COVID-19 and the Immigrant Population in the United States
By Martha Rojo, PhD, RN, Clinical Assistant Professor and Latrina Prince, EdD, Assistant Dean, University of Arkansas for Medical Science
The inability to understand important COVID-19 information and make appropriate decisions to prevent the spread of the disease will have a significant impact on the health and well-being of Hispanics and their local communities, particularly those living in rural areas.
Information regarding COVID-19 is often very limited in rural areas. Daily updates on COVID-19 through television and Internet broadcasts may not be accessible to those living in rural areas due to limited availability of these services. For many living in rural areas, the primary source of COVID-19 information may be through local news channels that may not offer Spanish translational services.
Although statewide health services may have developed written materials regarding COVID-19 in English and Spanish, it is highly likely that much of this information will not reach Hispanics living in rural areas who often speak Spanish only.
Lack of pertinent information can further perpetuate misconceptions that Hispanics have regarding the deadly coronavirus.
If COVID-19 information is not available in Spanish or is not easy to read or understand, this will limit the ability of Hispanics to make appropriate decisions and follow important recommendations, thus leading to increased rates of infection.
Background
In 2019, there was an estimated 59.8 million Hispanics living in the U.S., roughly 18% of the U.S. population. Approximately 10.5 million Hispanics are undocumented and Spanish is the primary or only language spoken. Health literacy skills are greatly diminished when there are language barriers and low education. Hispanics living in rural areas are more likely to be less educated, less proficient in English, and undocumented.
Since 1990, Hispanic immigrants have shifted from the geographic gateways of California, Texas and Arizona to more inland southern rural areas such as Arkansas, Louisiana and Oklahoma. Larger urban areas that have a long history with Hispanic immigrants have developed an infrastructure to provide assistance to those in need particularly during times of crisis. However, the rural southern states often lack the infrastructure to provide adequate information, financial assistance, and other necessary resources to Hispanics due to the large influx of immigrants in recent years.
Specific Strategies
During time of crises, it is important to make sure that all persons have access to critical information that is easy to read and understand. Effectively disseminating COVID-19 information to rural Hispanic communities might begin by utilizing local agencies such as grocery stores, gas stations, and other places in rural communities that are frequently visited and trusted by the local residents.
Another option would be to use community navigators who speak English and Spanish to share pertinent COVID-19 updates and critical information to rural communities by working with local business owners, and community organizations to make sure that information is rapidly available.
Distributing handouts and other recently developed COVID-19 materials through U.S. postal mail, posting flyers and distributing handouts throughout the community, and including updated COVID-19 information local or community newspapers would also help to disseminate information in rural areas.
Further, all materials developed should be written for persons with low literacy (5th grade reading level or less), available in English and Spanish, and use appropriate visuals for better understanding and retention of information.
Conclusion
Consequences of limited access or knowledge of COVID-19 information for Hispanics and undocumented immigrants in rural areas might include increased risk of virus transmission, more strain on the healthcare system, and higher rates of COVID-19 mortalities.
Certainly, it will be less expensive to develop strategies specifically targeting the rural Hispanic population so that they are well-informed of measures to prevent the spread of this virus than to deal with the cost of a growing epidemic and loss of human life.
It is essential to ensure that those who speak limited or no English have access to current COVID-19 information so that they are informed on preventive measures and care procedures for those who may become infected. Such strategies do not currently exist in rural areas; we must not underestimate the importance of effectively communicating regarding COVID-19 in rural areas with large Hispanic populations to mitigate the spread of this novel virus.
It is a frequent conundrum regarding how much assistance should be provided to immigrants at a time of limited resources. As this pandemic has developed, U.S. hospitals and healthcare systems have struggled to find the resources to fight this deadly virus. However, ignoring this vulnerable immigrant population may create an even larger problem for the health care system and the health of those living in surrounding communities.
Martha Rojo, PhD, RN, Clinical Assistant Professor, and Latrina Prince, EdD, Assistant Dean, University of Arkansas for Medical Sciences
