The COVID-19 pandemic has highlighted existing structures that create a lack of health equity for communities of color here in the United States and across the globe.
Whether it’s access to testing, vaccines, or public health guidance about ways to mitigate risk of spread and exposure to the virus, communities of color are often lacking the resources they need to keep themselves healthy and safe. According to the U.S. Centers for Disease Control and Prevention (CDC) these disparities are further compounded by long-standing inequities in social determinants of health that affect these groups.
A team of public health workers in Connecticut is working to address these disparities through a program focusing on outreach to communities of color by staff who live and work in the neighborhoods they serve. The Community Outreach Specialist (COS) program is a health equity initiative based within the Connecticut Department of Public Health’s contact tracing program. The Connecticut Department of Public Health hired a subcontractor to employ and manage its contact tracing program. The COS program is designed to improve contact tracing outcomes for vulnerable populations across the state. The COS team is comprised of 25 staff members who are mostly bilingual and serves 11 of the highest social vulnerability index (SVI) communities towns and districts in Connecticut.
“We have a connection to the community, we have networks within the community, but most importantly we have a commitment because it’s our community,” said Angela Franklin, one of the supervisors for the Community Outreach Specialist program.
Once the COS team started their work, they quickly discovered there were several challenges to reaching diverse communities in addition to language barriers. There’s a large Spanish speaking population in Connecticut, for example, which includes undocumented residents, some of whom were afraid to access information about COVID-19 resources.
“These barriers make it challenging to get in touch with residents because they may not answer the phone or return our calls out of fear over their immigration status, which keeps them from getting key resources they may need if they’ve been exposed to COVID-19,” said Kelly Johnson, COVID-19 Corps contract tracing coordinator for the CDC Foundation and the Program Director of the COS Program.
In the early months of the pandemic the team conducted calls to help identify unmet needs for those who tested positive for COVID-19, or were potentially exposed to the virus, and worked alongside the larger Connecticut Department of Health staff to lead virtual community workshops. The work of the team has evolved to meet the changing needs of Connecticut residents as the pandemic has continued. The team's focus has moved from contact tracing to directly supporting the Department of Public Health's efforts to schedule vaccine clinics to reach vulnerable populations while also educating residents about vaccine safety, and access as well as creating communications materials for these same communities. The teams' approach is to use their deep community connections as long-time community leaders to determine the gap in care and access and fill them with the access that is most needed.
We have a connection to the community, we have networks within the community, but most importantly we have a commitment because it’s our community.
The work of the COS program also serves as a critical point of contact for the health department’s Community Resource Coordinator (CRC) program. Under the CRC program, short-term case managers work to connect cases and contacts to resources that help them safely quarantine or isolate, including food, hotels, diapers, thermometers, rental assistance, referrals to health care, etc. Residents can only access these critical resources through the work of the contact tracing system, which is why the work of the Community Outreach specialist team is so important.
Earlier this year, the team launched a mass media campaign in collaboration with media outlets in the Polish, Portuguese, Haitian-Creole and Spanish speaking communities. They have also hosted pop-up vaccine clinics around the state in high social vulnerability index (SVI) communities.
“We hosted these pop-ups in very different communities—English speaking Caribbean and the Portuguese speaking community. We had 100 percent turnout,” said Franklin. “What we’ve learned is that a very hands-on approach works best, and we use the resources that already exist in the community to reach people.”
As the world considers a new normal following the COVID-19 pandemic, the success of the Connecticut Department of Health’s Community Outreach Specialist program demonstrates the continued need for a health equity lens across public health initiatives.
This article is supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $68,939,536 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.
