Ask the expert: Covid-19 and obesity

Ask the expert: Covid-19 and obesity


This resource was created with support from Pfizer.

The experts:

Kelynne Oristel, RN-BC, DDN PNL, APRN-BC

President of the New York Metropolitan Area Haitian Alliance Nurses Association

Adrianna Nava, PhD, MPA, MSN, RN

President of the National Association of Hispanic Nurses

How has the COVID-19 pandemic impacted the community you serve?

(Kelynne Oristel) When we look at the pandemic and where we come from, shall we say, I basically see my clients living with some of the consequences, or some of the hangovers, of being sick with Covid. We need to understand that obesity itself is a significant risk factor for disease and having, being obese predisposes you to a lot of medical problems – high blood pressure, high cholesterol, uh, asthma, you know breathing difficulties and then having, uh, Covid makes it even worse the fact that, and knowing my community, my people, you know, were very reluctant to seek assistance during that time, and there were some trust issues. So those things that I think, uh, have had a huge impact on access for, you know, people within my community. And those that I work closely with who are, you know, disproportionately, you know, at a disadvantage regarding access to health care and health promotion and health maintenance activities.

( Adrianna Nava ) In my role as president of the National Association of Hispanic Nurses, many of our advocacy efforts focus on the Latino community, and we know that in advocating for improved health outcomes for our community, the Latino community has experienced an impact significant, since the Covid-19 pandemic. We have recorded higher infection rates as a population and higher mortality rates. There has been an economic impact as the pandemic, surely, has been bad for those people who work in industries like retail and food service and have been greatly impacted by the pandemic, and then there has also been an impact on the education as were our Latino children who were sometimes unable to transition to remote learning due to limited access to technology and the internet. So these are some of the things or ways our community has been impacted by Covid.

Have you seen that people living with obesity have been more affected by Covid-19 than others?

(Kelynne Oristel) There were some huge, uh, disparities regarding clients who have obesity and other risk factors that predispose them to certain diseases, like diabetes and asthma. So these diseases had a big impact, because they were there in the beginning. Obesity itself, although people find it hard to understand that it is a chronic disease, further puts people at risk for illnesses and complications related to Covid-19 in general.

What has complicated coping with Covid-19 symptoms for the community you serve, and did you feel they had enough information and resources at their disposal?

( Adrianna Nava ) One of the things that has complicated some of the ways to deal with symptoms or their experiences with Covid-19 has been the significant amount of misinformation being spread throughout the Latino community, and this information and misinformation has been spread in a variety of channels, including social media, mutual messaging apps, sometimes word of mouth, and some of the examples of misinformation were, you know, related to some of the conspiracy theories, false cures and treatments, or misleading information about vaccines, so sometimes it would be a little more difficult for our community to actually have the correct information and get it in a language that would make them more accessible and able to treat their symptoms or seek care. So this was something that our organization aimed to address and unfortunately our community has experienced a fair amount of poor health outcomes as I mentioned earlier but one of the things we are trying to do is fight this information and by uniting to other coalitions to make sure that our community and other communities have the most up-to-date and correct information available.

Because we work with patients from different cultures, we understand that some patients may not feel comfortable asking questions. In your association, how do you ensure that your patients get their questions answered? How do you make sure they understand their treatment options and how do you help them navigate these options?

(Kelynne Oristel) Questioning the vendor in my community who is, uh, Haitian, uh — you know I’m of Haitian descent and most of the, uh, my customers are of Haitian descent — there’s a struggle, right? In the Haitian community, when you have someone accessing health care, they don’t ask questions. You’d be lucky to get them to do what you ask them to do to cure the disease. Part of it is seeing someone they can relate to, right? To communicate the need to ask questions, and as an organization, we try to enable those people in the community to ask specific questions, uh, when I get out of here today — and we might need someone to translate it for them because, or make it as simple as possible. When I leave here today, what should I follow? If you have been prescribed this drug, what is it for? How do I take it? So it’s really about making things as simple as possible, so when your clients come to you and they come with these alternatives, complementary alternatives, uh, modalities or, or treatments, don’t let them get away. See how we can actually make this work as part of the treatment regimen? Part of the, uh, thing about getting people comfortable, uh, to ask questions, they have to feel comfortable with the, the, person who’s delivering the message, right, and not feel overwhelmed or not feel, uh , minute or small, as if this person were bigger than me. We have to put our customers at ease and therefore provide accurate information. Don’t discourage, uh, their cultural practices because that impacts their pursuit of health care, right? So those, I think, are quite important,

What are you doing to educate your nurses to better serve diverse communities?

( Adrianna Nava ) One of the things that we have really focused on as an organization is the professional development of our nursing workforce and, in part, you know, active communication, empathic listening, being able to learn about different cultures and, the importance of diversity, just because we want to make sure our nurses are able to treat different types of patient populations, not just our Latino community, but making them aware and comfortable doing so, and one of the other things we do specifically for obesity is that we work within the Nurses’ Obesity Network, and this is a diverse group of nursing organizations that are committed to changing how we view treatment and advanced care for people living with obesity, not how a proud member of this organization, and we focus on creating materials, educational materials, for our members, as well as advocating and making sure to educate lawmakers about the different options for addressing obesity, as well as looking at it from a prevention perspective but also from a treatment perspective, so we can improve outcomes for our communities. So some of the things that we focus on is educating our nursing workforce. We also work with the American Nurses Association. They have a Healthy Nurse, Healthy Nation initiative that’s really cool and focuses on the nursing workforce, how they can integrate some of that, you know, sometimes as nurses, we, we, you know, take care of other people and not we are the best at taking care of ourselves. So making sure they have access to education about adequate nutrition, physical activity, etc., but then also looking at it from the outside lens of how we advocate for change, and some of our work has been focused on legislative change.

Can you share your success in how you are handling not only the obesity conversation, but more importantly the obesity care continuum in the time of Covid-19?

(Kelynne Oristel) For those who weathered the storm, um, and are here today, let’s not forget that those, you know, based on some stats — and, you know, look at the CDC stats — that, um, you know, there was an increased risk of hospitalization for those people who are of a certain age, especially 65 and older, and those with an increased BMI, of course, were also at risk, um, but because, uh, the , the your height, uh, in 2020, we’ve made, uh, big strides, right? So through, um, vaccinations, um, really pushing, uh, people to get vaccinated even though there was tons of misinformation. I know in the community that I serve now, a lot of people went to get vaccinated, and in the beginning, these are the same people who were, you know, anti-vaccination, so we’re making, uh, leaps and bounds. We’re still trying to fight, you know, some of these misconceptions, and, saying, saying, that gaining, uh, um, weight puts you at higher risk for certain diseases, and if you were to get sick with something like Covid- 19 or, er, er, the flu, being obese makes managing that disease, that acute disease, a little more difficult, and so it’s about educating the community. It’s about, uh, sharing information.

(Adrianna Nava) As nurses within our organization, uh, we’ve played a big part in being out in the community, even once we’ve been able to get the vaccines, uh, making sure they’re available, and we’ve had many of our nurses out in the community providing immunizations to the community that sometimes didn’t have access or a regular source of care. So, I think that, uh, it’s definitely helped with the vaccination rates which, for the Latino community, were very low to begin with, but we’ve seen it at least increase significantly, so I think that’s been a big win for our community. .