CHAMPAIGN, Ill. — Public policies blocked many families of Mexican descent living in the U.S. from accessing vital services such as food and mental health care during the COVID-19 pandemic, even though these communities experienced some of the highest infection and mortality rates.

Thirty-eight perinatal women and mothers of young children were interviewed about the challenges they faced during the pandemic and proposed solutions to better meet the needs of their communities during future large-scale crises in a study led by University of Illinois Urbana-Champaign kinesiology and community health professor Sandraluz Lara-Cinisomo.

Co-authors of the study are molecular anthropologist Amy L. Non of the University of California-San Diego; Kimberly D-Anna-Hernandez, a professor of psychology at Marquette University; and U. of I. graduate student Mary Ellen Mendy and undergraduate students Jessica Avalos and Jacqueline Marquez.

The women in the study discussed the stressors they encountered during the pandemic, including their difficulties accessing mental health treatment, child care and food. Their suggestions and insights were used to identify actionable policies and programs that could help meet the needs of Latino communities during future emergencies.

The participants, who were interviewed between September 2021 and December 2022, were part of a longitudinal study that recruited them from a clinic in San Diego, one of the U.S. cities with large Latino populations of Mexican heritage.

The women were about 36 years old on average. Although about 81% of them were born in Mexico, many had resided in the U.S. for 17 years or more. About 31% reported having an annual household income of less than $21,000, while a similar percentage earned $40,000 or more, according to the study.

Lara-Cinisomo said participants faced complex stressors during the pandemic. Half of the women in the study said their families had challenges obtaining food due to loss of income and subsidies such as school lunches, as well as supply chain shortages and consumer stockpiling.

“While early in the pandemic various federal and state programs and policies were deployed to mitigate people’s risks for exposure and enhance families’ economic security, millions of tax-paying families of Mexican descent and other Latino backgrounds were excluded because of restrictions and exclusions set by those programs,” Lara-Cinisomo said.

The researchers found that more than twice as many Spanish speakers reported food-related issues compared with their English-speaking counterparts.

“Policymakers should consider how language barriers increase the risks of Spanish-speaking families losing out on benefits designed to meet their needs, such as CalFresh,” California’s iteration of the federal SNAP food assistance program for low-income people, Lara-Cinisomo said.

“Communicating food and health and safety information in linguistically appropriate media, such as texts, videos or commercials, is vital to ensure accessibility to people with differing literacy and technological skills and should be carefully considered by policymakers.”

Involving trusted sources in disseminating relevant and critical information was also recommended by the participants. For marginalized communities that have experienced historical discrimination and anti-immigrant propaganda, trust in these sources is vital, Lara-Cinisomo said.

“Research has shown that community engagement is critical in emergency preparedness and increases the likelihood of meeting the needs of marginalized communities,” Lara-Cinisomo said. Accordingly, she and her team recommended developing a contingency plan to train culturally and linguistically competent community health workers to cultivate networks of trusted community members to assist in crisis communication efforts.

Some women discussed feeling anxiety about the uncertainties associated with the pandemic, such as lockdowns and conflicting health information. These feelings were exacerbated by employment disruptions, pregnancy, and food access problems, and their concerns extended to family members residing in other households and those living in Mexico, participants told the researchers.

The majority of those interviewed advocated broadening access to food subsidy programs such as WIC and SNAP to offset income losses and food shortages during large-scale crises, along with providing public awareness campaigns about local food banks and assistance programs.

Even though California provides more services for undocumented immigrants — including paid family leave and one year of emergency coverage with mental health services under Medi-Cal, the state’s Medicaid plan, for pregnant women — caring for their mental health needs was a significant problem for many participants. Fifteen women reported needing mental health care, but twice as many of the English-speaking women mentioned these issues compared with their Spanish-speaking counterparts, the researchers found.

The researchers hypothesized that this difference may have been associated with cultural beliefs, with Spanish-speaking women feeling less comfortable disclosing mental health problems because of stigmatization compared with those who spoke English. Or, it may have been that those who spoke Spanish were more resilient or more concerned about immediate needs such as food assistance, the team said.

Participants recommended broadening access to mental health services for mothers and their families, promoting awareness with providers and patients, and disseminating mental health information and resources through videos and other media and via programs such as WIC.

Many of the women — largely those who spoke only Spanish — reported difficulties obtaining personal protective equipment and sanitization supplies because of shortages, consumer stockpiling, and price gouging, in keeping with other studies that showed low-income and marginalized communities were disproportionately affected.

Although the study sample was small, Lara-Cinisomo said it highlighted critical needs for responsive, culturally appropriate policies and programs to ensure the well-being of Mexican-descent perinatal women and mothers of young children during public health crises.

Lara-Cinisomo discussed the team’s findings and study participants’ recommendations during a virtual Briefing on Perinatal Health and Well-being on April 3 hosted by the journal Health Affairs, which published the study.

A scientific review has found almost no research studying the interconnections across three major threats to planetary health, despite UN assessments suggesting one million species are at risk of extinction, a global pandemic that resulted in over six million excess deaths, and a record-breaking year of global temperatures.

“When we began to look into it, we had suspicions the number of studies would be low, but not that low,” says Dr. Jonathan Davies, a researcher with University of British Columbia’s Biodiversity Research Centre who led the study, published today in The Lancet Planetary Health.

“There are misperceptions in the research community that more work in this area has already been done—but when you look for studies investigating the mechanisms linking the three crises, there isn’t much there at all.”

“I believe the majority of people would prefer to live in a more sustainable and biodiverse world, and empirical data show that people are healthier and have an increased feeling of well-being when closer to nature.”

In a review of over 1.8 million research articles published over the last decade, Dr. Davies and his team uncovered only a minuscule number of studies—128— investigating inter-connected drivers across infectious disease spread, biodiversity loss and climate change.

Human malaria was cited as a prime example of an emerging poly-crisis being super charged by overlapping pressures — climate change impacting mosquito distributions, development and vectors in ways that aren’t straightforward to predict.

The paper analysed research studies investing either infectious disease spread, biodiversity loss or climate change. While roughly 40,000 studies considered two of the areas in conjunction, only 505 combined research on all three areas. And only 128 actually investigated the mechanistic links connecting all three threats. And in those cases, the studies are overly focused on just three areas: infectious disease in amphibians, forest health, and Lyme disease.

The research team outlines how scientists and policy makers can better study the links and feedbacks between the crises—making it possible to identify pathways with win-win-win outcomes and also avoiding unintended consequences of only taking action in one area, and ignoring others.

“Greater effort needs to be made to search for solutions with cross-benefits,” adds Dr. Alaina Pfenning-Butterworth, who conducted the study while at UBC Botany.

“For example, planting huge numbers of new trees in order to sequesters carbon can appear like a solution to climate change, but may lead to unanticipated consequences —such as loses of native diversity and monoculture forests that are at increased risk of disease outbreaks.”                                                                                

The paper also argues that despite the best efforts of the research community and funding agencies, scientists from different disciplines need to work together more closely, including veterinary schools, medical schools, ecologists, conservation biologists, and computer scientists.

“I believe the majority of people would prefer to live in a more sustainable and biodiverse world, and empirical data show that people are healthier and have an increased feeling of well-being when closer to nature,” says Dr. Davies.

“But there’s broad scientific consensus that ‘business as usual’ is unsustainable, and we risk approaching a planetary tipping point beyond which reversing course will become exponentially more difficult. We have a valuable window of opportunity to decide how our future looks.”