are a lot of people who try to work through those things as well," Giclas said.
Beyond dealing with work issues, many public health experts say, historically, Latinos have been disenfranchised during pandemics because of limited access to healthcare.
“They tend to have every odd against them," said Jessica Nunez de Ybarra, a physician and President of the Sacramento Latino Medical Association.
Nunez de Ybarra also works as a medical officer for the California Department of Public Health.
“When you look at the factors by themselves, we want to make sure that young people of which Latinos tend to be, people that are at-risk from obesity, which Latinos are, that have co-morbidities like diabetes, which Latinos have, that they are the ones that we direct our attentions to," she said.
And one way Nunez de Ybarra said officials can do that is to make the H1N1 flu shot available. She said community clinics, doctors and pharmacies are targeting this community. And Nunez de Ybarra said many Latinos are eager to get the vaccines.
“We feel really good about the ability this season being that local health departments are really in the driver seats, they will insure that Latinos get access," she said.
But it’s not that simple because vaccine shipments to California have been delayed. She said some migrant workers might miss getting the vaccines before they go back to their home country and many here will have to wait, like everyone else, to get the swine flu vaccine.