COVID-19: Emerging Community Needs and Policy Solutions

"Raising the influence of community voices on health equity..."

In response to the ongoing COVID-19 pandemic and its disproportionate impact among communities of colour and marginalised and underserved groups in the United States (US) and globally, Health Equity Initiative (HEI) designed, organised, and hosted a Community Leaders Forum, the first in a series, to highlight the insights of community leaders from across the US who are working to address COVID-19 inequities. This document includes a transcript of the discussion and recommendations for policy solutions that are grounded in the experience of the community leaders who participated.

Moderated by Dr. Renata Schiavo (HEI founder and board president) and Tonya Lewis Lee, JD (entrepreneur, producer, writer, advocate, and health equity champion), the forum asked leaders who represent Black, Brown, and Indigenous communities in the US about: (a) the ways in which the coronavirus underscores existing challenges with health equity, (b) emerging community needs in light of the COVID-19 pandemic, and (c) community-driven ideas for policy solutions that may address emerging needs and priorities that contribute to COVID-19 inequities.

Among the themes that emerged from the discussion is the existing lack of trust in the healthcare and social systems among communities of colour, immigrants, and other key groups. These groups have reasons to believe that implicit bias, which can be expressed as racism or xenophobia, and a history of racial and social discrimination in healthcare settings may influence quality of care and the allocation of scarce life-saving resources in the event they contract COVID-19. One panelist, a community engagement policy analyst for the All of Us Research Program, explained the strategy this group has adopted, which includes bringing community members and medical personnel together to talk about trust and mistrust of medical establishments and participation in medical studies.

Other emerging issues include the increasing stigma toward people living in homelessness or with a substance use disorder, which complicates the ability of local community-based organisations (CBOs) to attend to the needs of these populations during COVID-19. In fact, an underlying message communicated in the forum is the importance of local CBOs - not only in calling attention to community-specific needs but also in designing the kinds of solutions and policy changes these communities require.

Directed at policymakers and/or other leaders and organisations across professions and disciplines who can effect change during COVID-19 response and recovery, the recommended solutions include:

1. Increase awareness of rising food insecurity, unemployment, and financial vulnerability among communities of colour and other marginalised and underserved groups, such as immigrants, people living in homelessness, and/or with a chronic condition or with a substance use disorder. Engage the public, policymakers, and community leaders via tailored awareness and advocacy efforts.
2. Develop a plan to mobilise and increase resources for hospitals and other clinical services in underserved neighbourhoods. Map existing resources and needs, tell patient stories, and address gaps, with a focus on collective benefits of strengthening the capacity of local clinical resources to mitigate COVID-19.
3. Create interventions and prioritise funding to address the increase in loneliness during the pandemic and its mental health impact among people living with disability and other marginalised communities.
4. Address the digital divide as it relates to quality of and access to the internet in underserved neighbourhoods, build health literacy and media literacy skills among disenfranchised community members, and discuss implications for telehealth, education, social connectedness, etc. during COVID-19 and beyond.
5. Expand the reach of and access to public and healthcare services available to immigrants.
6. Prioritise grant-giving to CBOs.
7. Improve access to and affordability of healthcare services to mitigate the impact of healthcare costs among low-income communities.
8. Continue to expand access to the Supplemental Nutrition Assistance Program (SNAP) by relaxing application requirements.

HEI plans to explore each of these themes in detail in future events and resources.

A concluding message: "Share the call to action and full report with your community, organization, and local representatives - as well as on social media - to advocate for the kinds of social and policy changes marginalized and underserved communities need to see in order to address inequities."

Click here to listen to the recording on SoundCloud.