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Public health tries to reach minority communities amid COVID-19

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A family of six in Catawba County found themselves in a tight spot — Dad and Grandma tested positive for COVID-19. The mom was left to care for their three children on her own for at least two weeks, all while trying to keep her job.

A school nurse saw their need. Catawba County’s community health workers — a program aimed at assisting hard-to-reach populations — stepped in.

Yesenia Cruz is one of three workers hired this fall by Catawba County Public Health with COVID-19 relief funding from the state. She was there to help the Hispanic family, Public Health Strategist Honey Estrada said. Cruz spoke with the mom's employer to help her fill out Family and Medical Leave paperwork and keep her job while caring for her kids and isolating effectively.

“That’s just one story, but you think about what could have happened if she wasn't able to access the resources she needed — how it would have impacted her family, her employer,” Estrada said.

Estrada and the team at Catawba County Public Health knew early on that the COVID-19 pandemic would significantly challenge Black, Hispanic and Asian communities because minority communities face language and cultural barriers.

“At the very beginning with COVID-19 we knew that there was especially going to be an impact in our Latinx and African American communities,” Estrada said. “We knew they were disproportionately going to be affected.”

Those communities were likely to be impacted by the pandemic because of several factors, Estrada said. People of Asian origin are 1.5 times more likely to live in poverty than a white person. People of Black or Hispanic origin are about three times more likely, according to the county’s 2019 community health assessment. In areas with higher poverty levels or more minority populations, the life expectancy is lower, Estrada said.

The pandemic posed bigger threats, Community Engagement Specialist Emily Killian said. “Those communities are already at higher risk of poorer health outcomes than other communities in our county so what we really want to do is make sure those communities have opportunities to improve their health status,” Killian said.

Before the pandemic, the health department was already making strides by connecting with local pastors.

“We look for opportunity to speak with pastors because they are very trusted members of the community and they speak with a lot of people in a given day or week or month,” Estrada said. “They have a lot of influence over their community. We want to make sure they have info so they can give it to people.”

By informing pastors and other community leaders about how public health can care for people, the leaders are able to direct their congregants and confidants to help when they need it, Killian said.

Those connections are crucial in a pandemic. First, the message was to wash your hands and stay safe, then to stay inside, then to wear masks. Public health also asked for help in getting people to answer contact tracing calls and tell the truth — a challenge in every community.

When testing became widely available, public health made a push in minority communities to make sure people knew testing was available. Public health had bilingual staff at the testing site at all times and all material was available in multiple languages, Killian said.

Now, with the vaccine finally available, minority communities will be the hardest to reach and most important to get vaccinated, Estrada said. She hopes a new program bringing on health workers with strong connections to small communities will help.

This fall the health department has turned to the new strategy for reaching people — community health advocates. Catawba County was one of seven chosen by the state to hire community health workers to help and support disadvantaged individuals and families in their communities.

Catawba County has hired three so far, one Hispanic advocate, one Black advocate and one white advocate. The three, who were brought on in October, represent the largest communities in Catawba County. The health department plans to hire more, Estrada said.

So far, the community health workers have served 3,000 people who needed aid because of the pandemic, including the family of six hampered by the virus.

Help looks different for each person, Estrada said. They may need help getting tested, help deciding if they should isolate, help getting health care if they lost their job due to COVID-19, or something more.

“It really just depends on what that community member needs,” Estrada said. “COVID is very broad, it’s affected people on so many different levels.”

The work they’re doing has had an impact, Estrada said. They were reminded of that by a thank-you card from a child of the family of six.

“A couple of weeks later (the mother) stopped by and her daughters had made an absolutely heartfelt — will bring tears to your eyes — card,” Estrada said. “It really reminded me of what was important.”


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