The Crisis of Accessing Healthcare During COVID-19
By Cassandra Drumond
For some groups, having access to healthcare has been out of reach since before the COVID-19 pandemic. Specifically, groups like Latino farmworkers, who are undocumented, and do not qualify for federally funded healthcare, depend on community care centers, who treat patients regardless of immigration status.
Community health workers are not a new concept, many countries have them in some form or another. Denise Octavia Smith, Executive Director of the National Association of Community Health Workers, which was founded in 2019 after nearly a decade of advocacy, states: “The National Association of Community Health Workers (NACHWA) are females of color, peers, neighbors and survivors working on the frontlines, in under-resourced communities. Over 50 title fit the community health worker description. We have a growing presence in medical, behavioral health and social service systems. We are an organization recognized by the American Public Health Association. Roles include community violence prevention, emergency department facilities, helping new immigrants and refugees find resources, conducting home visits, we work with state and local governments to amplify voices of those often not heard.”
In addition to the medical care aspect, Smith points out community health workers promote equity and social justice by providing language access and fighting racial discrimination by making patients aware of laws that may be relevant to them. For example, Title VI of the Civil Rights Act requires interpreter services for all patients with limited English proficiency who are receiving federal financial assistance. Community health workers inform members of their rights and connect them to high quality sources. In terms of data collection, one of the main roles of community health workers, workers advocate for data collection that reflects the diverse communities that they serve. Community health workers also share resources for racial discrimination such as the Stop AAPI (Asian-American and Pacific Islander) Hate Reporting Center website, where instances of hate based on race are documented firsthand.
Regarding the future of COVID-19, Smith explains: “Community health workers are confronting historic barriers and skepticism of taking a vaccine due to the history of administering experimental drugs without the will or knowledge of many Black people in this country. Building trust is one of the many roles of community health workers. They begin to build bridges to communities.”
Dr. David E. Hayes-Bautista, Director of the Center for the Study of Latino Health and Culture at UCLA Health, expands to issue of access to healthcare as it relates to the pandemic and Latino farmworkers. Dr. Hayes-Bautista explains: “Most could just go home and work from there, but most essential workers could not. Farmworkers work shoulder to shoulder, do not have health insurance, as left out of the Affordable Care Act. Due to the nature of the work, they are far more exposed to COVID-19 and have less access to care and testing. Latinos now have the highest rates of mortality in California.”
Dr. Hayes-Bautista also explains the cost of a Latino goes into the ER with a case of COVID-19, “The cost of Remdesivir, the treatment drug that president Trump received, would cost about $3,120, which is three times the average monthly salary of a Latino farm worker. This doesn’t include the hospital or transportation bill this is only for the medication. For Latino farm workers to pay for medical treatment, they would have to go entirely without meals or a house, as most do not have health insurance. Ultimately, Latino farmworkers would be unable to afford the high costs of treatment. Farmworkers have kept us fed during this time, and now accessing healthcare is beyond their reach.”
Community clinics try to bridge that gap, by not inquiring about immigration status and providing free services to undocumented workers. However, most count on funding via grants and donations, but there is uncertainty due to the availability of funding.
Lastly, Dr. Hayes-Bautista, reminds families that will gather during the upcoming holiday season, to wear a face covering, practice social distancing whenever possible and handwashing are all essential to stopping COVID-19 from spreading. Additionally, Dr. Hayes-Bautista recommends having gatherings outside, but keeping up with the major recommendations, as COVID-19 is still with us and most likely will be a part of our lives for some time.