Praise the role of community health workers in the response to COVID-19

By Anne Blythe

Viviana Martinez-Bianchi, a Duke doctor who raised Latin American voices from humble lunch tables to halls of power throughout the coronavirus pandemic, testified before members of the United States Congress in late September about the ‘one of the silver liners from the past 18 months.

Community health workers.

Known as ‘promotores de salud’ in Spanish and widely deployed across Latin America, community health workers are the trained people who travel to neighborhoods and workplaces to provide crucial health information. public. They have helped increase immunization rates, guided parents and children to critical COVID testing, and provided a long-needed bridge between hard-to-reach health systems and underserved populations.

Throughout the pandemic, many Latin American organizations deployed teams of these workers to neighborhoods and events where community health workers understood the culture of those they were trying to help, while also speaking their language. .

“Community health workers are an integral part of the successful deployment of health care in the community,” Martinez-Bianchi said at a joint meeting of two subcommittees of the House Committee on Education and Fine Work. September.

Hiring community health workers across North Carolina has been a long-standing goal, but was kicked off by the pandemic. The state Department of Health and Human Services began exploring the possibility of a community health worker initiative in October 2014.

In 2018, a group of stakeholders who organized summits and listening sessions after reviewing similar initiatives in other southeastern states released a report with recommendations on how to get such a project started. .

In August 2020, the state announced the selection of seven vendors who would hire and manage more than 250 community health workers to deploy to 50 counties.

To have an impact

Curamericas Global, which has an office in Raleigh, has been selected to help launch initiatives in Alamance, Buncombe, Chatham, Craven, Davidson, Davie, Durham, Franklin, Forsyth, Gaston, Granville, Guilford, Harnett, Henderson, Johnston, Lee, Onslow, Orange, Pitt, Randolph, Surry, Warren, Wake, Wayne, Wilkes and Vance counties.

Andrew Herrera, Executive Director of Curamericas Global, joined a recent Zoom meeting of the Latinx Advocacy Team and Interdisciplinary Network for COVID-19, or LATIN-19, an organization founded by Martinez-Bianchi and several of his fellow workers from Latin American health.

Herrera’s organization began reaching out to Hispanic families in North Carolina at the start of the pandemic when it was clear Hispanic residents were disproportionately affected by COVID-19. Many were on the front lines, working in food processing plants, grocery stores, the construction industry and other jobs deemed essential that often did not provide opportunities for social distancing or working from home.

Although nearly 10% of North Carolina’s population identify as Hispanic, they accounted for 44% of COVID cases as of July 2020.

Curamericas first worked in partnership with the Consulate General of Guatemala in Raleigh to secure more than 500 volunteers to reach 10,000 Latin American families by August 2020. Now the organization is working with 19 community organizations that already had crucial links in the County of 26. region, as well as paying workers at least $ 20 an hour, according to the organization’s website.

Some of these community partners include El Centro Hispano, where Fiorella Horna is the COVID-19 project leader with 40 community health workers in the Triangle region. She pointed out that in September of this year, Latinos accounted for 18% of COVID cases, a sharp drop from the peak in July 2020.

“I’ll send this to my community health workers a lot, share the dashboard and say, ‘Hey guys, this is what we’re impacting’. A little bit of what you’re doing is leveling the ground, ”Horna said on the Zoom LATIN-19 call.

Find, teach and connect

In recognition of the impact community health workers have had during the pandemic, DHHS announced that North Carolina recently received $ 9 million, or $ 3 million for each of the next three years, in federal assistance. to expand the Community Health Workers Initiative to 100 counties.

Maggie Sauer, director of the DHHS Office of Rural Health, said community health workers can help improve equity in access to care for communities that have faced systemic barriers for decades.

Horna and others who worked with community health workers during the pandemic explained how these teams connect with someone who might need help overcoming such obstacles.

“In the course of their work, they know that their role as a community health worker, a trusted community leader, is to find,” Horna said.

“They’ll go to neighborhoods, they’ll go to construction sites, they’ll go to malls, laundromats, churches, businesses, wherever you need to find people.”

The mission, said Horna, is for them to “find, teach and connect.”

Thinking beyond the pandemic

Many wear red or green T-shirts, approach people and try to give them information in small pieces. Their profession has evolved.

“The first six months of COVID, everyone was like, ‘Oh my God, what is this virus?’ Virus, virus, virus, ”Horna said. “Then the next six months, it was’ Oh my God, we have a vaccine, what is the vaccine? »Vaccine, vaccine, vaccine. Now we’re in this mode where we’re like, “Let’s talk about your health, your mental health, your well-being and what you’re doing to stay safe.” And then we can organize the conversations about the vaccine and the testing. “

More recently, community health workers received questions about vaccine recalls, how to find COVID tests when schools reopen, and questions about when children under 12 will be eligible for a COVID vaccine.

“The most important part of our job is community support,” Horna said. “Our community health workers are our eyes and ears in the community, but they are also the ones who provide support, motivation, check up on anxious, depressed people. “

Community health workers can listen, and then connect people to resources they might not have known otherwise.

“It’s always there, you guys, I know you know, people are very responsible for what’s going on,” Horna said. “So our community health workers are there and they bring them back to these community support entities in El Centro to do food or shelter, or maybe it’s financial aid or maybe he. it’s just about having someone on the phone to talk to, a lot of lately, so maybe it’s just someone on the phone.

Get off the beaten track

Martinez-Bianchi and other participants in the weekly LATIN-19 Zoom calls would like to see more use of community health workers, potentially even trained to administer vaccines to people who are housebound and others who have difficulty getting to the hospital. in a health center for treatment.

“My hope is that we can move beyond the pandemic and continue to have teams of community health workers funded in a sustainable manner, not just during an emergency crisis,” said Martinez-Bianchi. “There are crises all the time. There are several epidemics occurring in our community. “

She mentioned the high rate of uninsured people in the Latino community, especially in Durham and Orange counties, which have many places to get health care such as Lincoln Community Health Center, Duke Health, UNC Health, Piedmont Health and private practices which are not always easy to navigate.

“Latinos in the rest of the country are about 26% uninsured,” Martinez-Bianchi said, citing an ABC11 report. “When we get to Durham and Orange counties, we’re talking about 37% of Latinos without insurance.

“It really marginalizes our community, so a community health worker program that can work with Lincoln, with Duke, with other private practices and several practices in the area… we really have to think outside the box on how we do it. provide family health care. … The pandemic has really exposed so many different issues. “