CDC Engagement with Community and Faith-Based Organizations in Public Health Emergencies
Scott Santibañez, MD, DMin, MPHTM, Associate Director for Science, Centers for Disease Control and Prevention, Division of Preparedness and Emerging Infections; and Mark Davis
Introduction
In 2005, when Hurricane Katrina exposed troubling gaps in areas with inadequate resources, it also highlighted the community and faith-based organizations’ (CFBOs) ability to respond quickly in vulnerable communities. However, these organizations were not well integrated into the federal response.
Methods
We reviewed Centers for Disease Control and Prevention (CDC) reports and documents to assess progress integrating CFBOs into public health preparedness, response, and recovery in CDC-related domestic responses to pandemic influenza (2009), Ebola (2014), and Zika (2016).
Results
In 2008, CDC and the Association of State and Territorial Health Officials (ASTHO) developed the At-Risk Populations Project to help state and local health departments engage CFBOs and protect at-risk people during a severe influenza pandemic and other public health emergencies. CDC and ASTHO disseminated a resource document and conducted six in-person trainings and webinars. A related project, Engaging Communities in Response to Pandemic Influenza, begun in 2005 by CDC, the US Department of Health and Human Services (HHS), and Emory University, involved nine US sites. One example was the Minnesota Immunization Networking Initiative (MINI). In 2009, MINI organized H1N1 vaccination clinics in churches, mosques, a Hindu Temple, a Buddhist monastery, and Sikh, Vietnamese, and Ethiopian faith organizations, which helped to address limited access, transportation, scheduling, and mistrust. From 2006 to 2018, MINI provided over 85,000 free influenza vaccinations in vulnerable communities. The first US case of Ebola was identified in Dallas, Texas in September 2014. Contact tracers from CDC, the Texas Department of State Health Services, and Dallas County Health and Human Services actively monitored 179 contacts for Ebola symptoms. The initial case patient lived in a three-mile-square neighborhood with 25,000 residents who spoke >40 languages. During monitoring, contacts reported difficulties meeting daily needs such as food, diapers, and routine prescription refills. Six of seven monitored households needed help with utilities, rent, or other necessities. More than three quarters reported stress, social isolation, and stigma. Contact tracers engaged CFBOs who provided food from the local food bank, toiletries, and other essential household items. Meeting the basic needs of Ebola contacts was essential to successful contact tracing, which is critical to interrupting virus transmission. Following the Dallas response, CDC organized national calls with CFBOs to share accurate Ebola information and counter stigma. Participants included over 2000 individuals from diverse Christian, Jewish, Muslim, Hindu, Buddhist, and secular organizations. When Zika virus emerged in 2016, HHS, CDC, the Florida Department of Health, and the Commonwealth of Puerto Rico organized a webinar series to engage CFBOs. The webinars’ strategy involved eliminating mosquito habitats, distributing insect repellent, addressing misinformation about Zika, and considering cultural sensitivity when discussion for prevention of sexual transmission of Zika virus. The Zika response showed that local response leaders could find common ground with religious leaders.
Conclusion
Although much has been accomplished in CDC and state and local public health engagement with CFBOs in domestic responses, this effort remains a work in progress. We hope this summary will help galvanize future efforts.
In 2005, when Hurricane Katrina exposed troubling gaps in areas with inadequate resources, it also highlighted the community and faith-based organizations’ (CFBOs) ability to respond quickly in vulnerable communities. However, these organizations were not well integrated into the federal response.
Methods
We reviewed Centers for Disease Control and Prevention (CDC) reports and documents to assess progress integrating CFBOs into public health preparedness, response, and recovery in CDC-related domestic responses to pandemic influenza (2009), Ebola (2014), and Zika (2016).
Results
In 2008, CDC and the Association of State and Territorial Health Officials (ASTHO) developed the At-Risk Populations Project to help state and local health departments engage CFBOs and protect at-risk people during a severe influenza pandemic and other public health emergencies. CDC and ASTHO disseminated a resource document and conducted six in-person trainings and webinars. A related project, Engaging Communities in Response to Pandemic Influenza, begun in 2005 by CDC, the US Department of Health and Human Services (HHS), and Emory University, involved nine US sites. One example was the Minnesota Immunization Networking Initiative (MINI). In 2009, MINI organized H1N1 vaccination clinics in churches, mosques, a Hindu Temple, a Buddhist monastery, and Sikh, Vietnamese, and Ethiopian faith organizations, which helped to address limited access, transportation, scheduling, and mistrust. From 2006 to 2018, MINI provided over 85,000 free influenza vaccinations in vulnerable communities. The first US case of Ebola was identified in Dallas, Texas in September 2014. Contact tracers from CDC, the Texas Department of State Health Services, and Dallas County Health and Human Services actively monitored 179 contacts for Ebola symptoms. The initial case patient lived in a three-mile-square neighborhood with 25,000 residents who spoke >40 languages. During monitoring, contacts reported difficulties meeting daily needs such as food, diapers, and routine prescription refills. Six of seven monitored households needed help with utilities, rent, or other necessities. More than three quarters reported stress, social isolation, and stigma. Contact tracers engaged CFBOs who provided food from the local food bank, toiletries, and other essential household items. Meeting the basic needs of Ebola contacts was essential to successful contact tracing, which is critical to interrupting virus transmission. Following the Dallas response, CDC organized national calls with CFBOs to share accurate Ebola information and counter stigma. Participants included over 2000 individuals from diverse Christian, Jewish, Muslim, Hindu, Buddhist, and secular organizations. When Zika virus emerged in 2016, HHS, CDC, the Florida Department of Health, and the Commonwealth of Puerto Rico organized a webinar series to engage CFBOs. The webinars’ strategy involved eliminating mosquito habitats, distributing insect repellent, addressing misinformation about Zika, and considering cultural sensitivity when discussion for prevention of sexual transmission of Zika virus. The Zika response showed that local response leaders could find common ground with religious leaders.
Conclusion
Although much has been accomplished in CDC and state and local public health engagement with CFBOs in domestic responses, this effort remains a work in progress. We hope this summary will help galvanize future efforts.