Some Latinos Face Hurdles In Getting H1N1 Vaccine

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For many Latinos — both migrant workers and low-income immigrants — access to health care is an ongoing challenge. So when it comes to getting the H1N1 flu shot in the middle of a pandemic, that's an issue, too. On top of that, some health providers report that these workers are showing up at clinics with severe flu symptoms because they've continued to work while sick. They say they've been told they'll lose their job if they don't come in.

MICHELE NORRIS, host:

We're going to hear now about some people that health officials are particularly concerned about when it comes to swine flu. Migrant workers and low-income Latino immigrants are on average more likely to lack health insurance, face intense job pressures and have higher rates of chronic disease.

From member station Capital Public Radio, Kelley Weiss explains.

KELLEY WEISS: 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.

(Soundbite of clinic)

WEISS: David Katz is a physician at the Davis Community Clinic just west of Sacramento. He says this is a big issue for his patients.

Dr. DAVID KATZ (Physician, Davis Community Clinic): 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.

WEISS: This was the case for one Latino patient he just saw in the clinic.

Dr. KATZ: 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. That's a very typical story for someone who's trying to just muscle their way through the illness.

WEISS: And as they get sicker, Katz says the public health threat increases. He says typically many low-income Latinos squeeze together in small living quarters because of tight budgets.

Dr. KATZ: When we have a pandemic situation, there's a concern that there'll 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.

WEISS: A patient leaving the health clinic, Antonio Malionis(ph), doesn't hesitate when asked about what he's done when he's had the flu.

Mr. ANTONIO MALIONIS: I used to just make up some kind of tea or something like that and go to work.

WEISS: Malionis moved to United States from Mexico. He's 65 now and retired, but he used to work in the fields and as a landscaper. He says it wasn't his boss who pressured him to work, it was the nine hungry children he had to take care of.

Mr. MALIONIS: I couldn't stay home because I need the money to feed my kids.

WEISS: Employers don't want sick people in the fields. Hank Giclas is with the farm trade group Western Growers Association. But he says convincing workers of this is always a struggle.

Mr. HANK GICLAS (Western Growers Association): If workers are sick, we would encourage people to go home and get well. But, you know, there's a lot of people that try to work through some of those things, too.

WEISS: Beyond dealing with work issues, many public health experts say historically Latinos have been disenfranchised during pandemics because of limited access to health care.

Dr. JESSICA NUNEZ DE YBARRA (President, Sacramento Latino Medical Association): They tend to have every odd against them.

WEISS: That's Jessica Nunez de Ybarra. She's 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. Here are some of the odds she says Latinos face.

Dr. NUNEZ DE YBARRA: 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, you know, 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.

WEISS: And one way Nunez de Ybarra says officials can do that is to make the H1N1 flu shot available. She says many Latinos are eager to get the vaccines, and even if they don't have insurance, the H1N1 vaccine is free.

Dr. NUNEZ DE YBARRA: We feel really good about the ability this season being that local health departments are really in the driver seat. They will be in a position to ensure, in their respective communities, that Latinos get access.

WEISS: She says 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. And there's no guarantee that'll be any time soon. California's Public Health Department says, because of vaccine shipment delays, even priority groups might not get the shots before the beginning of next year.

For NPR News, I'm Kelley Weiss in Sacramento.

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