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How Community Health Workers Support Access to Health Care During A Global Pandemic

On February 17, 2021, Community Health Workers (CHWs)/Promotores de Salud (Ps), Loma Linda University volunteers, and members of local churches gathered in Adelanto to help vaccinate 250 low-income, marginalized seniors. All over the country, non-Hispanic white individuals are being vaccinated at a higher rate than their Hispanic counterparts. This event was meant to combat that. 

Loma Linda University Health Professionals and El Sol Neighborhood Educational Center Community Health Workers and Promotores at an Adelanto Pop-Up Clinic for the COVDI-19 Vaccine

Data from the Centers for Disease Control and Prevention (CDC) shows that out of all the COVID-19 vaccines given as of February 25, 64% were given to non-Hispanic white individuals versus 9% for Hispanics. This data should be alarming to all counties as Hispanic people are dying at three times the rate compared to their non-Hispanic white counterparts. What’s more, only 29% of the vaccines given during the first month of the COVID-19 vaccination program went to adults ages 65 and older.

Overcoming Access Barriers

These numbers reflect the health disparities that have been present in low-income communities of color for years and which are the result of numerous social determinants of health including transportation, language, income, and education. Nevertheless, Community Health Workers/Promotores de Salud from El Sol Neighborhood Educational Center (El Sol), have been working against these odds for years and their experience has never been as crucial as it is today. 

El Sol CHWs/Ps have continuously been advocating to bring COVID-19 vaccines to where the community is, instead of having the community go to where the vaccines are. This is especially crucial for rural and hard to reach communities

Therefore, when these CHWs/Ps received approval and support for 250 dosis, they decided to have a pop up-clinic in one of the most marginalized and isolated communities in San Bernardino County, Adelanto. The passion and commitment of the CHWs/Ps made the impossible possible. In two days, they deployed effective community outreach strategies, connected with local religious leaders, and leaned on partnerships with food banks to reach one of the hardest hit groups of this pandemic, Spanish-speaking seniors with no transportation, or access to the internet.

When speaking with Vilma Lopez, a Community Health Worker/Promotora de Salud that supported the efforts in Adelanto, she mentioned that to reach these individuals CHWs/Ps had to make the process “easy”, which meant creating a ticket system. Vilma stated “there were no barriers because they did not have to make an appointment online or call to confirm, once we gave them the ticket they were set.” Vilma also highlighted the importance of having a local location, because seniors in the area have difficulties making the trip from Adelanto to San Bernardino, where most vaccination sites are located. This was apparent when half of the participants came walking to the event. 

Community Health Worker/Promotora de Salud Helping with Paperwork at the Adelanto Pop-Up Clinic for the COVID-19 Vaccine

What More Can We Do 

Through the great efforts of CHWs/Ps more than 250 seniors arrived at the event. But, there was one last barrier that this Spanish-speaking community had to overcome, an English only medical questionnaire. Erika Marroquin, a Community Health Worker/Promotora de Salud helping as a translator at the event, mentioned that the medical questionnaire had advanced medical terminology making certain sections hard to translate therefore making a Spanish version essential. What is more, there were only a handful of Spanish-speaking medical volunteers. 

Erika remembers a participant arriving with three pages detailing her current prescriptions. The participant then talked to CHWs/Ps about her concerns regarding the vaccine, but when CHWs/Ps guided her to a doctor, the participant shut down. And that is another barrier Erika witnessed. The participants felt comfortable talking with CHWs/Ps but they either felt embarrassed or powerless when in the presence of the medical staff. Erika believes that having more proactive Spanish-speaking, cultural competence medical staff willing to answer questions and support CHWs/Ps roles  will help overcome this barrier. 

The vaccination event at Adelanto was a great step towards equity in the COVID-19 vaccination program. However, more can be done and more will be done if Community Health Workers/Promotores de Salud have anything to say about it. Their dedication and love for their community is infinite and so should be our support for their efforts. 

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