COVID-19 cases soar among Hispanic population in NC, disproportionately high

Across North Carolina, they're the men and women bearing the brunt of the hardest work out there — farm work, construction, lawn care, food processing, restaurant work — and they're often Hispanic.

That same Hispanic population also bears a disproportionate load across the state when it comes to cases of COVID-19, the highly contagious disease that had claimed the lives of 137,420 Americans, including 1,568 North Carolinians, as of July 16. While Hispanics make up 9.6% of North Carolina's population, as of mid-June they accounted for 44% of the state's COVID-19 cases, according to a press release from the North Carolina Department of Health and Human Services.

That release noted that True Ridge, a Hendersonville nonprofit formed three and a half years ago, was one of five organizations statewide receiving grants of $100,000 each to address the disparate impact COVID-19 is having among the state's Hispanic population. True Ridge "works to connect members of the Latinx community with the resources and opportunities to help them grow personally, professionally, and spiritually," according to its website.

In the past few weeks, True Ridge has seen COVID-related requests for assistance steadily rise, according to Executive Director Lori Garcia-McCammon.

“Most of the community we work with that has been affected has been essential workers — from the moment that this whole thing started,” Garcia-McCammon said.

Their clientele includes "a little bit of everybody," she said, from restaurant workers who keep to-go orders flowing to agricultural workers tending apple orchards and construction workers who erect in-demand apartments and hotels.

In Henderson County, Hispanics make up 10.3% of the county's population, but Henderson County Health Department's statistics show they account for 29% of all COVID-19 cases. Buncombe has similar numbers, with Hispanics comprising 26% of all COVID-19 cases and 6.8% of the population.

As of July 16, Buncombe had recorded 957 COVID-19 cases and 42 deaths, while Henderson County had 982 cases and 51 deaths, according to state and county data.

North Carolina's Hispanic population has soared over the past two decades and is nearing 1 million, with 997,000 residents in 2018, according to the N.C. Demographer's Office. It grew from just over 75,000 in 1990 to 800,000 in 2010, and by another 197,000 from 2010-2018.

That's a 24.6% growth rate, which is considerably higher than the growth rate of the Hispanic population nationwide — 18.6%. The Demographer's office notes that 59% of Hispanics living in North Carolina are U.S.-born citizens.

More:Buncombe health board declares racism a public health crisis

Western North Carolina has a strong Hispanic population, with just over 52,300 residents in 17 mountain counties (see box). More than one in four NC Latino residents live in either Mecklenburg (148,000 Latino residents) or Wake (113,000), the Demographer's Office states.

2019 WNC counties' populations, percentage of Hispanic/Latino residents

Buncombe: population of 261,191. Percentage Hispanic/Latino: 6.8%. Total Hispanic residents: 17,760.

Henderson: 117,417. H/L: 10.3%. Hispanic residents: 12,093 

Haywood: 62,317. H/L: 4.3%. Hispanic residents: 2,679.

Rutherford: 67,029. H/L: 4.8%: Hispanic residents: 3,217.

McDowell:  45,756. H/L: 6.4%. Hispanic residents: 2,928.

Jackson: 43,938. H/L: 6.2%. Hispanic residents: 2,724.

Macon: 35,858. H/L: 7.4%. Hispanic residents: 2,653.

Transylvania: 34,385. H/L: 3.4%. Hispanic residents: 1,169.

Cherokee: 28,612. H/L: 3.3%. Hispanic residents: 944.

Madison: 21,755. H/L: 2.4%. Hispanic residents: 522.

Polk: 20,724. H/L: 5.9%. Hispanic residents: 1,222.

Yancey: 18,069. H/L: 5.5%. Hispanic residents: 993.

Avery: 17,557. H/L: 5.1%. Hispanic residents: 895.

Mitchell: 14,964. H/L: 6.2%. Hispanic residents: 927.

Swain: 14,271. H/L: 5.8%. Hispanic residents: 827.

Clay: 11,231. H/L: 3.9%. Hispanic residents: 438.

Graham: 8,441. H/L: 3.7%. Hispanic residents: 312.

Source: U.S. Census Bureau

Jobs play a key role

Census data shows Henderson County has about 12,100 Hispanic residents, or just over 10% of its population. That's the highest percentage of Hispanic residents in the 17 mountain counties, although Buncombe has more Hispanic residents by total, with about 17,800, according to 2019 Census data. 

In noting that North Carolina saw a sustained increase in confirmed COVID-19 cases in June in the general population, the DHHS stated it was "disproportionately high percentage of cases statewide are among historically marginalized populations." North Carolina’s Hispanic communities "are being hit hard by the virus, representing 44% of cases statewide (as of mid-June) where race and ethnicity are known," the release states.

"Many people in Hispanic/LatinX communities provide essential services and work in industries North Carolina relies upon, such as construction, child care and food processing," according to the DHHS. "Often, this work is in environments where social distancing can be challenging, health insurance is not provided and for a sick person, staying home could create a significant financial burden."

More:County: Coronavirus 5 times higher in Asheville, Buncombe Latinos; mask-wearers mocked

One of the main reasons so many Hispanics have gotten sick is because their essential jobs don't allow them to work from home. Sometimes, they cannot afford to quarantine themselves if they do come in contact with someone with COVID-19.

“They’re told they have to pass the quarantine, but if you’re the only one making money in the house, in your home, you’re weighing that,” Garcia-McCammon said.

In Macon, 76% of COVID-19 cases are in Latinos

That's definitely the case in Macon County, where as of July 8, 76% of the county's COVID-19 cases "were of Hispanic/Latinx ethnic background," according to Emily Ritter, public information officer for Macon County Public Health. The county had had 337 cases and one death as of July 16.

"We first began tracking and making this data public a month ago," Ritter said via email. "At the time, 80% our cases were of Hispanic/Latinx background."

Multiple factors play into such high rates, but employment is key.

"We know that factors such as employment as an essential worker and multi-generational living conditions have disproportionally effected the Hispanic/Latinx population," Ritter said.

At the Vecinos Farmworker Heatlh Program, which serves the eight westernmost mountain counties, Executive Director Marianne Martínez, said the number of cases among Latinos varies by county, but some common themes drive the high infection percentages like that in Macon.

More:Latino homes report serious COVID-19 symptoms nearly twice as often, survey of 1.6 million shows

Her organization is helping with a high case count at a migrant work camp in Franklin where the growth in cases is "exponential," Martínez said. All the workers are part of the federal H2A temporary work visa program.

"It's congregate living, and all the workers are Latino — they live in tight quarters and they ride to work together in very close spaces," Martínez said. "So, we’re working through that outbreak right now, and it's making its way through 100-some odd farm workers in that camp."

Work ethic plays a role, too

She notes that the workers ride to farms together on old school buses, and while they're wearing masks, they're still in tight quarters. These workers "want to work" and came here to do just that, so they're also reluctant to take time off for a quarantine, especially if they're asymptomatic or have mild symptoms, Martínez said.

"It is not the culture they live in," Martínez said. "They want to work, to be out doing stuff. That's why they came here."

Farmers are trying keep asymptomatic workers working together, or those with milder symptoms together, or keeping sick workers at home together. Growers have been very receptive to helping keep workers healthy, Martínez said.

At Buncombe County Health & Human Services, interim health director Dr. Jennifer Mullendore said Latino residents "often are employed in jobs that do not afford them the ability to work from home or take paid sick leave, and they often serve as front-line employees in jobs where physical distancing is not possible."

But it's a complicated issue.

"In short, systemic racism and the inequities it leads to in housing, employment, income, and other social determinants of health result in worse health outcomes for Latinx and Black, indigenous and people of color," Mullendore said via email. "An additional factor that contributes to the disproportionate impact on the Latinx community are concerns related to citizenship status, which can lead to hesitancy to engage with health care or governmental agencies."

Amparo Oviedo Acosta, a public health nurse supervisor with Buncombe County, said during a recent county webinar about COVID-19 and the Hispanic population that simply put, they're "trying to prevent the hospitals from being overrun.

"Our goal is to try to stop or slow down the virus," Acosta said, citing the 44% figure noted by the state and noting, "It's out there; it's in the community."

Latinos often are leery of the government or the medical system, or sometimes simply don't know about resources available to them, she said.

"Also, we’re not here to get anyone in trouble," Acosta said. "Our focus is not to know whether people have a Social Security number or not. When I talk to people, I always tell them, 'We are here to serve the community; we're not here to get anyone in trouble.'"

Steps taken to help

The idea with the state grants is to put people and resources together, and to prevent as many infections as possible.

Garcia-McCammon at True Ridge said it's important to explain, in culturally appropriate ways, for example, the reason for wearing masks. Her organization has been present at testing sites, distributing face coverings and it's helping those in need find resources, all while continuing their mission to curb domestic violence.

More:Amid coronavirus pandemic, Buncombe hires a new health director

The state DHHS says the five organizations will help with prevention practices such as wearing face coverings, social distancing and frequent hand-washing, as well as access to COVID-19 testing and engagement with contact tracers. They'll also participate in quarantine and isolation measures, and coordinate with the state on messaging. 

Earlier in the spring, True Ridge employees were helping with distributions in Henderson County, working closely with the Community Foundation, United Way and the Pisgah Health Foundation (a wellness program). Often, they were helping Latino families make ends meet because they hadn't gotten stimulus checks or unemployment hadn't come through.

"Now, we're seeing more people coming in asking for help because they been affected by the coronavirus, and they have had cases among family members," Garcia-McCammon said, stressing that the state money is part of a contract, not simply a grant. "We're being present at testing sites, distributing face coverings, giving them resources in areas that can help. That is what we've been doing here since April."

In Henderson County's apple country, grower Kenny Barnwell said he has five full-time Hispanic workers and usually hires three or four more to help with the harvest, which will hit full swing in August. He's already been distributing face masks and is taking steps to reduce close quarters when working, although he said that can be tough in packing houses.

Hand washing is key, and Barnwell will have portable hand-washing/sanitation stations in or near his 150 acres of orchards.

"When they come in for the day they wash their hands, and we have a guy designated to sanitize the station," Barnwell said. "They wash their hands before and after lunch, and when they leave in the evening. We're just trying to keep constant hand-washing in place, and we're trying not to crowd them together as best we can."

Advocates want to see more testing availability for Hispanics, with more locations and time schedules that accommodate long working hours.

In Macon, Ritter said early on in preparations for COVID, the health department "went to places, such as Hispanic/Latinx owned and operated business and churches, to develop connections and encourage the leaders in those communities to work with us to make sure that members of their community knew that we are here to help."

They also have a strong relationship with Vecinos, Ritter added, and the health department has produced education materials and videos in both Spanish and English.  

In Buncombe, Dr. Mullendore said, "From the beginning, COVID-19 communications have included real-time Spanish interpretation of all community updates and educational materials.

"Members of the Joint Information Center have worked to provide videos and messaging directed towards Spanish-speaking populations to address specific concerns such as citizenship status," she added.

For months the county has also worked closely with Cenzontle, a translation service, and Buncombe has "been intentional in language used on all forms at the testing sites to address concerns related to citizenship status. The information was shared with Latino organization partners in the Latino community, she said.

Also, the county offered one-day testing sites in May and June that were were "selected through an equity-reliant lens using census tracts to better understand and respond to the demographics in our community," Mullendore said.

"Our three current sites were also intentionally chosen for the their inclusivity, access (by car and mass transit), and locations near centers of general community interest and connection," Mullendore said. "There are Spanish-speaking medical interpreters available at the testing sites through a partnership with Western Carolina Medical Society and there are no cost barriers to getting tested."

More information about testing can be found on each county's Health Department sites.

Buncombe also has bilingual communicable disease and contact tracing staff available to work with Spanish-speaking individuals who have COVID-19 or have been identified as a close contact to someone with COVID-19. 

At True Ridge, Garcia-McCammon says they're doing all they can to stem the tide, but it's a daunting task as case numbers keep growing.

"For us, it's been, 'Let's do what we can today — one day at a time,'" she said. "We say, 'What can we do today to support our community?'"

About the grants: 

The N.C. Department of Health and Human Services announced grants of $100,000 each to five organizations to help stem the disproportionately high number of COVID-19 cases among Latinos. The organizations will help with prevention practices such as wearing face coverings, social distancing and frequent hand-washing, as well as access to COVID-19 testing and engagement with contact tracers. They'll also participate in quarantine and isolation measures, and coordinate with the state on messaging. DHHS grants are funded through the end of 2020 by the General Assembly’s Department of the Treasury.

These groups have received grants: 

True Ridge, Hendersonville — The nonprofit works to connect members of the LatinX community with the resources and opportunities to help them grow personally, professionally and spiritually. More at 

https://www.trueridge.org/about.

Association of Mexicans in North Carolina (AMEXCAN), Greenville — This is an advocacy organization with offices throughout eastern North Carolina and a mission to encourage the active participation of Mexicans and other Hispanic/LatinX individuals in their destination and origin communities in promoting appreciation, understanding and prosperity of the community through their actions. More at http://amexcannc.org/blog.

El Centro Hispano, Durham, Chapel Hill-Carrboro, Raleigh — A Latino nonprofit organization dedicated to strengthening the community, building bridges and advocating for equity and inclusion for Hispanics/Latinos in the Triangle Area of North Carolina. More at https://elcentronc.org/about-us.

Qué Pasa Media Network, Charlotte, Raleigh, Greensboro — Known as the link to and the voice of the Hispanic community in North Carolina through various media properties. More at https://www.quepasamedia.com.

Latin American Coalition, Charlotte — Envisions a diverse and vibrant North Carolina which embraces, supports and respects people of all cultures and backgrounds. More at https://latinamericancoalition.org/ourmission.