The Washington region falls short on Latinx wellbeing

A Brookings report this year ranked the Washington region within the top ten metro areas for wellbeing for all racial groups–except for Latinx populations. The report outlines several ways in which Latinx populations’ material needs aren’t being met, such as affordable housing, healthy and nutritious food, transportation, and quality health care. However, there were policies enacted during the COVID-19 pandemic that addressed many of these shortcomings, such as the eviction moratorium and COVID-19 funding that could be used towards food and transportation vouchers.

Addressing pandemic challenges, in turn, was an important approach for addressing social disparities. We are not in the same level of crisis compared to the onset of the pandemic: we know more now and are better equipped, yet we are still challenged with these same issues. Effective public health, housing, and transportation policies could help address the disparities outlined in the Brookings report.

What does the report measure?

Wellbeing scores are a holistic measurement of both material social and economic needs, as well as non-tangible factors that foster wellness. These factors include quality of relationships, community cohesion, and more that are often not considered in traditional measures of human development and wellness.

The decline in overall mental health, and increase of loneliness due to the pandemic has been well documented, which impacts this wellbeing scores, as one of their factors. Local jurisdictions can take some satisfaction in achieving a ranking of fourth overall nationwide for wellbeing, key for supporting the needs and growth of a diverse, multiracial, population.

The Latinx population isn’t reaping the same benefits as other groups

The Latinx community makes up a sizable demographic of DMV residents. With a population of around 900,000, over half of whom are foreign-born (53%), this is a large group that is not benefiting from the same conditions as others in this area. Given the size and the needs of the Latinx population, this is a considerable failure for these local governments, and a disservice to the Latinx individuals that reside within their municipalities. For example, accessing social services in the US is difficult for people whose primary language is not English or have limited-English speaking proficiency– the reality of many foreign-born residents. You cannot ask for help from someone who doesn’t understand that you are asking for help because they do not speak your language. Hence, local governments need to implement policies to not only improve their social services, but also consider if they can be accessed and utilized by the populations that reside in their jurisdictions.

Additionally, around 425,000 undocumented Latinx individuals resided in the metro area in 2016. Of the top 15 metro areas with high Latinx populations, the Washington region is one of two where a majority of its Latinx population was not born in the US (the other being the Miami-Fort Lauderdale-West Palm Beach metropolitan area). Foreign-born residents are disproportionately affected by poverty, with one-third of all immigrants being low-income. Low-income immigrants are more likely to not speak English well and less likely to have a college degree than immigrants who are not low-income. Factors like these make it difficult to engage in social mobility, which encompasses various factors including wellbeing measures, like education, health, and safety.

Nationally, the health outcomes of Latinx populations tend to lag behind their white counterparts or other racial counterparts. These include lower access to quality healthcare, as well as the social determinants of health. Within the field of public health, these determinants are studied to understand how other social factors, such as the built environment, shape people’s health.

Achieving higher wellbeing scores for Latinx populations here in the Washington region, also means changing the landscape of the region to serve undocumented, limited-English speaking, and foreign-born Latinx populations, which in turn can benefit all Latinox individuals and other immigrant communities.

I spoke with doctors, nurses, program directors and managers, and members of boards of directors from Federally Qualified Health Centers (FQHCs) and community based organizations (CBOs) here in the Mid-Atlantic region that predominantly serve Latinx populations about challenges providing services to their clients throughout the COVID-19 pandemic. Every informant reported that their clientele’s needs only became more urgent and dire with the pandemic, but those needs have always existed, such as food insecurity, housing insecurity, and unstable employment.

Some pandemic responses helped

Some specific pandemic-born policies demonstrated the ability of the Washington metro area to materially benefit and provide resources for vulnerable communities. These included policies such as telehealth flexibility and reimbursement, open enrollment for Medicaid, and the mailing of specific medications that had to be picked up in person previously (such as medication provided through the AIDS Drug Assistance Program), implemented after the onset of the pandemic in 2020 and 2021. These improved the quality of life for vulnerable Latinx populations for the better, and canceling these programs since the end of the federal public health emergency on May 11, 2023, leaves those who came to depend on them with fewer options.

Within this region, some FQHCs and CBOs adopted a racial equity emphasis with the onset of the COVID-19 pandemic, addressing Latinx patients’ holistic needs (such as housing and transportation) first, in order to meet their specific health needs. After all, you cannot provide patients care if they are unable to get to your clinic in the first place. Health policy is critical in advancing and addressing some of these disparities, and effective health policy will translate into effective transportation and housing policy. The US Department of Transportation has put together recommendations on health and equity as related to transportation and housing, including transit affordability, rapid on-demand service, and housing costs.

Policy changes during COVID-19 showed that local and surrounding county governments were able to make changes that benefited the Latinx community. Unprecedented times allowed for new measures, but while we cannot always predict times of crisis, we can choose how to react to them, and decide what to keep from that reactive approach. Crises like COVID-19 worsened existing social issues, only further demonstrating the need for holistic policy measures.

Making Latinx wellbeing a priority

We’ve seen some steps forward and back within the Metro area. DC has a medical assistance program for undocumented residents (all of whom are ineligible for Medicaid or ACA programs), but only for those who meet the income requirements and live within DC. In addition to limited availability, there is a lack of Spanish-speaking and culturally competent providers to serve the needs of these communities, further exacerbating inequalities. Maryland rolled back a grandfathering process to certify limited-English speaking community health workers in June 2021 that bypassed a mandatory course– currently only offered in English– needed for state community health workers. We have a ways to go, but we have seen what has worked here in the region due to the unprecedented circumstances of the COVID-19 pandemic.

The Washington region can become a metropolitan area that serves all of its residents. However, if it is committed to advancing to a society that serves people of all racial backgrounds, socioeconomic backgrounds, and immigration status, more has to be done, and more can be done through wellbeing-focused policy measures. Holistic measures that address myriad sources of inequity, and also consider non-tangible factors like community cohesion, can make it possible to benefit the Latinx community and beyond.