Center for Health Equity Newsletter
February 2022
In this newsletter:
Greetings from the Center for Health Equity
Message from the Director
CONNECT: An Outstanding Partnership: Reaching out to Greater Minnesota with COVID-19 Vaccination
STRENGTHEN: Addressing health disparities and advancing health equity through COVID Response
AMPLIFY: SEWA-AIFW: Meeting the needs of the community
Greetings from the Center for Health Equity
With this February newsletter, we want to wish everyone Happy Black History month! We encourage folks to educate themselves on Black history, support Black vendors, and celebrate Black joy. We grieve the death of Amir Locke and stand in solidarity with our Black community. We must continue focusing on systems that perpetuate inequity and injustice. We mourn the loss of a person and are reminded of the systemic issues that bring us to these far too frequent moments. We hope that you all are taking time to take care of yourselves and your community during this time.
Earlier this month, our dear Helen Jackson Lockett-El retired after a long career of public service dedicated to improving the lives of communities most impacted by inequities. Helen served for over 5 years in the Center for Health Equity (CHE) as a community engagement planner and, most recently, also as grant manager. She brought over 25 years of community engagement experience working to facilitate and promote health and well-being. While at MDH, Helen oversaw a project to address infant mortality among U.S.-born African Americans in Hennepin County. She led the co-creation of a nationally recognized model, the Community Voices and Solutions (CVAS) Leadership Team, which established a shared decision-making approach in addressing infant mortality within, by, and for the community impacted. Most recently, Helen served as the lead facilitator for the Community Solutions Advisory Council, a legislatively funded project focused on healthy child development. In 2019, she guided the council through a robust, equity centered selection process. Helen will always be a part of our CHE family. Please join us in wishing her well in this next chapter!
In this newsletter, you can learn more about the toll COVID-19 has taken on our disability communities, about new health equity efforts through CHE, and about two stories of community partnerships to address COVID-19.
Interested in being a guest writer for a future newsletter?
Email your idea to health.equity@state.mn.us and we will be in touch!
Message from the Director
The inequitable wrath of COVID-19
The COVID-19 pandemic led to a sharp rise in morbidity and mortality in our community, with minority communities and those with a disability absorbing a disproportionate share of the impact. The disproportionate consequences of the pandemic are well documented and can be attributed to systematic social and racial discrimination. In other words, these disparities highlight underlying systems of structural inequity that have long shaped inequitable treatment and access to opportunities, especially among people of color, American Indians, people with disabilities, and other marginalized groups. These structural inequities work to constrain access to health-promoting resources and opportunities, unequally distribute health-related risks and exposures, and drive weathering processes that impose a more significant health burden. In this month's message, I wanted to highlight a few of the many layers of challenges that people with disabilities are facing and urge us to recognize disability as a health equity issue and embed it in all we do.
For so long, even before the COVID-19 pandemic, people with disabilities were more likely than those without to report several inequities, including decreased access to food and health care. Research shows that around a third of food-insecure households included a young adult with a disability. About 1 in 4 adults with a disability reported delaying or not getting medical care at all. In addition to the increased risk of COVID-19 infection among people with disabilities, measures or core strategies aimed to mitigate the spread of the virus—including wearing a mask, handwashing, and social distancing—may not always be easily accessible to those with a disability living with their families, relatives, or in congregated living settings, as they are at an increased risk due to amplified exposure from these informal and formal care providers. A study based on a household survey conducted from April 14 to April 26, 2021, revealed that adults with one or more disabilities were up to two times more likely than those without to experience food insufficiency and delay or not get needed medical care due to the COVID-19 pandemic (https://pubmed.ncbi.nlm.nih.gov/35151597/). In a similar survey conducted from December 29, 2021, to January 10, 2022, Minnesotans with one or more disabilities were more likely to report not having enough food sometimes or often and delaying or not getting needed medical care at all (https://www.census.gov/data/tables/2021/demo/hhp/hhp41.html).
It is clear that the impact of the pandemic on vulnerable and susceptible populations is significantly higher. In general, members of our communities that are living with disabilities are differentially affected by COVID-19 because of the increased risk of poor health outcomes from the disease itself, reduced access to food and routine health care and rehabilitation, and the adverse social impacts of efforts to mitigate the pandemic. Addressing this triple burden of the pandemic requires integrating disability as a lens into all public health works to address the negative impact of the COVID-19 pandemic on people with disabilities. In addition, it is worth noting that some strategies to overcome the pandemic might, inadvertently, also have a harmful impact on people with disability. And we must be vigilant that our well-intended strategies, policies, and systems are not inadvertently harming people with disabilities.
Yours, in belonging
Dr. Halkeno Tura, MA, MPH, CHES, PhD
Director of Center for Health Equity
CONNECT
We are a network hub – leading, connecting and strengthening networks of health equity leaders and partners across MDH and Minnesota communities.
This article is part of a series of stories about community outreach and partnership in response to the COVID-19 pandemic. Learn more and find more stories on the COVID-19 Stories of Community Outreach and Partnership page.
An Outstanding Partnership: Reaching out to Greater Minnesota with COVID-19 Vaccination
Minnesota Department of Health (MDH) partnered with Briva Health Clinic; Islamic Association of North America (IANA); and African Career, Education & Resource (ACER) to host a pop-up vaccination site in St. Cloud. The organizations noticed there were concerns about vaccine from women and youth in the area. A previous series of vaccine clinics held at mosques and door knocking at apartment complexes reached the 65 and older age population but showed that "a lot of parents were reluctant to have their children vaccinated," said Aisha Galaydh, the African Immigrant COVID Community Coordinator (CCC) Lead. Hodan Guled, the Briva Health Clinic Program Director for COVID-19 response commented the "high hesitancy to vaccination across the different ethnic groups" made hosting the vaccine event in greater Minnesota imperative. Previously, the CCC organizations had rarely hosted vaccine events outside of the Metro area, where "there are more barriers to African immigrants in accessing social services and connecting with local public health," confirmed Galaydh. Through the meaningful partnership and collaboration of MDH with its various CCCs, community engagement and diverse media contractors, CentraCare hospital, and local public health (LPH), more than 200 people turned up to be vaccinated, which was a great surprise for the team!
Riding on existing partnership
MDH's African Immigrant Community Liaisons and their partners observed how working with existing partners and being intentional in planning, messaging, and outreach were important in encouraging women and youth to come for vaccination. The population in greater Minnesota consists of "newer immigrants and refugees [who are] disconnected with local public health," said Lensa Terfa, African Community Liaison team member. This meant strategizing on which contractors to work with and what "tailored messaging would look like for youth…and women," said Galaydh. Leveraging the existing relationship with LPH, the CCC used diverse media and Center for African Immigrants and Refugees Organization (CAIRO) to connect with other community partners to understand the needs on the ground and amplify their messaging.
Well-known and trusted by the community, Briva Health Clinic brought its Somali doctors, nurses, and volunteers to assist people with registration, vaccination, and to make them feel safe. Tents were pitched outside with a doctor present to greet people and answer questions. Having health providers that look like the community, who were acquainted with the language and culture, was meaningful because people could relate to them "and help them understand — if they had questions about the vaccines," said Guled. During the vaccine event, African Community Liaison Okash Haybe witnessed one concerned mother later agreeing to have her 12-year-old son vaccinated after she engaged in a discussion with one of the Somali nurses on site.
Collaborative planning with partners
Several meetings were held with community partners to coordinate and share responsibilities for the vaccination event. Community engagement coordinators serving the African immigrant community, including CAIRO, Central Karen Fault, African Immigrant Community Services (AICS), IANA, and ACER, brought their knowledge of community needs and concerns. Briva Health Clinic, already connected to the Muslim community, helped to shed light on some of the barriers to vaccination among youths and women. The team also realized the importance of having "someone on the ground who does the work involved in the meetings," said Galaydh. Hani Jacobson, one of the CentraCare public health nurses who led COVID-19 vaccine and outreach, health, and education in the Somali community, shared this crucial perspective in the planning meetings.
"To increase vaccine turnout, IANA made weekly announcements about the event through email/text messages to the Somali Community and sent its two staff members to support the vaccine event in St. Cloud," said Abdiqafar A. Jama, the IANA Program Supervisor. All the contractors, worked together in tailoring messages to families, women, and children. Many of the community members who attended the vaccination event were from multigenerational households.
"Another thing that was helpful during the event was the $100 incentives, given to those that completed their vaccine series," said Guled. Different social media platforms were used to promote the event and share videos of youth and women getting vaccinated. Information was also communicated through St. Cloud Somali Radio, Somali TV of Minnesota, Xogmaal Media, Xidig TV, Laari Media Group, Saint Cloud School District, and community events such as the Annual Health Professional Conference. Flyers with faces of trusted Somali health professionals were designed and distributed. Delmar, a popular Somali celebrity, was also invited to the event to entertain the crowd with local music, while Somali TV of Minnesota captured the whole event. Previous and current CCC's like the Islamic Association of Northern American, an umbrella organization of 35 mosques, brought the news of the Briva Health vaccine event to mosques.
Reflecting back
Winfred Russell of ACER shared, "The reality of collaboration outside the cities, where you don't have a lot of MDH staff but have local public health staff, was different but unique." The vaccination event succeeded due to a community-driven model tapping into existing partnerships, community expertise, community knowledge, and the use of trusted health providers. "Each partner organization came with their own strengths to make it possible to vaccinate over 200 people in this vax event," concluded Jama.
STRENGTHEN
We provide leadership in advancing health equity and cultivate health equity leaders within MDH and across Minnesota communities.
Addressing health disparities and advancing health equity through COVID Response
We are thrilled to share that the Minnesota Department of Health (MDH) was recently awarded a two-year health equity grant (July 1, 2021 – June 30, 2023) by the Centers for Disease Control and Prevention (CDC). This grant invests $25 million across two years to address COVID-19 related health disparities and to advance health equity. The intended outcomes of this grant include reducing COVID-19 related health disparities, improving access to testing, and increasing contact tracing among communities most impacted, and improving state, local, and Tribal health department capacity and services to prevent and control COVID-19 infection.
The project involves a myriad of community partners, including health care systems, local public health, Tribal Nations, urban American Indian organizations, community-based organizations, and state agencies. The grant also involves collaboration across MDH where project leads are engaged in several exciting activities to advancing health equity. The leads are developing data standards to make data collection tools more inclusive, identifying best practice and strategies to develop guidelines to address long-COVID, advancing community voices in data, and developing regional health equity networks to enhance coordination of context-specific health equity efforts. For example, the Community Voices in Data and Public Health effort is engaging community leaders, community-based organizations, and professionals with an expertise in long-term effects of COVID. This effort seems very promising in sharing power with community and providing them with opportunities to co-create the Long-COVID surveillance project. Through this effort, MDH continuing to learn and practice how to engage with communities authentically.
AMPLIFY
We amplify the work of communities most impacted by health inequities and support them to drive their own solutions.
This article is part of a series of stories about community outreach and partnership in response to the COVID-19 pandemic. Learn more and find more stories on the COVID-19 Stories of Community Outreach and Partnership page.
SEWA-AIFW: Meeting the needs of the community
Raj Chaudhary, executive director at SEWA-AIFW (Asian Indian Family Wellness), a nonprofit organization committed to serving the South Asian community, emphasized how pre-existing partnerships with Minnesota Department of Health (MDH) and other foundations provided opportunities for her organization to meet the multi-faceted community challenges of COVID-19, including increased food insecurity, inadequate shelter, sexual violence, mental health, and access to testing and vaccinations. Despite these numerous challenges, and keeping staff afloat, the organization was able to tirelessly respond to community during COVID-19, whilst promoting self-care amongst its staff.
Leveraging pre-existing partnerships
MDH has partnered with SEWA-AIFW since 2005. This collaboration was welcomed by the community as SEWA-AIFW is a trusted organization in the community. Responding to COVID-19, SEWA-AIFW organized virtual meetings and webinars such as "Building resilience and strengths during uncertain times" and held other events in conjunction with partner experts. These sessions helped to communicate about COVID-19 and legal information about the travel ban affecting many community members. Furthermore, podcasts and materials were produced in native languages to deliver COVID-19 messages, address myths and misconceptions. They also addressed domestic and sexual violence, disability, and leveraged their referral system to provide peer-to-peer support in the community. Information was also communicated through in-person and virtual health clinics, telehealth program, with referral screenings and consultations reaching 500 and 5,000 people respectively.
Through mobile units, MDH continues to support their testing, vaccination, and resource sharing efforts across partners. SEWA-AIFW partnered with MDH and Hennepin County Public Health to distribute personal protective equipment kits (hundreds of saliva test kits, 15,000 masks, and 5,000 hand sanitizers) to temples, churches, and mosques in communities. They also worked with MDH to provide mobile units to help support testing, vaccination, and outreach events.
"Despite that [community] demand was greater than the capacity, [partnerships] were helpful in facilitating assistance to communities," said Chaudhary. Looking forward, "maintaining and sustaining all the great relationships and networks into the future is needed," said Xp Lee, COVID-19 Community Coordinator (CCC) lead. Many valuable lessons were learned from working with communities that could be applied and be of benefit in other areas. Similarly, Vu Dai, CCC supervisor, observed how there is still room to develop more networks and partnerships to reach out to "some API communities that are not well represented and where services have not reached," concluded Vu Dai, CCC supervisor.
SEWA-AIFW continues to receive regular calls regarding the COVID-19 testing centers and where to get booster shots from – resulting in 300 people having received boosters through their clinics. Dasharath Yata, assistant director at SEWA-AIFW noted that they received recognition from the community in doing COVID-19 vaccination by receiving an award from three regional non-profit and cultural organizations. The staff continue to receive thank you notes and text messages of appreciation from the community.
An emotionally fulfilling moment of this work was to witness how "one old Hindu man finally received a shot after being convinced of the importance of being vaccinated before he could see his grandchildren whom he missed," recalled Mubina Qureshi, gender and health equity programs manager. The shot was the man’s first injection in his life.
Reflecting back
MDH’s ability to reach out to affected communities during COVID-19 is mostly due to its pre-existing and trusted relationships with various community partners prior to the pandemic. It was important for the team to work with organizations they trusted to reach out and connect to communities. Vue Sincai, former MDH Asian and Pacific Islander (API) community liaison team member, confirmed how such partnerships have been unique, "in making the API community liaison team nimble in their response to community needs and requests." MDH’s partnership with SEWA-AIFW is a testament to how "identifying [trusted] existing partners [is] crucial," as API Community Liaison Lead Duzong Yang believes.