Covid-19 rural health inequities: insights from a real-world scenario

Background: During the pandemic, Mount Pleasant, Texas became a hotspot for Covid-19 cases in the Hispanic community employed by a local meat packing plant and many other industries. An important consideration for rural communities is the language barrier and lack of easily accessible Spanish information explaining Covid-19. In addition, rapidly changing discoveries about the virus and subsequent vaccines creates a sense of confusion within this population already burdened with difficulty understanding health information leading to even more confusion about prevention, treatment and vaccine acceptance. Methods: In response to a request for assistance from Titus Regional Medical Center, focus groups were held to investigate patient voices in person. Hiring of a bilingual Community Health Worker (CHW) empowered the hospital to connect with the community and hold the focus groups where patient voices could be heard. Results: Barriers identified included inadequate billing explanation, rushed and impersonal service, language barriers and lacking cultural competency. TRMC aims to build infrastructure and relationships employing health literacy practices to (1) communicate in a manner to bridge Spanish/English; (2) take proactive steps to build a bilingual workforce; and (3) leverage CHWs, health literacy and cultural competency to improve care outcomes. Conclusions: This brief report demonstrates that healthcare system openness to patient and community-centered care offers lessons to providers, public health personnel and policy makers about the importance of effective and sustained patient and community-centered care. Such care should include health communication that is culturally and linguistically congruent to abate this pandemic and future threats to public health.