COVID-19 health equity initiatives: UC San Diego Refugee Health Unit

In this installment of "COVID-19 health equity initiatives," we look into an initiative to address the exclusion of refugee communities in the San Diego, California area from decisions that impact their well-being and access to resources, with regard to the COVID-19 pandemic.

UC San Diego Refugee Health Unit

UC San Diego Refugee Health Unit is the backbone organization of the San Diego Refugee Communities Coalition (SDRCC). Their mission is to provide research, evaluation, training, planning and program development services in support of community-based organizations and cross-sector partnerships that aim to improve health and wellness outcomes for San Diego’s refugee populations.

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The SDRCC mission is to lead coordinated action to ensure that individuals and families from refugee communities throughout San Diego County are healthy, safe, and thriving.

We have multiple program initiatives including a recently funded Refugee Communities COVID-19 Communication and Health Outreach Initiative (funded by County HHSA) through which eight members are delivering outreach and education to multiple refugee communities. The following refugee communities are included in this initiative: Afghani, Burmese, DR Congo, Haitian, Ethiopian, Eritrean, Iraq, Syria, Somali, and Sudanese.

Our goal is to ensure an effective response to COVID-19 within San Diego’s refugee communities to prevent spread, ensure early recognition, facilitate rapid access to testing and treatment, support the recovery of impacted individuals, and build a more resilient and culturally competent system.

We have been building this plane as we are flying which is both exhilarating and terrifying. COVID-19 while presenting enormous challenges is also offering some unique opportunities. —Amina Sheik Mohamed, Refugee Health Unit founding director

We recently completed a comprehensive assessment of the impact of COVID-19 (PDF). As a result of this assessment we will be conducting community-based participatory research (CBPR) to answer the following questions:

• How can the experiences and perceptions of San Diego’s refugee communities during the COVID-19 pandemic be used to inform more effective and compassionate e-health care interactions and practices?
• What are the cultural discursive markers of empathy and compassion, and what actions, language, gestures might either highlight these qualities or inadvertently signal lack of these qualities?

Formation of the SDRCC in 2019 to address disparities in health, exclusion of refugee communities from decisions that impact their well-being and unequal access to resources among ethnic community-based organizations (ECBOs).

Planning for SDRCC began in 2018. The group was formed in September 2019 and consists of 11 ECBOs representing refugee and new immigrant communities of East African, Middle Eastern, Central and South Asian, and Haitian backgrounds.  The work is ongoing and at this point there is no end date.

Results of the proposed CBPR project are:

• Policy and procedure recommendations which incorporate actions relating to use of existing and emerging e-health platforms.
• Development of a prototype bench marking or assessment tool such as a Refugee-Competency e-Health Services Index that can be used to evaluate the adherence of health care providers to policy and procedure recommendations including those relating to linguistic and cultural competencies and refugee-focused trauma informed practices within a defined health care focus area.

The timeline for this project is two years.

San Diego County HHSA had never contracted with small ECBOs before this. Now they are and the ECBOs are exceeding all expectations—for example they hired 16 bilingual/bicultural community health workers in two weeks. Each ECBO is implementing outreach approaches that work best for their communities using multiple methods and mediums.

• County of San Diego Health & Human Services Agency (HHSA); Departments of Public Health and Behavioral Health Services
• Family Health Centers of San Diego (FHCSD), a federally qualified health center, and its Laura Rodriguez Research Institute.

SDRCC members

• African Coalition Workforce (ACW)
• Haitian Bridge Alliance (HBA)
• Horn of Africa, Inc. (HoA)
• Karen Organization of San Diego (KOSD)
• Majdal Center (MC)
• License to Freedom (L2F)
• Partnership for the Advancement of New Americans (PANA)
• Refugee Assistance Center (RAC)
• Somali Bantu Community of San Diego (SBCSD)
• Southern Sudanese Community Center of San Diego (SSCCSD)
• United Women of East Africa Support Team (UWEAST)

Continuing to build allies and secure funding to support and sustain the work.

Engage ECBOs who are trusted within their communities and have linguistic and cultural competency.

• SDRCC COVID-19 Community Impact Report (PDF)

For more information about the UC San Diego Refugee Health Unit, please contact Amina Sheik Mohamed, founding director of the Refugee Health Unit at [email protected].

• Black Arizona COVID-19 Task Force
• Cambridge Health Alliance (Massachusetts)
• Chicago Racial Equity Rapid Response Team
• Meharry Medical College
• Michigan Public Health Institute
• Milwaukee Health Department
• New York Department of Health
• Public Health Alliance of Southern California
• Spectrum Health Lakeland

Visit the COVID-19 health equity initiatives main page for additional information.