Ocean: Hey Nina! Firstly, I just want to say welcome to the DEC team! We are so lucky to have you and its great knowing that we have a dedicated trainer to help others comprehend the unique issues, realities, and experiences of the diverse communities we serve. With that being said, I am excited to speaking to you about todays’ topic. As you know, August is National Immunization Month and so I wanted to talk about the COVID-19 vaccine and some of the general implications it has on daily life in diverse communities.
Nina: Hey Ocean! I’m so excited to join the DEC! It’s been great to jump in and deliver trainings with healthcare and social service providers. Whether I’ve delivered a training for providers on the east coast in Massachusetts, or the west coast in California, one thing is on everybody’s mind right now: COVID-19, and the vaccine. We know diverse communities have been disproportionately impacted by COVID-19, and the vaccine roll-out process, so I’m glad we’re talking about this today.
Ocean: It is so interesting to see the unique issues of each diverse community in terms of the COVID-19 vaccine roll-out. For many of our non-English speaking older adults in diverse communities, vaccine hesitancy may arise from a lack of information or misinformation that arise from in-language unreliable resources whereas for other diverse communities such as African American/Black, Hispanic, and American Indian and Alaska Native communities, it may be because of distrust which may have resulted from historical discrimination and systemic racism. Transportation is also a barrier for many older adults.
Nina: Absolutely. When we have large-scale processes, we often forget to consider the unique realities and needs of communities that are diverse in race, ethnicity, gender identity, sexual orientation, language, immigration status, culture etc. We know that Asian American and Pacific Islander (AAPI) individuals make up over 40 unique cultural and racial identities, encompassing 100 different languages. And yet, vital healthcare information relayed over the phone often remains in English; phone menus are in English, voicemails are in English, and mail is sent in English. This impacts Southeast Asian American older adults significantly; over 85% of Vietnamese, Laotian, Cambodian and Hmong older Americans are Limited English Proficient (LEP). To increase access to crucial healthcare services, including and especially the vaccine, we must increase language access for our LEP older adults so they can have real and meaningful access to the information, services and supports they need.
Ocean: Personally, I think the more we neglect our diverse communities by not accounting for their cultural and linguistic challenges, the more likely it is for misinformation and disinformation about the COVID-19 vaccine to spread in our diverse communities. As a result of the lack of available in-language information, we see diverse communities using alternative platforms such as Facebook forums, encrypted messenger groups such as WhatsApp and WeChat, and others web platforms to get in-language health information. All of our data, including the US 2020 Census points to a rapidly diversifying and aging nation yet many of our health care and social service systems only cater to English-speaking, heterosexual adults. The lack of investment in our diverse communities has led to many disparities that have only become apparent during the COVID-19 pandemic… we need that to change.
Nina: We see these disparities play out in real-time when we look at the impacts of COVID-19 on diverse communities. A recent article written by Karyne Jones, President & CEO of our member organization, the National Caucus and Center of Black Aging, Inc. shared that Black seniors have contracted and died from COVID-19 two to three times more than other older adult populations. In fact, Black seniors ages 65-74 have died five times more than Whites of the same age. Black seniors have also accounted for 37% of the 65 and older COVID-19 hospitalizations, even though they only represent 12% of this senior population.
Ocean: It’s clear that pre-existing disparities among our diverse communities worsen health outcomes during the pandemic, especially for those who reside in low-income communities, racially/ethnically segregated communities, and rural communities where health information and resources may be difficult to access. Luckily, we have seen many organizations, including the DEC member organizations provide targeted resources and information for our diverse communities during the pandemic. We have also seen a lot of focus on equity and inclusion, however there needs to be more investment on a national level in our diverse communities to mitigate the effects of pre-existing disparities.
Nina: And yet, despite the disparities and barriers that diverse communities face, they remain resilient. The importance of family is a cultural value held by many diverse communities, including the American Indian and Alaskan native community. Kerry Hawk Lessard, the executive director of Baltimore and Boston-based Urban Indian Health program Native American LifeLines, shared: “The “language you hear throughout Indian country is ‘be a good relative,’” Lessard says. “Do this for the grandmas, do this for the ceremony, do this for the language, because our people are precious….We already lost a lot. We can’t afford to lose more.” This prioritization of family had led to American Indian and Alaska Native communities holding the highest vaccination rates in the country.
Ocean: It starts with the community! We can ALL learn something from our American Indian and Alaska Native communities during this time. The messaging within the community accounts for cultural values that are important to many American Indians and Alaska Natives. This should be applied to all of our diverse communities. We need to acknowledge and actively listen to our diverse communities to best address their needs.
The opinions expressed in this article are those of the author and do not necessarily reflect those of the Diverse Elders Coalition.