CHARLOTTE, N.C. -- As the coronavirus continues to affect North Carolina's Latino communities, outreach workers are providing public health information, in Spanish and culturally relevant to this growing population.

Hector Salgado, community impact director for the American Heart Association in Charlotte, was spearheading an effort to raise awareness about heart health and blood-pressure monitoring among Latinos when the pandemic hit. With help from the Mecklenburg County Public Health Department and Blue Cross/Blue Shield, he said, the program pivoted to COVID-19 prevention. As the crisis worsened, Salgado said, he began to notice what he described as rampant misinformation in the Latino community.

"And those resources are not reflected," he said. "I went to the farmer's market and I saw signs, I saw social distancing. And then, I go to the flea market, where there's a lot more Latinos, and I don't see any signs, I didn't see any social distancing."

This month, he said, ads in print, on radio and social media will emphasize the importance of wearing masks and include Mecklenburg County's COVID hotline number. Anyone with questions or concerns about the coronavirus can call 980-314-9400.

Salgado said the six-week heart-health pilot program has transitioned to virtual classes and now is training more than 100 community members on how to monitor blood pressure. He noted that around 47% of Hispanic men and 40% of women have hypertension. Research shows that puts a person at higher risk for severe COVID-19 illness.

"Particularly with a lot of the churches, they said, 'People would come out here and give us a lecture on blood pressure, but nobody gave us the machines to actually do it.' So, we created this curriculum with this mentality that the community has most of the resources that they need," he said. "We're going to give them the things that are missing."

In the past decade, Salgado said, North Carolina's Latino population has nearly tripled -- and yet, these neighborhoods often are neglected in terms of public-health outreach.

"You know, as a Latino, I think that we need to start demanding more," he said. "We need to start asking why, if we're accounting for 50% of the cases, where is the accountability? Where are the resources going to make sure these numbers are coming down?"

He said he hopes the "Promotores de Salud" initiative results in more testing, increased mask-wearing and greater social distancing among Latino residents.

California could be in for some big cuts to health care for low-income families under a second Trump administration, according to health experts.

Policy specialists at the nonprofit KFF said they are bracing for Trump allies in Congress to make major reductions to Medicaid expansion under the Affordable Care Act, in order to pay for big tax cuts promised by the president-elect.

Larry Levitt, executive vice president of health policy at KFF, said it would force states to backfill or raise costs.

"For the ACA, simply letting enhanced financial aid expire after next year would result in big out-of-pocket premium increases, reduced enrollment and more people uninsured," Levitt projected.

Robert F. Kennedy Jr., President-elect Trump's choice for Health and Human Services Secretary, did not say much on the campaign trail about funding for Medicaid or the Affordable Care Act, so his positions are unclear. Kennedy has expressed skepticism about vaccines and has said the U.S. should stop putting fluoride in drinking water.

Jennifer Kates, senior vice president and director of the Global Health and HIV Policy Program for KFF, said the Centers for Disease Control and Prevention cannot require states to follow its recommendations on vaccines and fluoridation.

"That's up to states and local governments," Kates explained. "But CDC can recommend, and if those recommendations are not being made or being watered down or changed, that sends a message to states, to schools, to parents."

Health advocates are also raising concerns DACA recipients could lose access to health plans sold on the state marketplaces created under the Affordable Care Act. Changes to so-called "public charge" rules could make families with mixed immigration status hesitant to use Medicaid benefits.


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Some Kentuckians are more likely to be diagnosed with cancer and more likely to die from the disease than others.

Dr. Nathan Vanderford, associate professor of toxicology and cancer biology at the University of Kentucky College of Medicine, said Kentucky has a massive cancer problem. The Commonwealth ranks first in the nation for overall cancer incidence rates and second for overall cancer mortality rates, around 30,000 cases each year and 10,000 deaths. He added Appalachia is ground zero for cancer.

"What's worse is that the cancer problem is significantly greater in eastern Kentucky," Vanderford pointed out. "There are 54 counties in Eastern Kentucky that are in the Appalachian region and cancer rates there are significantly higher."

Lung cancer incidence rates are more than 100% higher in Eastern Kentucky versus the national average. Appalachian Kentucky residents are 8% more likely to die from a preventable or screenable cancer than their non-Appalachian counterparts.

Vanderford pointed out more than 150 Appalachian students have participated in the Appalachian Career Training in Oncology program, an education and intervention program aiming to address cancer disparities. Dozens of participants have gone on to medical school.

"We engage high school students and undergraduate students from any of the 54 Appalachian counties in cancer research, cancer education, clinical shadowing, all around the goal of motivating and preparing them to pursue cancer-related careers," Vanderford outlined.

Holly Burke, coordinator of the program, said participating students explore how cancer has affected their families and communities, particularly lung cancer.

"They talked about experiences with cancer and why they think the rates are so high," Burke observed. "And then they also gave solutions on what they think can be done to lower those rates."

The American Cancer Society recommends yearly screening for lung cancer for people aged 50-80 years old who smoke, or formerly smoked and have a 20-pack a year or greater history of smoking.

By Marlowe Starling and Andrew Wasley for Sentient.
Broadcast version by Mike Moen for Minnesota News Connection reporting for the Sentient-Public News Service Collaboration

As global leaders at the UN in New York pledged to tackle human suffering caused by antimicrobial resistance, the U.S. food giant Cargill was found to be slaughtering cattle containing residues of powerful antibiotics.

Data obtained by the Bureau of Investigative Journalism (TBIJ) covering the past two years showed that farms supplying Cargill are still using antibiotics that the World Health Organization (WHO) deems vital for human health.

Two years ago, TBIJ revealed that Cargill, which sold beef to McDonalds, sourced meat from farms that used at least five critically important antibiotics. At the time, Cargill said it was "committed not to use antibiotics that are critically important for human medicines," although it defended using other human antibiotics in farming.

This time, there were 12 different antibiotics found to be in use, including two of the most important types.

These drugs, known as "highest priority critically important" antibiotics or HP-CIAs, are so important for human health that the WHO warned livestock farmers to stop using them entirely. Use on farms can make the drugs - which are often the last treatments available for treating serious bacterial infections - less effective.

Leaders attending the high-level meeting at UN headquarters yesterday made an international declaration to cut the number of deaths caused by antibiotic resistance. The draft specifically mentions cuts in drug use on livestock farms.

Megan Brown, a sixth-generation hog and cattle farmer based in California, said that enforcement of existing rules on antibiotic use in farming in the U.S.: "Historically, we've shown we really can't be trusted unless we're made to."

Cargill said there was no evidence that beef with excessive antibiotic residues had entered the food chain as any cattle testing at these levels would be segregated, and that the company complied with relevant food safety standards.

New Rules in Farmers' Hands

In 2023, the US Department of Agriculture introduced a rule requiring a vet's prescription before farmers could get antibiotics for their animals. However, the new rule still leaves farmers in control of how to give antibiotics and relies on them to make sure there's enough time between treatment and slaughter, according to Crystal Heath, a vet.

Heath is also the founder and executive director of Our Honor, a nonprofit that advocates for animal welfare. She says that intensive livestock farming has created a vicious cycle that relies on confining animals in smaller and smaller spaces. This in turn increases the risk of sickness, leading to more antibiotics being used. "This is going to be a problem for as long as we raise animals this way," she told Sentient and TBIJ.

Daniel Czyz, a microbiologist at the University of Florida who studies antimicrobial resistance, said: "It all boils down to lowering the price of the production and increasing the profits for producers that are already struggling."

The FDA rule was meant to minimize people's exposure to antibiotic-resistant bacteria, which can increase the risk of superbugs spreading to people.

Antibiotic residues can linger in meat products if an animal is slaughtered too soon after being treated, before the drug has cleared its system. The U.S. government routinely investigates livestock farms that send animals for slaughter that contain drug residues, including antibiotics.

Brown, the cattle farmer, said that while some farmers still felt under pressure to send their animals on for slaughter soon after treatment, the FDA rule had changed how she used antibiotics. "I'm not going to send it to the yard until I know the withdrawal is gone," she said.

These days Brown uses vaccinations more often than antibiotics, which she says boosts the value of her cattle while reducing the risk of disease. The drugs, she added, are expensive.

Antibiotic Wild West

While Brown has taken steps to reduce antibiotic residues, the US Department of Agriculture's food safety agency recently questioned certain meat industry claims that some beef products have been raised without antibiotics.

The agency collected samples from nearly 200 cattle slaughtered at U.S. meat-packing plants and analyzed them for 180 veterinary drugs. One in five of the samples from the "raised without antibiotic" market contained antibiotic residues.

A prominent industry association continues to defend some controversial uses of antibiotics. Social media posts by the Animal Agriculture Alliance (AAA), a lobby group with links to Cargill through one of its board members, appear to endorse "preventative" antibiotics for farm animals - using the drugs on animals who are not unwell - despite concerns that this increases the risk of drug resistance. Preventative antibiotic treatment was recently restricted in the EU in 2022.

Another AAA post claims that there is "little overlap between antibiotics used in animal agriculture and antibiotics used in human medicine." This is at odds with the views of many public health experts, including the WHO, who agree that farms' use of antibiotics is directly contributing to drug-resistant disease in humans.

The AAA did not respond to requests for comment.

Cargill said: "Our position has been and continues to be a commitment to finding ways to reduce the use of human antibiotics across our operations and supply chains, while protecting the health and well-being of animals in our supply chains."

"We don't want to use antibiotics in agriculture that are clinically used for humans," said Czyz. He warned that once a disease develops resistance to a drug, it's difficult or impossible to reverse.

For real progress to happen, according to Czyz, there needs to be a coordinated global approach to the problem of antimicrobial resistance, as shown at the UN this week. "We cannot target [antimicrobial resistance] at one place if another place neglects the issue," he said.


Marlowe Starling and Andrew Wasley wrote this article for Sentient.


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