Oxnard-raised duo tries to bridge COVID-19 health care gap for Latinos – Ventura County Star

Casimiro Lepe broke his foot when his son, Bismarck, was 3. The migrant worker refused to see a doctor, limping for months as he picked peaches in the Central Valley and strawberries in Oxnard.
“It was really expensive and he had a family to feed. He was like, ‘I’ll power through it,'” recalled Bismarck Lepe, now 42. “He wore two or three socks and he tied his boots tighter.”
The farmworker held off on care until he returned to his small town in Jalisco, Mexico, where a physician who happened to be his brother could treat him for free.
The memory stuck with the younger Lepe as he grew up in Oxnard, earned an economics degree from Stanford, worked at Google and launched lucrative start-up companies. The barriers to care his father faced grew into potentially deadly blockades for Latinos as COVID-19 raced across the nation.
Latinos are twice as likely to die from the disease as white non-Hispanics and almost three times as likely to be hospitalized, according to recent data from the U.S. Centers for Disease Control and Prevention.
In Ventura County, Latinos make up 45% of the population and contract COVID-19 more often than any other group. Though their death rate from the disease is lower than that for whites,  they’re less likely to be vaccinated and represent 49% of the people hospitalized for the disease over the last two years.
There are many inequities. Language is one of the biggest, Lepe said in a phone interview from his Bay Area home.
“People who speak English know they need to be vaccinated and they know where to get vaccinated,” he said. “That isn’t as readily available to the Hispanic population… They’d have to miss an entire day of work. If it’s something they don’t feel is life-threatening, they don’t do it.”
Lepe believes technology can help bridge the equity gaps. He and his business partner, Dr. Devon Huff, raised $5 million to start a health-tech company called MiSalud – My Health – and launch an app that connects Latinos online with Spanish-speaking coaches and doctors who provide wellness advice, virtual examinations, and information about COVID-19 care, vaccines and test sites.
Eventually, subscriptions to the app will be sold to individuals and companies that employ Spanish-speaking workers. Because of the pandemic, the app is being offered for free to individuals across California.
“We think there is a huge opportunity to help this community that has been decimated by COVID because of the long-standing inequities,” Huff said.
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Huff also grew up in Oxnard.  His father and grandfather were family doctors there. He and Lepe graduated from Oxnard High School in 1998, both near the top of their class.  While his friend went to Stanford, Huff headed to UCLA, then medical school in Buffalo, becoming a general surgeon.
Factors such as lack of health insurance, difficulty finding doctors who speak Spanish and fears about immigration status have long pushed Latinos away from health care.
During the pandemic, people put off treatment for many conditions because they were afraid to go to hospitals. A higher proportion of Latinos are at risk for COVID-19 exposure because they work at essential jobs that place them in constant contact with other people, such as in restaurants, hotels and farm fields.
Latinos are also at higher risk for obesity, diabetes and other chronic conditions, leaving them more vulnerable to severe illness from the coronavirus.
“You’re like, ‘Holy crap, how is one group hit that much harder than everyone else,” Huff said. “It hits people who are marginalized substantially harder than we would have guessed.”
The new online health platform is structured to promote wellness by connecting people virtually to a network of Spanish-speaking coaches in Mexico who are physicians, understand Latino culture and serve as the first line of contact, Huff said.
People who need medical treatment for any condition are then connected to Spanish-speaking physicians in California who offer online care, prescriptions as warranted and referrals to hospitals or urgent care centers.
The doctors and coaches answer questions about COVID-19 symptoms and provide guidance on when people need hospital care, how long they should quarantine and where they can go for vaccinations and tests.
Maybe most of all, MiSalud staff try to offset the torrent of misinformation about COVID-19 and unfounded fears of vaccinations.
“There are a lot of people who don’t have a relationship with a doctor,” Huff said. “They have Google. When you start searching you find all sorts of stuff out there.”
In Ventura County, vaccination and COVID-19 outreach events have targeted farmworkers and Latino communities throughout the pandemic. Advocates have gone door-to-door in neighborhoods with higher transmission rates. Private and government health systems cater to Latino communities, offering telehealth and in-person care. 
Health care inequities in Ventura County are different than those in other regions of the country, said Rigoberto Vargas, the county’s public health director.
Though the pace of COVID-19 infections and hospitalizations among Latinos locally is high, the death rate doesn’t match national trends. Latinos represent 45% of the county’s population but makeup 35% of the 1,284 COVID-19 deaths. White non-Hispanics represent 43% of the deaths.
Vargas said it’s unclear why Latinos have a comparatively lower mortality rate, though it could be an indication that access to health care and quality of care is better here.
But the cultural barriers are real and so is the need for more health care, said Carolina Gallardo-Magana, a Latino community advocate who lives in 93033, the Oxnard zip code with the most COVID-19 cases in Ventura County.
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“If it doesn’t hit our family, we don’t believe it’s bad,” she said. “When it hits our family directly, we believe it’s true. It’s happening.”
Gallardo applauds efforts to connect people with doctors and provide more information about COVID-19 but worries about relying on computers and smartphones.
“A lot of people don’t have access to the technology,” she said.
Huff said technology and COVID-19 are pushing medicine toward apps and telehealth. He worries that too few of the platforms focus on the people who may need help the most.
“The Hispanic population is always an afterthought,” he said. “We are intentionally creating a system that is culturally relevant.”
Lepe said he’s involved in the push for change because of his upbringing. He remembers shivering in the cold when his parents schlepped him to the citrus groves at 5:30 a.m. He remembers hearing them worry about whether they could afford a doctor.
“This is very personal,” he said.
His parents left the fields to raise the family in Oxnard, where they still live. His mother went back to school and then re-entered the workforce. His father was an electrician for decades. They have insurance and money. They still go to Mexico for health care because they think it costs less and it’s what they’ve always done.
Lepe said his goal is to give people more health care options and push them toward preventative care. He said the COVID-19 crisis shows the urgent need to connect more people with doctors now.
“People are dying because of access,” he said.
For more information about MiSalud, see misalud.ai.
Tom Kisken covers health care and other news for the Ventura County Star. Reach him at tom.kisken@vcstar.com or 805-437-0255.
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