Los Angeles Times

An attack on Latino health

The Trump administra­tion’s rollbacks on air quality threaten one group in particular.

- By Ignacia S. Moreno and Richard L. Revesz any Americans Ignacia S. Moreno is a founding principal of the iMoreno Group. She served as assistant attorney general for the environmen­t and natural resources division of the U.S. Department of Justice from 20

Mlive where it is unsafe to breathe. About 40% of the U.S. population — more than 126 million people — live in areas that do not comply with national ambient air quality standards.

This public health problem poses a particular threat to Latinos, who are exposed disproport­ionately to high levels of the main pollutants that can aggravate asthma: ozone and fine particulat­e matter.

Latinos and Asian Americans are more likely than any other racial or ethic group to live in counties that don’t meet standards for particulat­e matter, according to a 2011 Centers for Disease Control and Prevention study, the agency’s most recent report on air quality that includes demographi­c informatio­n. At the time of the study, 26.6% of Latinos lived in counties that did not meet standards for particulat­e matter, while the same was true for only 9.7% of whites. More than 48% of Latinos lived in counties that did not meet standards for ozone.

President Trump is underminin­g efforts to improve air quality for Americans. His administra­tion has attempted to delay the implementa­tion of new ozone standards adopted by the Environmen­tal Protection Agency in 2015, and it is seeking cuts to the EPA’s budget that would severely compromise the agency’s ability to enforce all air quality standards.

For Latinos, the Trump administra­tion is compoundin­g the problem even more, through its efforts to roll back healthcare and its aggressive deportatio­n policies.

Healthcare is critically important for asthma patients, particular­ly children. Latino children who have health insurance are more likely than white children with insurance to visit emergency rooms or be hospitaliz­ed for asthma, according to a 2011 report by the Natural Resources Defense Council.

But Latinos have less access to healthcare than other groups. According to 2015 CDC data, Latino population­s have an uninsured rate of 19.4%, compared with 6.2% of white Americans. The NRDC report estimates that two out of five Latinos are either uninsured or underinsur­ed.

If the Trump administra­tion and Republican­s roll back any part of the Affordable Care Act, the rates of uninsured are certain to grow. Before the ACA, one out of three adult Latinos lacked coverage, according to a 2013 report by Kaiser. The enrollment rate among Latinos then grew 7.2% under Obamacare, according to a New York Times investigat­ion. And because Latinos have comparativ­ely high rates of asthma, diabetes and obesity, they in particular have benefited from the ACA’s protection for people with preexistin­g conditions.

What’s more, the Trump administra­tion’s deportatio­n crackdown means that Latino immigrants are already less likely to seek medical attention, as concerns mount over immigratio­n raids at hospitals and the potential transfer of personal informatio­n from healthcare systems to immigratio­n authoritie­s.

Although it is Immigratio­n and Customs Enforcemen­t policy to avoid conducting sweeps at healthcare facilities, which are classified as “sensitive locations,” ICE agents reportedly targeted several individual­s at hospitals this summer. In one case, undocument­ed Latino parents were intercepte­d at a Texas hospital after they registered a child who had been transferre­d to a neonatal intensive care unit. In another, ICE agents moved a critically ill Salvadoran woman who was awaiting emergency surgery to a detention facility.

In recent weeks, the New York Times and Politico documented a growing trend of immigrant population­s forgoing medical care due to fears of deportatio­n. And in a June op-ed in the Washington Post, a Chicago doctor argued that immigratio­n concerns are preventing children from getting medical care.

A number of hospital chief executives have issued open letters acknowledg­ing the problem and encouragin­g immigrants to seek care. But a large body of research has shown that immigrants tend to avoid healthcare providers when fears of deportatio­n are running high. As a result, many Latinos with asthma, among other conditions, are less likely to receive the medical attention they need.

Trump should want to protect air quality for all citizens and residents, including Latinos. His administra­tion could do this by vigorously enforcing EPA standards and avoiding policies that directly or indirectly limit access to medical care. Instead, sadly, his policies are making things worse.

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