Why are more Latinos in Idaho contracting COVID? It’s probably not Vitamin D deficiency
In a recent meeting of the Southwest District Health board in Caldwell, board members briefly pondered the high coronavirus rate among Latino residents of the health district, who continue to be disproportionately sickened by COVID-19 in Idaho and across the country.
But first, one commissioner and board member asked staff why they were tracking Latinos and COVID-19 at all.
“I have mixed feelings on that, because I think we’re all just people,” said Kelly Aberasturi, board member and Owyhee County commissioner, in an exchange first reported by the Idaho Press. “...Is it strictly because we want to do a race thing?”
Even if Southwest District Health board members were unsure of the value, their own data and demographics breakdowns make it clear. Latinos are testing positive for coronavirus at higher rates than their white counterparts in nearly all of the six counties in Southwest District Health’s region.
The disparity is especially concerning in Canyon County, which has the most Latinos in the state and has been a COVID-19 hot spot for months. Even though Latinos are only a quarter of Canyon County’s population, they are at least 38% of the county’s coronavirus cases. There is slightly more parity in the breakdown of cases in Caldwell and Nampa, where 36% and 28% of cases in those respective cities are Latino.
Evidence that coronavirus is hitting the district’s Latino communities harder than their white counterparts abounds even in other cities around the district. In Weiser, at least 44% of people who tested positive are Hispanic or Latino. They are also 44% of positive cases in tiny Marsing, which has only had 107 positive COVID-19 cases overall, and 30% of cases in Fruitland. The exact percentages are not certain, as Southwest District Health’s data dashboard groups non-Hispanic cases with cases where the ethnicity is unknown or missing.
Southwest District Health Director Nikki Zogg explained to board members she believed so many Latinos in the district were testing positive because of jobs in the agricultural and food processing industry, where social distancing can be almost impossible. They are more likely to live in multi-generational, larger households, Zogg said.
“There’s something else that you’re missing when it comes to the Hispanic, Black and Asian population,” said Adams County Commissioner Vicki Purdy. “They are all very low in Vitamin D ... why aren’t we telling people to check their Vitamin D levels?”
Purdy, who has shared COVID-19 misinformation on her personal social media in past months, then went on to discuss the contested benefits of hydroxychloroquine and claimed it was impossible for children to pass coronavirus to adults,
which is false, according to the CDC. The district’s medical staff immediately refuted these assertions, and the district issued a press release shortly after clarifying there was scant evidence hydroxychloroquine could successfully treat coronavirus.
“The personal opinions of the members of the Board of Health may not align with or reflect the guidance and recommendations provided by Southwest District Health,” Zogg wrote in the Aug. 12 release.
Health board staff also suggested Latinos may have a proclivity for larger gatherings— a strange claim in a district where large events like the Gem County Fair, the Payette County Rodeo in New Plymouth and more are allowed to continue with few restrictions, and many people of all backgrounds do not wear masks indoors or in public spaces. Like most of the state, the counties in Southwest District Health are operating in Stage 4 of the state’s reopening plan, placing few restrictions on large gatherings.
Many Latino-owned businesses in Canyon County — although certainly not all — ask employees and customers to wear masks and practice social distancing. However, neither Southwest District Health nor cities and counties under the district’s jurisdiction have passed mandates requiring masks. The choice and attempts to enforce that choice are left up to individual businesses owners.
What about Vitamin D deficiency?
At the moment, there is not enough evidence to determine whether increased COVID risks in Latino populations are solely attributable to inherent vitamin D deficiencies.
Vitamin D plays multiple roles in our bodies so it’s no surprise its deficiency has been linked to several ailments — including respiratory diseases, chronic conditions and mental health issues. However, it is difficult to know whether vitamin D deficiency is a cause or a consequence of such conditions.
Recent evidence suggests that vitamin D deficiency has been found in severe COVID-19 cases, and that supplementing it to patients could reduce the inflammatory processes that lead to severe illness and death.
Our bodies produce most of our vitamin D in our skins through sun exposure. According to the U.S. surgeon general, you can be considered vitamin D deficient if its concentration in your blood falls below 20 ng/mL, and optimal levels are around 40 – 50 ng/mL.
A 2016 study that evaluated vitamin D levels in more than 36,000 U.S. patients found that people with darker skin had higher probability of having severe vitamin D deficiency.
However, they also found that at least 85% of the U.S. population — regardless of race — have vitamin D blood levels lower than 40 ng/mL, “indicating that everyone in the U.S. population who is not already using ample vitamin D supplementation would need to do so.”
Underlying conditions may make some Latinos more vulnerable to COVID-19
According to the CDC, Latinos are 50% more likely to die from diabetes and liver disease than white people. These chronic diseases have been associated with a higher risk for developing severe illness from COVID.
A few studies have evaluated the genetics behind chronic disease in Latino populations. One study found that the genetic variant associated with diabetes in U.S. Latino populations is the same as in other ethnic groups, and only increases their risk of developing diabetes in 7%.
Another study found that the causes of chronic liver disease in Latino populations are varied — from autoimmune diseases, to cancer or cirrhosis — and so are the possible genetic variants behind them.
Although diabetes and liver disease have genetic factors that may put certain people more at risk of developing them, there is a general consensus that environmental factors play a major role in their prevalence.
Dr. Jessica Evert, medical director of the hospitalist program at St. Luke’s in Nampa, explained that “the reason that those (diseases) disproportionately affect a population also has to do with their access to health care (and) the social determinants of health.”
In Idaho’s Latino population, Evert identifies three main problems: access to health care could be greatly limited by language barriers; risk of exposure could be higher because more Latinos work in essential jobs that can’t be done from home; and cultural factors, such as living in multigenerational housing, could increase the likelihood of transmission between family members.
Does agricultural labor and exposure to pesticides play a role?
Chronic exposure to pesticides in agricultural and farm workers is known to have several associated health consequences, including an increased risk of upper and lower respiratory problems.
Although there is no direct evidence linking COVID-19 severity and exposure to pesticides, it could be another factor explaining the higher severity of COVID-19 cases in Latino communities. According to Dr. Evert, “any type of environmental exposure that weakens the lungs, or causes chronic lung disease is going to put people at increased risk for severe COVID.”
This story was originally published August 24, 2020 at 4:00 AM.
