Take Care Annapolis

Program Action - Logic Model:

Background: 

According to the Centers for Disease Control (CDC), “long-standing systemic health and social inequities have put some members of racial and ethnic minority groups at increased risk of getting COVID-19 or experiencing severe illness, regardless of age… History shows that severe illness and death rates tend to be higher for racial and ethnic minority populations during public health emergencies than for other populations.”^[1] Indeed, CDC data reveal that Black people have a COVID positivity rate at approximately five times that of whites, and that Hispanics and Latinx people have a COVID positivity rate of approximately four times that of White people.

LULAC’s (League of United Latin American Citizens) COVID-19 Latino Impact Report identifies a multitude of risk factors that enhance the spread of the disease, including overcrowded housing, poor access to healthcare, work providing “essential services,” and underlying health conditions that may heighten vulnerability to COVID complications (diabetes, obesity, and high blood pressure). To make matters worse, fear of stigma, or even deportation, may make undocumented individuals and their families less likely to seek medical and social services, COVID testing, or even respond to contract tracers. 

The Hispanic/Latinx community in Annapolis is experiencing extreme stress due to COVID-19. Contributing stressors include: housing instability, food insecurity, and unemployment. The Centro de Ayuda (Center of Help) - a local services organization that works with Latinx people in the county - reported 1,604 cases of requests for assistance between March 15 and May 31, representing a 53 percent increase over the same time period in 2019. They have processed five times as many employment-related cases (including unemployment applications, weekly unemployment certificates, and employer relations) and assisted with 197 requests for rent subsidies and 229 cases related to food security. The one area where they report a fall in requests was in medical services - suggesting that this crisis, paradoxically, has reduced the prioritization of health care, as other basic human needs take priority.

The City of Annapolis has a population of approximately 40,000, of which 22 percent are Black and 21 percent are Hispanic/Latinx. Yet, the Anne Arundel County Department of Health reported that more than 70 percent of Annapolis’ COVID-19-positive cases were Hispanic/Latinx in May, a number that has dropped dramatically since the launch of the Ciudate/Take Care program. In addition, Anne Arundel Medical Center (AAMC) reported that the people seeking treatment due to COVID-19 symptoms are majority Hispanic/Latinx. There are still concerns that those with jobs may be putting themselves and the public health at risk by continuing to work, due to lack of access to health care options and information. To date, our ongoing “Cuidate” Survey has found that more than half of the Latinx community respondents have no Primary Care Provider and more than 80 percent are uninsured. 

The Black community is also experiencing greater risk for COVID-19 than the White population. Nationwide, statistics show that Black people have had the highest risk for testing positive. In Annapolis, the percentage of African Americans participating in COVID testing sites is low in comparison to other demographic groups, making it difficult to track infection rates. 

Our Objectives:

The objectives of this educational outreach program are as follows: 

1. Target vulnerable communities with culturally appropriate health education information in Spanish and English in order to reduce COVID-19 cases and increase preventative care; 
2. Design and conduct strategic and culturally competent outreach to our minority communities;
3. [For Hispanic Outreach] Address the need for our Latin American residents who have studied health professions in Latin America and have been unable to enter the health field in the United States and therefore become a pipeline program for marginalized groups to enter a specialized workforce;
4. Help to create structures within these communities to collectively promote healthy habits and health care;
5. Facilitate connections between people and services;
6. Empower communities to make informed medical decisions for themselves and family members;
7. Create long-lasting structures in place for community leadership to emerge; and
8. Identify and promote community leadership to work with medical centers and government who will help connect individuals to resources.

Our Teams: 

The Cuidate/Take Care team is uniquely positioned with a wealth of knowledge. We hired two outreach coordinators and nine team members to work on specific outreach strategies for each community. The Take Care/Latinx outreach team is composed of highly skilled professionals from Latin America who have immigrated to the United States. Their previously untapped potential now directly benefits this program because of their backgrounds in law, medicine and education.   According to the Migration Policy Institute’s latest report on immigrants in the US with health care degrees, their “language and cultural skills may allow them to communicate more effectively on sensitive topics such as disease” and are an important resource to turn to as we struggle to find adequate answers on how to bridge the gaps in resources for the Latinx community.^[1] Our African American outreach team also has health professionals and local leaders that have been able to establish strong relationships and bases for building stronger trust between our government, health care, and the community.

Within one month of the start of the programs, we had canvassed almost all known predominantly Latinx and Black neighborhoods and were able to return with resources and services specific to the needs expressed by these communities. We created a coalition with key stakeholders in education, health, outreach, and services organizations to provide educational and informational videos and graphics. We surveyed more than 350 people in the Hispanic-Latinx community on their social and health situations and used that data to drive action not only within the city but within our partner and stakeholder organizations and agencies. We have also surveyed more than 600 people in the African-American community around COVID-19 information and concerns. We created flyers, videos, and a new mass texting service that reaches 600 Hispanics/Latinxs city-wide thus far. We were able to provide flu shots across the City. We also offered preventative care information about high-risk populations for COVID-19 mortality through Health Fairs and Targeted Campaigns. (Updated: February 2021)