BCMS Medical Record Fall 2020 - 38

Student Summer Research Projects
continued from page 37

Evaluating Disparities in English
versus Spanish speaking
Hispanics in SARS-CoV-2
Infection Rates
William Lovett, MD; Victor Cabello, MD ,MBS;
April Smith, MPH; Luis Murillo, MD; Nicole Vieira, BA
Department of Family Medicine, Reading Hospital,
Reading, PA
INTRODUCTION: The scientific community is increasingly aware
of the disparities in COVID-19 infection rates, with recent data
showing Latinxs1 and Blacks are 3 times more likely to test positive
for COVID-19 (Oppel Jr., Gebeloff, Lai, Wright, & Smith, 2020).
Public data on ethnicity and race is lacking nationwide (Madrigal,
2020), and even if public data was to be reported, nuances exist
within these populations that public data cannot address. Hospital
EMRs offer the unique ability to explore the relationship between
language and COVID-19 infection rates. At the Family Health
Care Clinic (FHCC) at Reading Hospital, Spanish speaking Latinxs
were found to be 3.04 times more likely to test positive for the
novel coronavirus than their English speaking Latinx counterparts
between the period of March 1 to May 31 (see Table 1). Few
research projects have studied the nuance between these two groups
but hypotheses about Latinxs as a general group may explain the
disproportionate burden on Spanish speaking Latinxs if the two
populations are significantly different, such that differences in terms
of employment, living situations, or insurance could explain the
disparity in COVID-19 infection rate. Research shows that Latinxs
in general may have higher exposure due to dependence on public
transportation (Syed, Gerber, & Sharp, 2013), greater likelihood
of working jobs that cannot be done remotely (Bureau of Labor
Statistics, 2020), experiencing housing insecurity (Jacobs, 2011) and
having larger (Quinn et al., 2011) and multigenerational households
(Oppel Jr. et al., 2020). Furthermore, Latinxs have been shown to
be the group in the U.S. with the greatest proportion of uninsured
people (Berchick, Hood, & Barnett, 2018). This could lead to
inferior management of chronic diseases and greater susceptibility to
COVID-19 (Yeheskel & Rawal, 2019). This preliminary data led to
the development of our qualitative study design that seeks to explore
what is causing this disparity with open ended questions rather than
objective measures.
Table 1: Expected versus Actual COVID-19 positives in Hispanic
(English versus Spanish speaking) Patients in FHCC practice

METHODS: We will utilize a 25-question structured interview to
explore the experiences of Spanish and English speaking Latinxs from
the FHCC who tested positive for COVID-19. Interviews will be
conducted in the language of preference of the patients. Our aim will
be to suggest more research and hypotheses to explain this observed
disparity. Doctors will contact patients to explain the study and ask
their permission to contact them, then interviewers will call to seek
informed consent and conduct the interview over the phone. Interviews
will be recorded and professionally transcribed and translated (as
necessary) and safely stored on a password protected computer.
Transcripts will be individually coded for themes by study team
members and outside sources. The coding will be done inductively
based on grounded theory.
RESULTS: The research project is ongoing, and we expect to have
results by October. Contact Nicole Vieira for more information.
1

Latinx: a gender-neutral term referring to a person of Latin American descent

References
Berchick, E. R., Hood, E., & Barnett, J. C. (2018). Health Insurance Coverage
in the United States: 2017. Retrieved from https://www.census.gov/content/dam/
Census/library/publications/2018/demo/p60-264.pdf
Bureau of Labor Statistics, U. S. (2020). Table 1. Workers who could work
at home, did work at home, and were paid for work at home, by selected
characteristics, averages for the period 2017-2018. In. U.S. Bureau of Labor
Statistics U.S. Bureau of Labor Statistics.
Jacobs, D. E. (2011). Environmental health disparities in housing. Am J Public
Health, 101 Suppl 1, S115-122. doi:10.2105/AJPH.2010.300058
Madrigal, A. (2020, 6/15/2020). The COVID Racial Data Tracker. Retrieved from
https://covidtracking.com/race/dashboard
Oppel Jr., R. A., Gebeloff , R., Lai, K. K. R., Wright, W., & Smith, M.
(2020, 7/5/2020). The Fullest Look Yet at the
Racial Inequity of Coronavirus. Retrieved from
https://www.nytimes.com/interactive/2020/07/05/us/coronavirus-latinos-africanamericans-cdc-data.html
Quinn, S. C., Kumar, S., Freimuth, V. S., Musa, D., Casteneda-Angarita, N.,
& Kidwell, K. (2011). Racial disparities in exposure, susceptibility, and access to
health care in the US H1N1 influenza pandemic. Am J Public Health, 101(2),
285-293. doi:10.2105/AJPH.2009.188029
Syed, S. T., Gerber, B. S., & Sharp, L. K. (2013). Traveling towards disease:
transportation barriers to health care access. J Community Health, 38(5), 976993. doi:10.1007/s10900-013-9681-1
Yeheskel, A., & Rawal, S. (2019). Exploring the 'Patient Experience' of Individuals
with Limited English Proficiency: A Scoping Review. J Immigr Minor Health,
21(4), 853-878. doi:10.1007/s10903-018-0816-4

Nicole Fujiy Vieira is a graduate of Lehigh University and
Hispanic English
Hispanic Spanish

is currently a second-year student at the Drexel University
preferred
preferred
College of Medicine, Philadelphia, PA. Nicole serves as Student
Percent in practice
34.3%
10.7%
Recruitment Coordinator at Streetside Clinic for Drexel's
Expected number
23
7
of positives based
Health Outreach Project and as Treasurer for the Latino
on percent in practice
Medical Student Society at Drexel.
Actual number
25
23
of positives
Total number of positive patients (including Hispanics and non-Hispanics): 66
38

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