Monday, June 27, 2022

HHS subcommittee tasked with strategizing healthcare needs for historically marginalized populations

The county’s subcommittee on historically marginalized populations began brainstorming ideas on how to reach these demographics to provide increased access to healthcare. (Port City Daily/file)

NEW HANOVER COUNTY — The state has tasked county health departments to craft strategies for engaging historically marginalized populations who are disproportionately impacted by the pandemic.

A subcommittee of the New Hanover County Health and Human Services Board met for the second time Wednesday to brainstorm ways to address the needs of those populations when it comes to health education and mitigation. Members of the committee include Dr. Stephanie Smith, Dr. LeShonda Wallace, Dr. Virignia Adams and Dr. Thrasher Horne, along with health director David Howard and newly hired health equity coordinator Fawn Rhodes.

“Due to many different reasons, there are more severe and a greater number of impacts on historically marginalized populations during Covid-19,” Howard said at the meeting. “A starting point is some of these are long-lasting and historical issues in terms of access to healthcare, access to insurance, when they choose to go to a provider.”

The main course of action the committee agreed upon is to engage grassroots organizations and local nonprofits that already work with these various demographics to understand the needs of those communities.

“Our goal here is to get resources to our community members instead of having them come [to us],” Wallace said.

Hospitalizations among African American and Hispanic groups are occurring at a higher rate, as they typically wait longer to seek care until it becomes urgent, Howard said.

Transportation needs and competing priorities, such as work and childcare, tend to increasingly burden these groups as well, HHS board chair Wallace explained.

The subcommittee will use data from the North Carolina Department of Health and Human Services dashboard to narrow its focus. For hospitalizations, the dashboard only provides a breakdown of data for the Southeastern Healthcare Preparedness region, comprising New Hanover, Brunswick, Pender, Columbus, Bladen, Onslow and Duplin counties. The committee would like to see information specific to New Hanover to determine how to best allocate resources.

“We can’t depend on other entities to support our solutions,” board member Adams said. “If we’re going to look at goals to address these issues, I don’t think we would go beyond our county.”

Rhodes, who was hired last week, will lead the coordination efforts between the HHS board and the county’s Office of Diversity and Equity team. As she has been tasked with analyzing all populations, she requested additional data that may not be provided by NCDHHS. 

For example, that dashboard does not report anything from Veterans Affairs, the Department of Defense, Federal Bureau of Prisons and Indian Health Service – additional groups who need help when it comes to accessing healthcare.

“We can identify what is and is not available in terms of data, so the committee understands what suite of data is available,” Howard said. “And set a baseline for keeping and maintaining health equity across the community, as well as educating the community of the availability of services.”

The subcommittee acknowledged that to understand how best to reach different groups of people, it must first know what barriers are in place – whether it be transportation, misinformation or another line of thinking.

When vaccines first became widely available, New Hanover County HHS held vaccination events targeting minority populations, in addition to its community-wide, appointment-based clinics. Howard said the department conducted events at jails, homeless shelters, churches and LINC, a nonprofit re-entry program for recently incarcerated individuals. HHS has also hosted a vaccine clinic for special needs children at Independence Mall, where it continues to provide shots for anyone eligible, and contacted group homes inquiring about their access to vaccines and testing kits.

One caveat mentioned was ensuring residents who received their first dose of the vaccine were able to come back for their second regiment or receive the proper information on where to go in three or four weeks to obtain it.

That outreach has amped up now with the availability of booster shots, Howard added.

According to the NCDHHS dashboard, 47% of the Black population in the county is vaccinated with at least one dose of the vaccine as of Jan. 7. Fifty-nine percent of the white population has received at least one dose of the vaccine; 65% of the Asian or Pacific Islander population has and 51% of the American Indian or Alaskan Native population has. 

Rhodes suggested using what she calls a “silent army” to assist with educating homebound demographics.

“I would like to reach out to our home healthcare aides and CNAs – those that go into clients’ homes – and see if we can get them educated and I believe that could be a turning point to help increase our numbers,” she said. “A lot of people may not be able to come out and get vaccinated or have chosen not to because they don’t understand the information.”

Home health aids are often highly trusted by their clients, Rhodes explained, so it could be a source of additional information. 

Adams suggested the development of some form of community health workers could extend that initiative and be the eyes and ears of the community — beyond Covid-19. 

“We are dealing with chronic illnesses in those communities and all kinds of things, so I’m looking at the holistic picture – how we can educate the community about lots of things,” she said.

The subcommittee met for the first time on Oct. 15 and will continue to meet every two months.

Members of the community are welcome to attend or listen in to the next meeting in March – a date and time has not yet been scheduled. The public may also submit comments and recommendations to the HHS portal, Wallace said.

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