With Demand For Community Health Workers Rising, So Does Need For Sustainable Funding

Promotoras de salud, also known as community health workers, are helping to connect Latino immigrants with reliable and factual information about COVID-19. Using a peer-to-peer outreach model, a team of seven promotoras de salud from Centro San Bonifacio have "interacted with more than 4,000 Spanish speakers in Chicago."

After becoming a COVID-19 hotspot, Guadalupe built partnerships and built trust among community members to effectively track cases, dispel misinformation, and increase vaccinations. The Town Council partnered with Pascua Yaqui tribal leaders, the broader Maricopa County, Native Health, and a COVID-19 response team composed of faculty, staff, and students at Arizona State University to lower infection rates. A combination of at-home testing, contact tracing and, eventually, vaccination events helped, as did the use of promotoras – community health workers who talk with residents to help ease anxiety.

The COVID Ambassador program trains people to listen, be empathetic, and acknowledge people’s COVID-19 vaccine concerns. Ambassadors’ training includes substantial practice talking to people who are resistant to getting vaccinated and they receive ongoing support at bi-monthly meetings, which has increased their confidence and led to more conversations with community members hesitant to get vaccinated. Like other community health worker programs, the ambassador program’s ability to be successful relies on the idea that people trust information from their peers more than from the government.

Accredited social health activists (ASHA) across India fight COVID-19 related misinformation on WhatsApp. ASHAs provide basic health care to people in their villages, which puts them on the frontline of treating COVID-19 patients and educating people to dispel the many myths about the virus and its treatments. ASHAs' local interactions often identify prevailing myths, which they quickly dispel in their face-to-face exchanges and by posting in the many local WhatsApp groups that have been created. The local groups have been an effective mode of educating people and helped ASHAs gain villagers’ trust.

One rural hospital in Indiana vaccinated hundreds of immigrants from Central America by working with trusted community leaders and setting up a Hispanic Health Task Force. Health officials held vaccine clinics alongside trusted community members at locations that were familiar to residents, like a local Catholic church that offers Spanish-language services. The hospital and task force initially established community connections to distribute information about COVID-19, so they were able to utilize the connections to increase vaccination rates once the vaccine rolled out.

Community health workers from One World have gained community trust over the years and now go door-to-door to talk with residents about the COVID-19 vaccine and dispel misinformation. They provide resources in Spanish and carry vaccines in a refrigerated bag so residents can get vaccinated on the spot. The group has invested a lot of money, time, and personnel having intensely personal conversations with people. They also host pop-up clinics in the community and allow at-home vaccination appointments. The areas served by One World has seen more vaccinations than almost anywhere else in Nebraska.

The White Mountain Apache Tribe in eastern Arizona was able to slow the spread of Covid in the community by implementing a daily routine of "contact tracing, surveillance of high-risk individuals, and vaccinations." Since starting the regimen – which includes going door-to-door to community members' houses to monitor potential exposures, symptoms, and to offer vaccines – the tribe has curbed the spread and hasn't reported any more deaths in months.

To extend aid to the Minnesotans most vulnerable to the coronavirus, state and local health departments, backed by $4 million in state funding and by community groups' on-the-ground help, conducted an extensive campaign of culturally appropriate outreach to offer free COVID-19 tests and healthcare advice. The efforts have included one-on-one contacts, email blasts to free-school-lunch recipients, and TV and radio ads on media targeting Black, Latinx, immigrant, and refugee populations. Immigrant communities and people of color have been disproportionately hit by the pandemic.

The Community Health Representative Program has been helping connect the Navajo Nation with health-care resources for decades, but when the Covid-19 pandemic began to impact community members, the role of the representatives shifted. By "using their knowledge of the community in a different way," the representatives have largely become contact tracers, a role they are uniquely suited for given their understanding of the importance of cultural competency and their longevity in the community.

The city of Baltimore escaped the worst of COVID-19 with high vaccination rates, high rates of health coverage, and strong support from political leaders who cooperated across ideological lines. Medicaid expansion helped achieve relatively high health insurance rates. Officials were also a bit more and cautious in reopening businesses and schools and relaxing mask requirements. The city didn’t escape the death and illness seen during the pandemic, but for these reasons it fared better than comparable areas.