Latino Community’s Pandemic Toll: National Hispanic Medical Association’s Dr. Elena Rios on Quest for Equity

Dr. Elena Rios

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Moderator : Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter, a show where we speak to the top thought leaders
in health innovation, health policy, care delivery, and the great minds
who are shaping the hea lthcare of t he future.

This week Mark and Margaret speak with Dr. Elena Rios, President
and CEO of the National Hispanic Medical Association. Dr. Rios talks
about the devastating impact, the pandemic has had on the Latino
populations in this country with more than dou ble the death toll, and
great economic hardship as well, impacting health and mental health
in that community. She talks about the powerful potential in The
American Recovery Act and The American Families Act under
President Biden, to address some of the d riving forces behind health
and equity.

Lori Robertson also checks in, Managing Editor of F act C heck.org , looks
at misstatements spoken about health policy in the public domain,
separating the fake from the facts . And w e end with a bright idea
that's improv ing health and well being in everyday lives.

If you have comments, please e - mail us at [email protected] or find
us on Facebook , Twitter , or wherever you listen to podcast s . And you
can also hear us by asking Alexa to play the program. Now stay tuned
for our interview with Dr. Elena Rios here on Conversations on Health
Care.

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Mark Masselli: We’re speaking today with Dr. Elena Rios , the President and CEO of
the National Hispanic Medical Association, representi ng 50,000
Hispanic physicians in the United States. She is also President of the
National Hispanic Health Foundation, seeking to improve the health of
the Hispanic populations in this country.

Margaret Flinter: Dr. Rios is an internist; she served as Advis or for Regional and
Minority Women’s Health at the U.S. Department of Health and
Human Service s. And she is a trustee of the New York Academy of
Medicine. Dr. Rios, we welcome you to Conversations on Health C are ,
today .

Dr. Elena Rios : Thank you, honored t o be here.

Mark Masselli: That’s great. Dr. Rios, the Hispanic community has been hit especially
hard by the pandemic, amplifying the depth of health and equity, long
experience d by people of color in this country. I wonder if you could
help our listeners understand the true impact that COVID - 19 has had
on the Hispanic community and put it into perspective for us.

Dr. Elena Rios

Dr. Elena Rios: Well, I think overall, you know not every state collects data on
Hispanic, that’s the first problem. But overall, Hispanics and o ther
vulnerable communities have really had you know twice as many
deaths than the W hite population. And a lot of that is because of the
underlying conditions that Hispanics who a re mostly lower income,
working class people known as essential workers in ou r communities
now , have lots of underlying conditions like diabetes and obesity and
heard disease and cancers . A nd also are living in multigenerational
housing, and working in small businesses or in the service industry or
in the agriculture business or me at packing plants etc. where they
have lost jobs, and are really feeling that the impact, the economic
impact of COVID - 19 as well as the physical and emotional impact of
this horrible pandemic.

Margaret Flinter: Well, Dr. Rios I think one piece of good new s is that there seems to be
adequate supply of vaccine out there now, in most communities, but
we still see vaccine hesitancy in many communities and we see some
of it in the Latino community as well. I know the National Hispanic
Medical Association of whi ch you have been such a leader, has
launch ed the Vaccinate for All campaign to address this issue . T ell us
about this after then what are the vaccine resistance, challenges, the
key areas that you're seeking to address, educate or help overcome .

Dr. Elena Rios: Well, I think some of the important issues with vaccination is
education and outreach. And many people are afraid of government
programs, just don’t trust government programs. And we do know
that the NIH has worked with the pharma companies to produc e
vaccinations are very safe, very effective. But many people just don’t
understand that yet . A nd I think the other problem is that we do have
people that are, again don’t have the money to pay for vaccines and
don’t know that it’s free. So and that for pe ople that are
undocumented, maybe or have undocumented people in their family
may be afraid of the privacy issues, and not have, you know making
sure that people know that the vaccine providers are not going to give
away information to anybody like the INS or any other authorities an d
that it really is a private issue.

So the National Hispanic Medical Association is proud to be able to
have national campaign funded by CDC . And we call it Vaccinate for
All, because we think everyone in the family should unde rstand how
important vaccinations are for everyone. Right now we can get
vaccinations to those who are 12 year olds and older. So I can tell you
that the most important part of our campaign is that we're
encouraging health professionals and patients alike to sign up and be
a champion for Vaccinate for All, which means that if they come to
our website which is www.nhmamd.org and go to the Vaccinate for
All page, they can sign up and become a champion where they can
send information to their families and to their loved ones . A simple

Dr. Elena Rios

information in English and Spanish about how to get vaccinated and
the importance of these key facts about vaccinations that they are
safe, effective and important . T o be able to have a vaccin ation in one
or two doses, that will be very effective in decreasing the impact of
the disease of COVID - 19. And that it’s much better to get a
vaccination then to end up in a hospital on a ventilator. So that’s our
main message.

Mark Masselli: Well, that i s such a great program . A nd you know you said the word
earlier that key to having all this happen is developing trust. And you
know probably hasn’t been a lot of trust that happening with the
Department of Homeland Security, but they recently stated that I CE
and the Border Patrol will not conduct enforcement operations at or
near vaccination sites . T hat must be so critical to the work that the
National Hispanic Medical Association is undertaking. And I'm
wondering is this fact getting out to the community, and also just talk
to us about the negative impact the immigration policy has had on
Hispanic health.

Dr. Elena Rios: Well, I think we all need to tell more people of the importance of this
message about those who are getting the vaccine, will not be fearf ul
of having any kind of government ICE or INS be part of that, the
vaccination sites. So yes, it is very important that more people know
about it. I think the most important problem for undocumented is
that there are very few access to healthcare, one is through
Community Health Centers, Federal Community Health Centers are
supported to take care of anyone that walks in their doors. And the
other is emergency rooms, but and I should say doctors who are able
to provide charity care. And we do see a lot of H ispanic doctors
especially in our poor communities taking care of patients when they
can.

I do think that it’s important to know that some places like California
and New Jersey have changed state laws to allow funding f or
Medicaid from the state portion to be able to take care of people that
are not documented. And I think that that’s the major problem is the
lack of access to resources because you know, and many can get some
insurance from employers , you know while employe r s are still able to
provide insur ance.

Margaret Flinter: You know Dr. Rios, I want to thank you for the shout out to
Community Health Centers, obviously where we do most of our work.
Now but also, you know, Mark, it never even occurs me these days
that people would think there is a cost f or the vaccine, because there
has been no cost associated. But you're so right Dr. Rios that maybe
something I take for granted is absolutely known among our
communities and may not be, so thank you for that reminder.

And I wanted to ask you also about Dr. Marcella Nunez - Smith , who I

Dr. Elena Rios

know was the keynote speaker at the recent annual meeting of your
organization, of course she is the Biden administrations Director of
Equity through the pandemic and beyond. Sh are us some of her
insights on how the President’s policies might have the potential to
address some of th ese really entrenched health equity challenges that
we've lived with for way too long, and desperately need to do
something about.

Dr. Elena Rios: Yeah, Dr. Nunez - Smith was great, and I think that her big message
was how important it was to be more inclusive, and to listen to
people in our communities that have suffered so long with health and
equities, because of their poverty levels, lack of education, limited
English, you know maternal mortality, th ere is just, you can go on and
on and on. And I mentioned earlier obesity and diabetes and heart
disease. I would just say that it’ s toxic stress in poor communities that
need to be addressed.

And what Dr. Nunez - Smith did, she did a great job in discussing some
of the key points that we now know as the American Rescue Plan of
President Biden in the White House that’s been, he actually address ed
this last week with, in the joint congressional session. And I think a lot
of this will be taken care of just basi c necessities like more funding for
food programs in our communities. The schools having money to
revamp school so they can open, college student loans, rent for
people and other housing programs. People are really desperate right
now, because they have lo st so many jobs and more unemployment
until the fall.

And I think that one of the major issues that I think we're really proud
to see is that this administration is taking a real look at poverty and
decreasing child poverty in half by the tax credits that they have put
into the American Rescue Plans . S o the tax codes would be changed
so that families would get tax credits for not only being married or
having a family but for each child. And I think that that’s going to go a
long way to help again working fa milies, have a little bit more hope
with some money to pay their bills and buy food .

Mark Masselli: We're speaking today with Dr. E lena Rios, President and CEO of the
National Hispanic Medical Association a nd President of the National
Hispanic Health Found ation, seeking to improve the health of the
Latino population in this country. You know I would really want to pull
the thread on your shout out to the Biden administration, and about
the American Families Act and the American Rescue Plan. I'm just
wonderi ng as you think about policy going forward, no plan is perfect,
this one does a really good job, you really talked about the guarantee
for really trying to cut child poverty in half throughout the land which
is so important to do. But one other additional reforms you a n d the
National Hispanic Medical Association are advocating for things that

Dr. Elena Rios

people at state should keep their eye on as well as the national level.

Dr. Elena Rios: Well, I think again with the stress that has been developing even you
know at a higher level than ever because of the pandemic , I think
we've to look at the importance of anxiety and mental health and all
of the issues happening within families, domestic violence, you know
opioid abuse, was always there but it’s just exacerbated. The other
issue is really the healthcare workers themselves. We really need
more diversity within the medical profession, doctors, nurses,
dentist s, b ut more importantly we need more community people to
step up and be part of the messenger system in the .

Y ou know we've seen the Biden administration increase community
health workers for accessing health insurance through the Affordable
Care Plan. I think we need more community health workers working
within the public health, to be the trusted messengers for you know
getting people to understand where they can go get a vaccine, helping
them find appointments. The navigators if you will within public
health. And I also think that we're going to see a lot more importance
of public health and building back the infra structure of public health
that was there in the 1950s, when we had polio, and polio vaccines,
you know in the 1960s.

And you know we've so many problems in our community, I mean
homelessness is another one, that really is a public health issue when
we thi nk about getting prepared for the next pandemic. So these are
just some of the things I could think of that are really across the
border, needed at the state level and the national level.

Margaret Flinter: Well, Dr. Rios, every one of those that you mentio ned is very
important, but I wonder if we could just zero in for a moment more
on your specific thoughts about, how we reach into the Hispanic
Latino communities and excite people, engage them and thinking
about careers in the health professions, and bring them in . And you've
done a spectacular job with physicians within your organization,
within the world of physicians. But I'm wondering, you spoke about
nurses and community health workers, the dentist s , the therapist s
that people are going to lead and run these operations. What are your
thoughts about how we do that so that individual who comes into any
healthcare organization, feels like, w ell this is a place that reflects me
as well as everybody else in the community.

Dr. Elena Rios: Well, it starts youn g and I think we need more awareness among
young people, you know in the K through 12 and our grammar schools
and high schools, about the important role for jobs. The healthcare
industry is the number one industry with jobs in this country. And
anywhere yo u go, you can get a job in the healthcare industry. You
can move you know and find a hospital , a nursing home, clinic. And I
think that that there are jobs that don’t take that much time, not

Dr. Elena Rios

everybody can go to medical school and has that stamina to stay
there you know for 10 years and go to school. But I do think it has to
start young .

A nd the other thing is we really do need more role models, you know
the National Hispanic Medical Association is made up of mainly the
Hispanic doctors that are alumni of t he United States Medical Schools.
But unfortunately, only 5% of all the doctors in the country are
Hispanic. So there is a very few of us. And what we need is more
doctors in our medical school alumni, to go out and talk to community
you know PTAs, parents of grammar school kids, talk to the grammar
school kids about what it takes to, you know if you're very interested
in Science and Math and critical thinking, there is no reason why you
can’t be supported to continue along that path. Unfortunately we
don’t have the good counselors in the public school system to
understand that they can make or break a student’s vision of
themselves going to be in healthcare , i f they don’t support them, in
continuing to be good in Math and Science.

And then in college I thin k the same thing, we run a program called
the College Health Scholars Program, and we've seen over 2,500
Hispanic stu dents from Texas, California, the east coast and just
different places around the country. We're matching them with
mentors who are Hispani c students that are in medical school, that
are telling them, look we made it, you can make it too. And I think
that’s what’s real important that we've mentoring, because so many
of our families do not have fathers or mothers that are health
professionals. Although they may go to a dentist or go to a doctor and
see them, they don’t, you know they don’t necessarily think that they
can get to that point.

Mark Masselli: Well that’s just a wonderful roadmap for the future of the individuals ,
but also for the fu ture of the healthcare system, by providing that
mentoring. I think it’s fair to say you're a futurist for healthcare and
the National Hispanic Medical Association a s we talked about a little
easier, is involved in the A ll of U s precession that is an initi ative as a
f ederally qualified health center, we were one of the vanguard, when
Dr. Collins started this program up. It’s so important to have a
program that focuses on research that looks like all of the country,
not just a limited part of the country. I' m wondering if you could share
with us your vision for this wonderful effort by NIH and how it may
lead to improved healthcare and healthcare outcomes in the Latino
community.

Dr. Elena Rios: Yeah, the All of Us program was designed to follow a million peo ple in
America that live here over 18, who can be followed for 10 years. So
that our researchers can learn more about how people live and how
they face different diseases as they age over 10 years. And I think it’s

Dr. Elena Rios

so important that we've more Latinos sign up for the program. And
there is a website that where you can sign up, but I think it’s
important that we've participants who can provide knowledge for the
next generation about our communities. And we'll only learn about
how Latinos face diabetes or hear t disease and the struggles they go
through, but also the important you know tips and how they respond
to medications and therapy and exercise and I think it ’s just so
important that we get involved so that we can also learn from each
other and pass on the information to the next generation.

Margaret Flinter: Well that’s great and I think like we can say that they are still
accepting people into that program, and they are still recruiting. So
not too late for people to participate and get their families inv olved as
well. We have been speaking today with Dr. Elena Rios, she is the
President and CEO of the National Hispanic Medical Association and
President of the National Hispanic Health Foundation . L earn more
about her work by going to www.nhnad.org or follow her on Twitter
@ElenaRiosMD. Dr. Rios, we want to thank you so much for your
leadership for all of your contributions to health equity and for joining
us today on Conversations on Health Care.

Dr. Elena Rios: Thank yo u. It was a pleasure.

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Mark Masselli: At Conversations on Health Care we want our audience to be truly in
the know when it comes to the facts about healthcare reform and
policy. Lori Robertson is an award winning journalist and Managing
Editor of Fa ctCheck.org, a nonpartisan, nonprofit consumer advocate
for voters that aim to reduce the level of deception in U.S. Politics.
Lori, what have you got for us this week?

Lori Robertson: Stanford Medicine says it, “ S trongly supports the use of facemasks to
c ontrol the spread of COVID - 19. ” Yet, viral stories falsely claim a
Stanford Study, showed that facemasks are unsafe and ineffective
against the disease. The p aper is actually a hypothesis not a study
from someone with no current affiliation with Stanford. And it has
since been retracted by the Journal that originally published it.

One claim shared on Facebook said this supposed Stanford Study said,
facemasks “can cause health deterioration and premature death.”
The p aper was the author’s hypothesis publishe d in a journal called
Medical Hypothesis. While t he p aper says the author is affiliated with
Stanford, a spokesperson for the university told us that’s incorrect.
The author had a one year term as a visiting scholar that ended in
2016. We reached out to th e author but didn’t get a response.

The p aper said that the virus itself SARS - C o V - 2 was small enough to
pass through any facemasks. But J Alex Huffman an Aerosol Scientist

Dr. Elena Rios

at the University of Denver told us that betrayed a fundamental lack
of understandin g of respiratory aerosols. There is a wide range of
sizes of particles people emit when breathing, speaking or coughing,
from 10 nanometers to 100s of microns, most of them Huffman said
are removed by good mask. Lab studies have shown masks especially
mult ilayered masks that fit well can partially block exhaled respiratory
droplets which are thought to be the primary way the virus spreads.

The p aper went on to claim that masks can cause insufficient oxygen
or too much carbon dioxide in the blood. Experts ha ve repeatedly
rebuff ed such claims. The American Lung Association notes, “we wear
masks all day long in the hospital the masks are designed to be
breathe through and there is no evidence that low oxygen levels
occur. ” The editor - in - chief of Medical Hypothe sis has since retracted
t he p aper. The journal said t he p aper was misleadi ng and apologize d
to its readers. And that’s my fact check for this week. I'm Lori
Robertson, Managing Editor of FactCheck.org.

Margaret Flinter: FactCheck.org is committed to factua l accuracy from the country's
major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you'd
like checked e - mail us at www.chcradio.com , we'll have
FactCheck.org's Lori Robertson check it out for you here on
Conversations on Health Care.

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Mar k Masselli : Each week Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. Over th e past
few decades kids have been getting less and less physical activity
throughout the school day. And as budgets have been tightened and
achievement requirements have increased Phys Ed has become less
prevalent in many schools. The University of Michiga n researchers
wanted to find a creative and effective solution that would increase
kid’s movement and increas e in sedentary lifestyles without
disrupting the school day.

Dr. Rebeca Hasson : We looked at the scientific literature in terms of prolong sitting. And
they have administrated that if you just do two minutes of activity, a
small -- ; get up do some movements, sit back down, activity in that
small of a dose can have dramatic improvements on health, on
cognition, on learning. So we decided to develop an intervention , a
program that would allow children to get these small b ursts of activity
throughout the day.

Mark Masselli: Dr. Rebeca Hass o n is Pr incipal Investigator for I n PACT, Interruption of
Prolong ed Sitting with Activity. She wanted to find out of j ust two to
three minutes short burst to physical activity, five times a day would
impact the kid’s cumulative movement. The research showed that

Dr. Elena Rios

kids of all shapes and body types found the program easy to
participate in.

Dr. Rebecca Hasson: We typically se e in PE or recess lower participation in girls compared
to boys. But in classroom activity breaks, you actually see similar rates
of participation if not higher rates of participation in girls compared to
boys. We also saw that for children who are carryin g few extra
pounds, that those children also were exercising at a high intensity,
even children with asthma, they were even able to do the activity
breaks at a higher extent than the children without asthma.

Mark Masselli: Dr. Hasson, a kinesiologist said, they wanted to design the
intervention that would be easy for teachers to adopt and manage. So
they created videos design to get kids moving quickly, then allow
them to quickly ease back into their learning mode.

Dr. Rebecca Hasson: We created a compendiu m of 200 activity breaks th at are just three
minutes long. S o that teachers had a variety of different types of
activities whether it was jumping jack, leap frog, something that will
get their heart rate in a target heart zones. We got a lot of positive
re sponses, particularly for the videos from the teachers , because it
was really easy to implement.

Mark Masselli: Kids burned on average about a 150 more calories per day a nd at the
end of the week, had accrued a significant amount of physical activity.

Dr. Rebecca Hasson: The kids when they left the laboratory, when they went home, they
still continued to be physically active. We' d th ese little
Accelerometers, they measure movement at the hip and so it tells us
how many calories were the kids burning away fr om the laboratory
and how much physical activity were they getting.

Mark Masselli: A low cost, easily adoptable fitness intervention for kids, allowing
short burst the physical activity throughout the school day. Enhancing
fitness, empowering kids to move more positively impacting the
learning experience, now that’s a bright idea.

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Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and Health

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M oderator : Conversations on Health Care is recorded at WESU at Wesleyan
University, streaming live at www.chcradio.com , iTunes, or wherever
you listen to podcasts. If you have comments, please e - mail us at

Dr. Elena Rios
[email protected] or find us on Facebook or Twitter. We love
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