Community needs during the COVID-19 outbreak

By Nicole Turcheti and Jan Capps

Introduction

The COVID-19 outbreak and some response measures put in place to keep Washingtonians healthy, such as social distancing and closure of businesses, have affected communities’ ability to meet their basic needs. The impact is especially acute in communities of color, due to longstanding inequities they already experienced prior to the outbreak. 

To better understand the needs of King County residents, particularly in communities of color, Public Health Seattle & King County staff interviewed 16 people that have been providing services and supporting our community in the course of the COVID-19 epidemic. We asked them what were the needs of individuals and families that had emerged or been exacerbated with COVID-19. Community advocates from the following organizations and groups shared their time, their knowledge and their stories with us: Africatown, African American Maternal and Infant Health Community Action Plan Workgroup, Asian Counseling and Referral Services, Center for MultiCultural Health, Crew Leadership, The Church Council of Greater Seattle, Healthy King County Coalition, The Vine Seattle, International Community Health Services, Living Well Kent, Potlatch Fund, Public Health Seattle & King County, Seattle Indian Health Board, Southwest Youth and Family Services, Urban Impact, Wallingford United Methodist Church, and Within Reach. 

It is important to note that these consultations took place in early May 2020, and thus precede the nationwide uprising that followed the killing of George Floyd by a police officer in Minneapolis. The needs that were discussed then may have been impacted by what the Black community and our community at large have been experiencing in the last weeks.

What follows is a compilation of the perspectives that these sixteen community advocates have shared with us, organized by the seven topics below.

Scroll down or click on the topics below to learn more about needs in our community

FOOD SECURITY

Food security was a prevailing issue when interviewees were asked what community needs were prominent during the COVID-19 outbreak. With rising unemployment and people strapped for cash, the need for food has grown significantly.  Many who had never needed help accessing food, are now turning to food assistance programs and community organizations for support. Within Reach, a community resource referral organization, reported that approximately 80% of the calls for help they receive are for food assistance.

Organizations that have not traditionally been part of the emergency food service network are stepping up to attend to a rapidly increasing demand for food for their members, neighbors, and the community at large. Examples are the Center for MultiCultural Health, Wallingford United Methodist Church and The Vine Seattle. In response to the effects of COVID-19, they have promptly mobilized to distribute food in their communities. Potlatch Fund shared that many of their Seattle Urban Native Nonprofit partners had immediately adjusted services to provide food delivery for the Native American community. They call the elders to check on dietary needs and strive to accommodate them. As highlighted by interviewees, there are also individual initiatives from community members. They have been getting in touch with neighbors and acquaintances to help them get informed about available resources and, at times, to share their own pantry with them.

Transportation can be another barrier to accessing food. Interviewees shared that people worry about increasing their exposure to COVID-19 by taking public transportation and some do not have a car, which makes it harder to go to food banks or grocery stores. For that, Urban Impact is offering rides to people in the community that need to go get groceries and do not have another option for transportation that feels safe. The organization also picks up meals from schools and delivers them to community members’ homes.

Finally, although some of the community organizations are providing food delivery to people’s homes, Living Well Kent argues that it is important to offer folks the option to go pick up the food boxes at the community organization’s office location. Delivery often occurs during business hours, and in some households all adults are out working at these times and would otherwise not be able to get ahold of the food boxes.

Interviewees talked about lower income persons of color being pushed into living in crowded homes. Such living conditions make the virus more susceptible to spread to others, in the case a household member gets infected. Unable to afford rent, many people are moving in with extended family members and friends. A community health worker shared the story of a family that ended up having to leave their furniture and other belongings behind, not being able to afford storage. The economic impacts of COVID-19 have also increased the risk of becoming homeless – said the Seattle Indian Health Board (SIHB), an organization that offers homelessness diversion and housing navigation programs integrated within a community health center. 

Community organizations are finding new ways to support families undergoing housing insecurity. The Vine Seattle, a faith-based organization serving the Brazilian community in the Seattle area, created a website to share with community a list of programs they can apply for to get rental assistance and other related resources. International Community Health Services is also connecting people with financial and rental resources, besides helping them with applications for cash assistance and food programs.

EMPLOYMENT

Interviewees talked about how rising unemployment due to the COVID-19 response measures has restricted residents’ access to the cash they need to meet even their most basic needs: food and housing. In the months of March and April 2020, about one in five Washington state workers filed for unemployment benefits. Job loss has occurred through layoffs and furloughs as businesses close or have reduced services.

Africatown said that communities of color have been hit hard by job loss and that Black Americans are concerned about job recovery: “We [Black Americans] are the first to lose our jobs, and we’ll be the last to get them back.” Immigrants with limited English proficiency who entered the U.S. workforce through hospitality or domestic services were, according to the Asian Counseling and Referral Service, among the first impacted by the closures. Moreover, as other organizations mentioned, people with limited English proficiency often have a hard time applying for public assistance programs.

As reported by interviewees, amongst those who are still employed, many had their work hours reduced.  To compensate, some are attempting to get new jobs, even with low pay. The Vine Seattle pointed out that people who now have less hours available in domestic services or in the roofing business want to enter food delivery business to supplement their income. However, some do not own a car or have a car that does not match the employer’s requirements (the organization clarified that cars need to be fairly new per request of companies offering food delivery jobs). Within Reach highlighted that among those who are still employed, many are anticipating job loss in the future.

Interviewees observed that many people from the communities of color they serve are essential workers and work in high contact settings such as nursing homes, airports, agriculture, and food distribution. These essential workers feel high levels of stress as they worry about contracting COVID-19 at the workplace or in public transit on their way to and from work. Some have been asked for a negative COVID-19 test, which they cannot afford, in order to keep working. A few interviewees also pointed out childcare access as another issue these essential workers are facing.

Finally, the Vine Seattle shared stories of people who were facing adverse conditions in order to keep their jobs.  For example, a nanny was told she could not leave her employer’s home or she would lose her job as the employers were concerned that she could get infected and bring the virus to their home. In order to provide for her family, she opted to stay at her employers’, which meant not being able to see her own children.  

INFORMATION AND AWARENESS

Awareness about COVID-19 and how to decrease its spread is crucial, yet not all communities in King County are getting the information they need. Interviewees that serve Latinx and Black communities shed light on possible reasons for the misperceptions around COVID-19 they have heard from members of these communities. One is that the information coming from different media outlets are at times misleading or contradictory, making it hard for people to know what to believe. Another reason is that, as public health officials learn about this new virus, information evolves and leads to new guidelines for the public.

HEALTHCARE ACCESS

Interviewees talked about how communities face multiple barriers to accessing health care during the COVID-19 pandemic. They described concerns about getting infected when riding public transit or visiting clinics and hospitals, where there could be people with COVID-19 who could potentially transmit the virus.

Reduced public transit can make it harder for those who rely on public transportation to go to their care providers. Telehealth options provide an alternative to physically going to hospitals and clinics for care. However, telehealth requires having a laptop or smartphone and internet connectivity, which many lower-income families do not have.

When it comes to getting health care, interviewees said trust is a very important factor for communities that have been historically marginalized by the government and other institutions. For instance, a participant serving the Black community voiced that people are reluctant to seek care from a provider different from their usual team or clinician (who might be working with COVID-19 patients) because they are afraid of how they will be treated. A member of the African American Maternal and Infant Health Community Action Plan Workgroup elaborated on how existing racial inequities can also make folks even more concerned for their health in case they do contract COVID-19: “Because I am black will I have even less care? If I needed a ventilator, will I get it?”

A number of community leaders accounted for the need for culturally competent healthcare services – which continues to prevail during the COVID-19 epidemic. They pointed out that people want to get care, as well as information regarding health issues such as COVID-19, from people they trust.  The Seattle Indian Health Board (SIHB) surveyed clients – most of whom are American Indians and Alaska Natives– and found out that even when they had health care locations close to their residence, they would still go to the SIHB building. This is because, for them, “what is considered acceptable, [i.e. having culturally appropriate health care] is more important than what is available and accessible”. For that reason, the SIHB continues to offer a broad range of healthcare services, which are available both online and in-person.

Organizations serving low-income populations discussed how these families often face additional stressors with economic insecurity and living conditions – as some end up having to live in crowded homes due to financial constraints. Moreover, they cannot afford to engage in some of the activities that those with higher income do to cope with stress – such as taking a drive or even buying a new family table game. For the Healthy King County Coalition, the current situation “is a stress for everyone: people [that are living] by themselves and people who are trapped with a lot of others.”

International Community Health Services interviewed community members about the need for mental health services and the feedback was that “they need it now more than ever.” Asian Counseling and Referral Service and others anticipate the need for mental health services to increase in the coming months as a result of COVID-19.

Urban Impact, a community organization that serves Black and low-income families in South Seattle, worries that the social and economic hardships resulting from COVID-19 are contributing to an increase in substance use in the community. The organization also shared, along with the Seattle Indian Health Board, their concerns about increasing domestic violence as people shelter at home to avoid the spread of COVID-19. The Seattle Indian Health Board has been adapting their domestic violence program by merging it with social programs in order to better serve victims of domestic violence during this crisis.

The Vine Seattle, a faith-based organization in the Seattle area, said that women have been further affected during the outbreak by facing a heavier domestic burden: “Some of the moms are feeling really stressed... They are cooking meals, getting the kids activities, cleaning the house, all that. They are exhausted.” They often have to work while being in charge of house chores, the education of their children, and care for children and other family members – tasks that for many women are not equally shared with their partners.

A member of the African American Maternal and Infant Health Community Action Plan Workgroup talked about how hard it is for people they serve not being able to gather, hug and be close to others – practices that are deeply embedded in their culture. Asian Counseling and Referral Service and others explained why the lack of routine and normalcy can be particularly difficult for the elderly. As older generations frequently lack familiarity with technology, it can be a hard for them to interact with others online, which can lead to a deeper feeling of isolation.

INTERNET

Interviewees pointed out that there is great need within communities for either internet access or larger bandwidth, as many people shift to working, learning and connecting with others online. Southwest Youth and Family Services commented that although schools provide internet access for their students, “it is not strong enough for the whole family to connect.” Other interviewees said that prior to COVID-19 it was common for people to go to the community center or the library to use the internet when they did not have access at home. The COVID-19 outbreak and the consequent need to stay home and social distance have constrained the ability to access internet hubs outside the home.

Not having access to laptops, tablets or smartphones is another barrier identified by community-based organizations. Urban Impact talked about how families commonly struggle to share a single device in the home, which is especially limiting for families with more than one child. The organization also argued that the need for internet connectivity, including access to electronic devices, is affecting low-income children and youth’s ability to access online learning: “poor kids are falling further behind”. The Seattle Indian Health Board added that “people who live on the streets or live below the poverty line don’t have access to internet or computers.”

Wallingford United Methodist Church and others talked about how some of the adults they serve do not know how to use online meeting tools and social platforms. Some interviewees shared that not being accustomed to or skilled in using technology is even more common among older adults, making it harder for them to connect with families and friends.

Even when familiarity with technology is not an issue, other barriers pose challenges to communities staying connected. As we practice social distancing, many of us have been relying on the internet and social platforms such as Zoom and Skype to stay connected. Potlatch Fund pointed out that the use of these online platforms can, however, be triggering for elders in the Native American communities by reminding them of how their ancestors were recorded and then misrepresented by non-Native Americans. For that, since the COVID-19 outbreak it has become harder for community organizations to connect with elders in Native American communities.