Pandemic unequally shortened the lives of Sonoma County Latinos, with premature death rate 10 times higher than for whites

Lenore González was the glue that held her family together, a classic ama de casa, or stay-at-home mother and wife, who always assumed her husband and daughter would be coming home from work or school tired and hungry.

When her daughter Jessica, a medical assistant at Santa Rosa Community Health’s Lombardi Campus, walked through the front door, González would have hot food ready and the tortillas heating on the comal.

On Friday evenings, when her husband, Jose, a 63-year-old truck driver, came home after a long week out of town, the house was cleaned beyond clean and filled with the aroma of his favorite food — menudo, shrimp soup or pork spare ribs in red sauce.

Jessica, 26, said her mother was not only the foundation of her home but her best friend, a “really joyful person who was always smiling and always happy to help anyone out.”

But last fall, Lenore González contracted COVID-19. She died a month later on Dec. 16, 2020. She was 60. For Jessica, that was far too soon.

The same can be said of others in the Latino community, which has been disproportionately affected by the deadly virus. While it is true that COVID-19 prematurely ended many lives in Sonoma County, such deaths occurred among Latinos at a higher rate and younger age.

“A lot of these community members becoming infected are heads of household or breadwinners in the family,” said González. “It’s been devastating. She was my best friend. I never imagined I could have this much pain in my life.”

Surge revealed inequalities

When the first big wave of COVID-19 cases, hospitalizations and deaths struck Sonoma County in the summer last year, the first people in its crosshairs were older, frail residents, many of them living in skilled nursing homes and assisted living facilities.

But as the first year of the pandemic drew to a close, a much broader segment of the local community was suddenly grappling with a deadly winter surge of COVID-19.

It soon became apparent that long-standing inequalities had caught up with Sonoma County’s communities of color, especially Latino immigrants.

According to a recent study of how COVID-19 altered life expectancy in Sonoma County, Latino residents lost an average of 2.1 years of life, compared to the period between 2017 and 2019. Non-Hispanic white residents, meanwhile, lost only 0.7 years of life.

The study, conducted by county epidemiologist Jenny Mercado, found that COVID-19 killed Latinos prematurely at an alarming rate. The analysis found that:

• The premature death rate for local Latino residents — 409.4 per 100,000 people — was almost 10 times higher than for white residents.
• COVID-19 was responsible for 7% of all premature lives lost for Latino residents compared to 1% for white residents.
• The pandemic contributed to 12% of total deaths for Latino residents compared to 3% for white residents.

The findings echo those of a national study that found Latinos and Blacks in the United States saw significant declines in life expectancy in 2020 compared to white residents.

Theresa Andrasfay, a researcher at the University of Southern California, and Noreen Goldman, a professor of demography and public affairs at Princeton University, found an overall 1.31 year reduction in U.S. life expectancy, from 78.74 years to 77.43. However, the declines were two to three times larger for Black and Latino residents.

Their study found Latino life expectancy decreased by 3.03 years and Black life expectancy fell by 1.9 years. For whites, life expectancy dropped by 0.94 years.

In their study, published in JAMA Open Network, a monthly open access medical journal of the American Medical Association, the researchers said the pandemic essentially wiped away unique life expectancy advantages that Latinos in the United States have experienced for years.

The researchers posited that the unprecedented change probably stems from social and economic inequities associated with both higher exposure to infection and higher fatality among those infected. Local health officials agree.

Kathryn Pack, health program manager for Sonoma County’s epidemiology team, said the causes of these disparities are likely “multifactorial.” Before and during COVID-19, there were existing inequities “across the social determinants of health” that affect health and life expectancy.

Pack said such things as over-representation in the essential workforce, lack of sick leave and job protections, poverty-induced household density or shared living situations, and shared transportation have placed low income Latinos at higher risk of becoming infected with COVID-19.

Also, Latinos endure underlying health conditions such as obesity and diabetes at greater proportions than white residents, Pack said. These conditions are associated with a higher risk of COVID-19 hospitalization and death.

Latest data no surprise

Those in Sonoma County who have been struggling to address the disproportionate impact of COVID-19 on underserved groups, particularly Latinos, are not surprised by the county’s latest data on life expectancy.

And yet it’s still “stunning to actually see the numbers,” said Dr. Jenny Fish, a family medicine physician and health advocate. In October, public health officials shared the data with Fish and other members of a community health equity advisory group.

“I work with patients affected by these disparities every day,” Fish said. “They have faced financial insecurity, housing insecurity, food insecurity and health disparities.”

For communities of color, high rates of COVID-19 transmission, hospitalization and death are piled on top of higher rates of diabetes, obesity, hypertension and risk of cardiovascular disease, she said. In fact, these health disparities create a fertile ground for SARS-CoV-2, the virus that causes COVID-19 illness.

“All of those things increase the risk of getting COVID, getting sick from COVID and dying from it,” Fish said.

And it’s not just the frail elderly who are affected.

A more recent examination of COVID-19 deaths, by age group, found that local Latinos who succumb to the virus tend to be younger than white residents who die of it. Since June 1, 57.7% of Latinos who died of COVID-19 were between the ages of 45 and 64 and only 26.9% were 65 and older. For white residents it’s the opposite, with 58.3% being 65 and older and only 30.6% between 45 and 64.

“Those are wage earners, those are people that support their families, take care of their children,” Fish said, referring to COVID-19 deaths among younger people.

Why the good ones?

Eleven months after her father died of COVID-19, Fatima Rivas, 19, still imagines Leovigildo Rivas coming home from work or picking her up from school and kissing her on the cheek.

Pausing frequently, forcing out every muffled word, Fatima struggles to describe what she misses most about him. “I can’t even look at his picture without feeling sad … I just feel like it wasn’t his time yet,” she said, tearfully.

Her father, 50, died Dec. 17, just two weeks before his own mother died — also of COVID-19 complications. At the time, they were living in Southern California, where he worked in construction. They’ve since moved up to Sonoma County to be near family, but Rivas leaves behind a wife and three other children.

Fatima’s mother, Maria Rivera, 47, works as a house cleaner in Sonoma Valley and struggles to make ends meet after her husband’s death. But it’s the gaping hole he’s left that she struggles with most. Rivera said her husband was one of the good ones, responsible, tender and loving.

“It’s the one thing that I asked God when he died — why him?” she said, speaking in Spanish. “Why, when there are so many men who don’t deserve the title of father, they’re left all over in the world.”

Mario Castillo-Guido, who volunteers for a food pantry called Comida Para Todos, or Food for All, said the pandemic has laid bare the county’s extreme economic divides, which leaves many without a safety net, particularly in unincorporated parts of the county.

“The county wants our labor but they could care less about us,” Castillo-Guido said.

The county’s data on life expectancy, he said, “are connected to the historic racism that has existed and persisted in this county, and the pandemic has finally forced the powers that be to begin acknowledging it.”

Since the pandemic started, Castillo-Guido, Fish and other community advocates have been pointing out that the pandemic has spread like wildfire wherever social and economic injustice is left unchecked.

They say COVID-19 case rate, hospitalization and death rates shine a spotlight on extreme income inequality that leaves many Latinx families living in cramped housing where the virus rapidly spreads. Effective isolation and quarantine was a luxury many could not afford.

Also, many Latinos were forced to work through the pandemic, as essential laborers who had to choose between staying home or going hungry and not paying the rent. The virus, they said, thrived among those without health insurance, child care and employer-paid sick leave.

Pandemic’s lasting effects

Jessica González said her family contracted COVID-19 last year after a family gathering. Both her parents were hospitalized, but the disease attacked her mother far more aggressively.

She was placed into intensive care the same day she was admitted to the hospital. After almost a week, she was intubated but soon developed fungal infections as a result, González said, adding that it was difficult to see her mother so helpless when she still had so much life in her.

“My mother was always on the move, always finding something to do, finding more work for herself,” she said.

González said her father has since recovered and is actually doing better than she is. She said she still has ongoing conditions. “I still sometimes have episodes of shortness of breath, like my lungs are not functioning as they should be,” she said.

Historically, Latinos have experienced longer longevity than whites, despite generally having harsher jobs and less access to education and health services. The trend, known as the Latino or Hispanic Paradox, is most pronounced among immigrants, and health experts often attribute it to lower rates of smoking, healthier diets and strong ties to family and their community.

In the national study, Andrasfay, a postdoctoral scholar in gerontology at University of Southern California, found that COVID-19 essentially wiped away that health advantage.

“The generally good health of Latinos, which, all else being equal, should have protected them from COVID-19 infection and fatalities, has laid bare the risks associated with social and economic disadvantage,” Andrasfay wrote in her report. “Our estimates indicate an unprecedented mortality increase for Latinos, exceeding that for the Black population, that would eliminate over 70% of the previous Latino advantage relative to Whites.”

A foregone conclusion?

Mercado, the Sonoma County local public health epidemiologist, said life expectancy estimates the average number of years that a baby born in 2020 would be expected to live if that year’s mortality rates continued to apply throughout the baby’s lifetime. A life expectancy decrease of 2.1 years doesn’t mean that a Latinx baby born in 2020 will ultimately live 2.1 years less than they would have had there been no pandemic, she said.

“It’s not a forgone conclusion that a Latinx born in 2020 will live 2 years less,” Mercado said. “That is just the way the life expectancy calculation works.”

Mercado said every year new estimates are calculated based on what the mortality experience was for that year.

“I suspect 2021 will be similar, but once we exit the worst part of the pandemic it is likely that life expectancy will increase again,” she said.

But the disparities that COVID-19 exploited will likely remain, said Castillo-Guido.

In the meantime, Jessica González and her father no longer live in the Roseland home where the family lived for 10 years. She said her father could not endure her mother’s absence.

His sense of loss was especially painful on Saturday mornings; when he got up, he expected to see her in the kitchen cooking breakfast or knitting on the couch in the living room.

“He wanted to see her in every corner of the house,” she said. “He wasn’t getting that, so he no longer wanted to live there.”

You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.