Adverse health outcomes among Latinos can be better understood within the context of the social determinants of health experienced by the community. This section highlights some health outcomes where Latinos are disproportionately impacted.
Mental health includes emotional, psychological, and social well-being. Mental illnesses are among the most common health conditions in the United States, with more than 1 in 5 adults living with a mental illness34. The COVID-19 pandemic exacerbated risk factors for mental health illnesses, resulting in a 25% increase in the prevalence of anxiety and depression worldwide35 36.
During 2017-2021, nearly 16% of Latino adults in the county reported experiencing serious psychological distress in the past year, compared to nearly 11% of all adults in the county. Furthermore, 25% of Latino adults reported that their social life was affected by mental illness, compared to 19% of the county overall. Seventeen percent (17%) of Latino adults reported having serious suicidal ideation, compared to 14% of the county overall11. Seventeen percent (17%) of Latino adults also reported visiting a professional for mental health, drug, or alcohol issues at least once in the past year11. However, this may be an underestimate of the proportion of the Latino community that may benefit from mental health services. Barriers to accessing mental health services among Latinos include lack of culturally and linguistically appropriate services, limited access to healthcare and lower quality of care, and perceived mental health stigma contributing to hesitancy in seeking help37 38 39 40.
Reported psychological distress among adults in the past year in Santa Clara County, 2017 - 202111
COVID-19 had a particularly severe impact on health inequities in the Latino community. Factors such as working in a job considered essential, overcrowded living situations, and limited English proficiency increased the risk for COVID-19 infection among Latinos41. In California, Latinos were 8.1 times more likely to live in a “high-exposure household” compared to other racial/ethnic groups. These are households where there is at least one essential worker or where there are more people than the number of bedrooms in the home42.
From 2020 to 2022, Latinos in the county consistently experienced the highest COVID-19 case rate compared to other racial/ethnic groups. The case rate among Latinos was the highest in 2022 at 13,922 cases per 100,000 population.
COVID-19 case rates in Santa Clara County, 2020 - 20223 43
COVID-19 death rates among Latinos were higher regardless of the age of those who died. Latinos had the highest rate of COVID-19 deaths per 100,000 population across all age groups and all three years, compared to other racial/ethnic groups, except for those ages 35 to 64 in 2022.
COVID-19 death rates in Santa Clara County, 2020 – 20223 10 43
Note: COVID-19 deaths among age 0-34 group were excluded from the graph due to small sample size.
Beyond the direct impact of COVID-19 cases and deaths, Latinos experienced enduring social and economic impacts from the pandemic. For example, food insecurity concerns across the country increased particularly among Latino households where the heads of households lost their jobs because of the COVID-19 pandemic and where English proficiency among adults was limited44. During 2020-2021, Latinos in the county reported more experiences of reduced work hours, job loss, or difficulty paying for their mortgage during the pandemic, compared to other racial/ethnic groups11. Focus groups conducted between August 2022 – January 2023 among Spanish and Vietnamese residents of East San Jose, Gilroy and Mountain View indicated that significant recovery from the COVID-19 pandemic is still needed. Latinos continue to face economic hardship, challenges obtaining aid, and difficulty accessing healthcare and mental health care in the wake of the COVID-19 pandemic45.
Diabetes remains a significant health issue and concern among Latinos. Latinos have a higher risk of being diagnosed with diabetes compared to other racial/ethnic groups46. This increased risk is influenced by various social determinants of health, including access to healthy foods, education attainment, healthcare access, and access to environments that promote physical activity46. In addition, developing diabetes at a younger age increases the risk for diabetes-related complications, lower quality of life and premature death than developing the diabetes at a later age46.
During 2017-2021, a larger proportion of Latinos in the county had diabetes (10%) compared to the proportion among the county population (8%). Furthermore, a higher percent of Latinos in the county reported being diagnosed with diabetes before 40 years old (36%) compared to the county overall (21%)11. During 2017-2021, the rate of diabetes-related emergency department visits in the county was higher among Latinos (3,647 per 100,000 population) than the county overall (1,742 per 100,000 population)47. These higher emergency department visit rates are likely influenced by factors such as lack of routine preventive care, delayed medical care, linguistic barriers, lack of cultural competency, and problems navigating the healthcare system in addition to disparities in actual diabetes diagnoses48 49.