The Pandemic’s Toll
Dr. Varadi has witnessed the unequal toll the COVID-19 pandemic is taking on immigrant families and patients from diverse backgrounds.
“During the pandemic, I think there’s definitely a disproportionate amount of illness in our Hispanic population,” she says. “A lot of people are in construction and gardening, and jobs where they carpool to work. Often, people who are positive or have been exposed and should have been quarantined continue to go to work because otherwise they’re at risk for losing their housing and their ability to survive.”
Carpooling to a job site — often a necessity in the Charleston area given a lack of public transportation or access to personal vehicles — adds another vector to the mix: if there’s “one positive in the car, there are five positives in the car,” says Dr. Varadi, which increases exponentially the spread of COVID-19 in the community.
She’s also seen troubling trends in the teenage population during the pandemic.
“Pretty much 50 percent of all our teenagers have had a need to see a mental health specialist,” she says. “Anxiety and depression went from being about 20 percent in the teenage population to being about 50 percent, which is a significant rise.”
She points to two reasons: first, a lack of socializing, which “at that age is very important.” And second, the trauma of seeing their families struggle financially and sometimes even fall ill from COVID-19.
“Especially in our immigrant population, we have a lot of multigenerational households, so there’s that constant fear that grandma or grandpa is going to get sick,” she says.
Unfortunately, the economic fallout from the pandemic often leads to a cascade of negative consequences, especially for those who are Hispanic or Latino. According to the CDC, Hispanic or Latino persons have 1.3 times the risk of contracting COVID-19 when compared to the white/non-Hispanic population.
The numbers are even more stark when it comes to hospitalization and death: Hispanic/Latino persons are 3.1 times more at risk for hospitalization and 2.3 times more at risk of death from the disease as compared to non-Hispanics. A constellation of “risk markers” influence these numbers, including “socioeconomic status, access to health care,” and the fact that Hispanic/Latinos are more likely to hold jobs that can’t be done remotely. Data from the Bureau of Labor Statistics show that those who are Hispanic/Latino are overrepresented in jobs in construction, maintenance, groundskeeping, and housekeeping. Little job protection means choosing between staying home to prevent illness and missing pay or losing a job.
Women who are Hispanic/Latina have been hit hardest of all. According to the Center for American Progress, Latina workers have “seen the worst employment data of any racial/ethnic and gender group during the coronavirus-induced recession,” with an unemployment rate of 20.1 percent in April 2020. This isn’t only due to job loss; they are also “leaving the labor force at greater rates than Hispanic or Latino men because they have shouldered more of the increased caregiving responsibilities during the pandemic.”
The ripple effects extend to children, says Dr. Varadi. When parents are struggling to keep their jobs, “the older kids are often taking care of the younger kids as the parents are still trying to work,” says Dr. Varadi, adding to their stress and anxiety. Rates of food insecurity rise as families attempt to make ends meet while navigating job loss or a decrease in work hours. All of this weighs against the mandate to quarantine if exposed to someone diagnosed with COVID-19, forcing very difficult decisions for many families.
Pelican Pediatrics is doing what they can to help through offering important resources.
“We do test both parents and kids, because testing is still harder than it should be in South Carolina, especially if you don’t speak excellent English, and especially if you’re not very internet savvy,” says Dr. Varadi. “A lot of our testing registrations are done online. And many urgent care clinics are doing a lot of for-profit testing, charging a lot more than they should be charging.”
Long-term, Dr. Varadi sees hope in universal health care, especially for children.
“Obviously, adults are important as well, but kids have really no way to protect themselves,” she says. “Everybody can agree that all children deserve full opportunity, and we know that if you’re unable to stay well, you don’t have full opportunity.”
For other practices looking to reach diverse populations in their communities, it’s important to meet potential patients where they are, says Dr. Varadi. Seek them out and invite them to learn more about your practice and your approach to patient care.
“Don’t be afraid to go out into the community and let people know where you are, what you do and that you are happy to serve them,” she says. “Volunteer at health fairs for immigrants or some of the other local health fairs or schools.”
Ultimately, the goal is to be present for all patients, especially those who may have been left behind in the past. Pelican Pediatrics accomplishes this by staying true to its roots and tailoring the practice to the needs of the people it serves.
“We try to stay small, almost like a mom and pop practice. I think it’s easier to provide good medicine because things are not getting lost in the shuffle of paperwork and lots of people,” says Dr. Varadi. “It’s about forming that relationship and that trust and making sure that, not just the physician, but everybody in the practice is part of forming that bond.”