A team of researchers by Howard University’s Dr. Monica Ponder and UCLA’s Dr. Chandra Ford have received a $1.7 million grant from the CDC Foundation designed to reach historically marginalized and disadvantaged populations during public health crises.

The endeavor, Project REFOCUS, leveraging more than a decade of their experience applying epidemiology and health communication to racism as a public health problem, tracks the intersecting pandemics of racism, especially as expressed through stigma and COVID-19 with a focus on providing information to the communities most directly affected.

Key concerns include stereotypes about the origins of coronavirus disease and the historical and present-day ways structural racism influences the social determinants of health and health access among diverse communities.

“During crises, fear can have a counter effect on access and adherence to community-level mitigation efforts,” said Ponder, assistant professor of health communication in the Department of Communication, Culture and Media Studies at Howard’s Cathy Hughes School of Communications.

“Chronic stress is an important pathway by which stigma influences physical and mental health. That can become a vicious cycle, fueled by racism and bias. Public health crisis communications must also recognize the historical trauma, lived experiences and political climate in which people reside … to ignore this context is malpractice,” Ponder said.

In addition, prejudice stemming from rumors and scare-mongering can lead to unfair treatment and stress, which itself has a negative impact on physical and mental health.

“We have to shift the focus beyond merely documenting higher rates of death, disease and underlying conditions in our communities toward eradicating the inequities. As with any other threat to health, we can only do that by identifying the root causes – meaning the causes of the unequal social conditions” said Ford, founding director of the UCLA Fielding School of Public Health’s Center for the Study of Racism, Social Justice & Health and professor in the Department of Community Health Sciences.

Project REFOCUS’ initial funding is from the CDC Foundation, an independent nonprofit created by Congress to mobilize philanthropic and private-sector resources to support the CDC’s and public health community’s critical health protection work.
These very real issues have a huge impact on the ability of public health officials to slow the spread of a pandemic, much less treat the sick. Ford said the pandemic has disproportionately struck the nation’s Latino populations, as it has in Black, Native American and Pacific Islander communities where death rates COVID-19 are at least double that for whites and Asian Americans.

Public health practitioners face challenges in effectively monitoring the presence, spread and impacts of COVID-19 among these disadvantaged populations,” Ford said. “Lessons learned from prior epidemics, such as HIV/AIDS, make it clear that stigma and mistrust slow disease mitigation efforts among the most disadvantaged populations, contribute to mistrust of public health messages, delay access to services, and reduce adherence to treatment. This mistrust is rooted not in science denialism, but in legitimate concerns about the unequal treatment African American and other communities have received in health care.”

The project – officially, Racial Ethnic Framing of Community-Informed and Unifying Surveillance, or REFOCUS – will study COVID-19-related stigma and discrimination in communities of concern, and provide real-time information for public health officials, members of the public and policymakers to help them reach populations at increased risk by building trust between essential and frontline workers and the communities they serve.

Work on Project REFOCUS is underway and the research teams have developed crisis communication tools and strategies for local communities and media, as well as a prototype tool for a stigma-focused community listening and surveillance for monitoring indicators of racism and stigma.

For more information, go to projectrefocus.com.

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WI Guest Author

This correspondent is a guest contributor to The Washington Informer.

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