Trust in physicians and hospitals declined over the course of the COVID-19 pandemic
In surveys completed throughout the COVID-19 pandemic by U.S. adults, trust in physicians and hospitals decreased over time in every socioeconomic group.
NewsOct | 21 | 2020
There is no doubt that the COVID-19 pandemic has had a disproportionate impact on underserved communities. From poverty, to job and food insecurity, to housing instability, many challenges that have been historically prevalent in low-resourced communities have been greatly exacerbated by the COVID pandemic.
In a three-part series, Massachusetts General Hospital explores the frontline efforts of three community coalitions supported by Mass General’s Center for Community Health Improvement—in Chelsea, Revere and Charlestown—places where residents have been severely impacted by the virus.
One such community coalition is Revere CARES. Founded in 1997 to address substance use amongst youth, the coalition has expanded over the years to include nutrition and fitness, youth enrichment and workforce development initiatives in the community. In 2020, at the peak of the pandemic, Revere CARES pivoted again to support the unique needs of the community as it faced new and distressing challenges due to COVID-19.
Many of the people who live in Revere are immigrants who work in hospitality—an industry that was particularly impacted by the pandemic. Many were laid off, and those who did maintain a job were required to continue working in person and return home to, oftentimes, crowded living conditions. Revere quickly became a hotspot for COVID-19 infections and one of the cities with the highest unemployment rate in the area.
When the pandemic began, Revere CARES worked with their partners at city hall to come up with a plan for supporting the community. The city created an Emergency Community Response group divided into several committees, three of which Revere CARES participated in—a communications group, a wellness neighborhood group and a Spanish response group.
One of their challenges was communicating COVID-related public service announcements to a multicultural community. Simply translating messages from English to Spanish was not enough. Messaging needed to be culturally sensitive to resonate with the community.
"We have been helping with communication, interpretation and translation," says Sylvia Chiang, director of Revere CARES, who immigrated to the United States 20 years ago from her native Honduras. "I insist on cultural competency of the messages being sent out." The Spanish Response Group helped ensure that the city's 3-1-1 phone system was inclusive and accessible in multiple languages.
Additionally, initial guidance provided by the Centers for Disease Control and others did not often consider the reality of all people’s lives, especially in communities like Revere. For example, messaging that urged people infected with the virus to “use a separate bedroom and bathroom” from other household members was not always realistic.
"Many of the residents of Revere live in overcrowded homes, multi-generational homes. There is no such thing as a separate bathroom," Chiang says. Instead, she helped adapt the messages and educate people in a more realistic, culturally sensitive way—explaining how to isolate as much as possible, even in a crowded home.
Despite the pandemic, Revere CARES continues with its programming, much of which is virtual for the foreseeable future.
Revere CARES collaborates closely with the city on a "healthy eating, active living" campaign. Over the years, this effort has evolved to become a food justice initiative that combines food access with economic stability by helping community members produce and sell their own food.
"We found through our work that there is a lot of home production of food, such as people making arepas, pupusas and other typical ethnic foods," says Chiang. "And now we've evolved into this small food business, which not only increases access to culturally competent food but can also be an economic stabilizer."
Revere CARES also supports two functioning community gardens in Revere, MA.
Revere CARES has a strong partnership with the school system. They provide afterschool clubs and youth programs collectively known as the Youth Initiative, which is composed of the Power of Know Clubs and the Youth Health Leadership Council.
These programs, which include activities such as dance, drama and community service are for middle and high school students, and now also involve the Revere High School alumni. They give teens safe and fun activities to do after school while supporting them with issues such as college preparation and substance use prevention.
"The Workforce Development Initiative involves connecting unemployed or underpaid people to good jobs," says Chiang.
Half of the initiative involves figuring out who is unemployed or underpaid and finding ways to reduce barriers, such as by providing skills training workshops. The other half involves finding good jobs and building relationships with local businesses to develop better employment opportunities.
The initiative adjusted to economic changes related to COVID-19. Instead of focusing on jobs in hospitality, for example, they are now focused on other industries that are growing and looking to hire employees.
Most recently, Mass General has been awarded a $650,000 grant from the Massachusetts Health Policy Commission’s Moving Massachusetts Upstream (MassUP) Investment Program to work with community partners in Chelsea and Revere to address economic stability and mobility.
While other areas of Boston and the United States have seen COVID-related stress slow down after the surge, many people in the Revere community are still struggling to access essential resources such as food, masks and housing.
Before COVID, Revere had one food pantry. Now, there is an even larger and more urgent need, with a group providing 600 to 900 boxes of food to the community twice a week. Earlier in the year, community volunteers were able to help distribute food; but now that more people have gone back to work, there has been a decline in the number of volunteers. Help is still needed, especially for food banks. Volunteers are essential to prepare bags, load the trucks and distribute the food to the community.
To volunteer in Revere, contact Sylvia Chiang at srchiang@partners.org or call Revere 3-1-1.
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