Dr. Miguel Ruiz

Thank you, Barry. I think you bring up very important points and obviously coming from your own experience, a realization that, boy, this is a challenging area to tackle today. and yet is actionable. There are things that one can do that are specific and that make a difference. I think COVID-19, I think this pandemic has really given us another view of the

Thank you, Barry. I think you bring up very important points and obviously coming from your own experience, a realization that, boy, this is a challenging area to tackle today. and yet is actionable. There are things that one can do that are specific and that make a difference. I think COVID-19, I think this pandemic has really given us another view of the

of the impact of this social- It was a wake up call. Totally. I mean, the impact of the socioeconomic and educational level and so forth. We saw clearly that Latino black were not only affected more by infected more than whites, but also got sicker and had higher mortality.

of the impact of this social- It was a wake up call. Totally. I mean, the impact of the socioeconomic and educational level and so forth. We saw clearly that Latino black were not only affected more by infected more than whites, but also got sicker and had higher mortality.

So a lot has gone into why, and I remember reading a study from Harvard, looking at their population in Massachusetts, in which they clearly identified for the Hispanic Latino was the fact that they were living in overcrowded houses with multi-generational members of the family.

So a lot has gone into why, and I remember reading a study from Harvard, looking at their population in Massachusetts, in which they clearly identified for the Hispanic Latino was the fact that they were living in overcrowded houses with multi-generational members of the family.

meaning children that were going to school and going out with elderly parents who were living under the same roof and without little ability to do more isolation when one was infected, with less health insurance to go and be tested, with perhaps less means to drive to a testing site, that somebody who may have access to a car.

meaning children that were going to school and going out with elderly parents who were living under the same roof and without little ability to do more isolation when one was infected, with less health insurance to go and be tested, with perhaps less means to drive to a testing site, that somebody who may have access to a car.

And also with some of those middle-aged individuals in that same house working in a meat processing plant where high noise requiring to shout and scream to communicate also contributed to higher transmission. And then you look at the black community living in high-rise apartments using more public transportation, and they identified all these

And also with some of those middle-aged individuals in that same house working in a meat processing plant where high noise requiring to shout and scream to communicate also contributed to higher transmission. And then you look at the black community living in high-rise apartments using more public transportation, and they identified all these

totally socioeconomic factors that made a difference into and obviously with under higher rates of underlying comorbidities diabetes and pulmonary diseases that place individuals at higher risk for complications from covid so just to give you yet one more in case we didn't have enough one more view and taste of how these factors do impact uh these uh these communities uh and who are um

totally socioeconomic factors that made a difference into and obviously with under higher rates of underlying comorbidities diabetes and pulmonary diseases that place individuals at higher risk for complications from covid so just to give you yet one more in case we didn't have enough one more view and taste of how these factors do impact uh these uh these communities uh and who are um

been marginalized and who are at a disadvantage. So I think, glad that you mentioned Barry, the issue of cultural competence, because, and again, one of the factors for COVID was new arrivals. You talk about the new waves of people arriving for the Hispanic Latino newcomers have not only no connections in the community to know where to seek care, but also no health insurance.

been marginalized and who are at a disadvantage. So I think, glad that you mentioned Barry, the issue of cultural competence, because, and again, one of the factors for COVID was new arrivals. You talk about the new waves of people arriving for the Hispanic Latino newcomers have not only no connections in the community to know where to seek care, but also no health insurance.

The Hispanic Latino is the most uninsured community in our country. therefore delaying care. I had so many cases during COVID-19 coming to the hospital with an advanced case of COVID with complications, having to be intubated in the medicine department because they were not able to be tested because they didn't have the

The Hispanic Latino is the most uninsured community in our country. therefore delaying care. I had so many cases during COVID-19 coming to the hospital with an advanced case of COVID with complications, having to be intubated in the medicine department because they were not able to be tested because they didn't have the

the health literacy to be able to understand where the risk factors of the symptoms were. But what can we do? And you mentioned the word cultural competence. And I think I have a bit of a special feel about that concept because in my mind, I prefer to use the term cultural humility.

the health literacy to be able to understand where the risk factors of the symptoms were. But what can we do? And you mentioned the word cultural competence. And I think I have a bit of a special feel about that concept because in my mind, I prefer to use the term cultural humility.

And just to make the point very, very, very quickly, the one aspect that I don't like about the term cultural competence is that the word competence assumes some degree of mastery, of expertise, of arrival. We got it. We are now incompetent.

And just to make the point very, very, very quickly, the one aspect that I don't like about the term cultural competence is that the word competence assumes some degree of mastery, of expertise, of arrival. We got it. We are now incompetent.