COVID-19 Hmong and Hispanic Communication Network (H2N)

Bridging the communication gap to provide health information to at-risk communities

The COVID-19 pandemic has helped shed light on racial and ethnic disparities in healthcare and health outcomes. In central Wisconsin, Hmong and Hispanic communities are particularly vulnerable to the negative health, educational, and economic impacts of COVID-19.  Many of these disparities can be attributed to language, cultural, and literacy barriers as well as insufficient awareness of available services, resources, and lack of protection in workplaces. Immigration issues and discrimination add further complication.

The Wisconsin Institute for Public Policy and Service (WIPPS) has partnered with the Medical College of Wisconsin-Central Wisconsin to develop a network of concerned community organizations to respond and address existing communication barriers with the Hmong and Hispanic communities.  The Hmong and Hispanic Communication Network project (H2N), created in March 2020, focuses on the strengthening of communication channels and information exchange between public health facing organizations and people in the Hmong and Hispanic communities in central Wisconsin.

The H2N project collaborates with public health organizations, health systems, resource agencies and community organizations to provide Hmong and Hispanic communities with resources and tools to better withstand the COVID-19 pandemic.

“Back in March when COVID started, there was a realization that everybody needs to be reached with public health information, health system information, resources, and not all populations were being reached the same.”

– Dr. Corina Norrbom
WIPPS Health Policy Fellow in an interview with WSAW-TV

Through established relationships, WIPPS recruited respected and well-connected bilingual Hmong and Hispanic Community Coordinators (CCs) who then each recruited four individuals to be Community Health Workers (CHWs). Four Hmong and four Hispanic CHWs were trained in May 2020. Trainings included basic CDC and WI DHS information about SARS-CoV-2, prevention and mitigation of COVID-19, and familiarization with the CDC site. CHWs shared community concerns, information gaps, social networks preferred in their communities, and types of messaging that might be most helpful. Modelling prevention strategies such as wearing masks, physical distancing, hand washing/sanitizing was emphasized.

Since May of 2020, CCs and CHWs reached over 2000 people in the Hmong and Hispanic communities. People in these communities have been able to share their concerns and ideas, while at the same time receiving information about COVID-19 and access to resources in their own language.

Collaborative/connecting organizations

• Medical College of Wisconsin-Central Wisconsin
• Marathon County Health Department
• Aspirus
• Ascension WI
• Marshfield Clinic Health System
• E.A.G. Interpreters Hispanic Outreach
• Hmong WI Chamber of Commerce
• Hmong American Center
• Presbyterian Church Free Clinic
• United Way of Marathon County
• Bridge Community Clinic
• Abby Area Collaborative Team
• Wisconsin DHS
• Covering Wisconsin
• Mexican Consulate Mobile Outreach partners

CCs and CHWs have been able to reach community members in several ways such as farm visits, Hunger Coalition events, existing programs at the Hmong American Center, connections through friends and family, churches, and food box drop-offs for quarantined families. They have also assisted with translation and trust building for health department contact tracing and COVID testing sites. All CCs and CHWs are supplied with an iPad which allows them to connect community members with information and resources as well as access to virtual meeting spaces. This includes COVID-19 specific information but also resources for food/rent assistance, mental health services, domestic abuse, legal rights, and more.

“The main barrier is trust. Being able to be free and seek help because of the different factors that we have, whether it’s immigration, or it’s language, trust is the first thing. They want to see a familiar face, but it takes a while to build that relationship.”

– Tony Gonzalez
H2N Hispanic Community Coordinator in an interview with WSAW-TV

We have learned that written materials have limited value given language and literacy barriers. Video and person-to-person messaging is often much more effective. A partnership with United Way of Wisconsin developed to raise awareness about 211 with a goal of increasing Hmong and Hispanic community comfort with utilization of the service. Liaisons have been providing feedback about potential barriers and suggestions about making the service feel more accessible, welcoming, and safe for people in Hmong and Hispanic communities.

WIPPS/H2N was awarded DHS Influenza Community Outreach funding to engage Hmong and Hispanic communities about influenza and influenza vaccines beginning November 1. These funds allowed for the hiring of several more CHWs. Through CHW community conversations over the past several months, among other things, we have learned that there is general mistrust about vaccinations, disease constructs in Hispanic cultures or traditional Hmong culture may not be amenable to vaccines, and there are financial barriers for uninsured and logistical barriers for accessing vaccines. Outreach by trusted messengers and making affordable influenza vaccines accessible will be paramount in improving influenza vaccination rates in Hmong and Hispanic communities.

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H2N is now shifting to assist Hmong and Hispanic community members in signing up for COVID vaccinations through local health system websites. This is important given that some people are not internet savvy or do not know where to find the necessary information and the registration sites are written in English. CHWs are also working to provide factual information about COVID vaccines and dispel common myths in their communities through conversations and on Hmong and Hispanic media.

Whether or not a person has health insurance significantly impacts their health, particularly in a pandemic scenario and tumultuous economic times. H2N CCs and CHWs received training about the ACA marketplace and open enrollment through Covering Wisconsin in November, and they are letting people know about open enrollment and potential public and private health insurance options. CCs and CHWs also received training regarding the Public Charge Rule to be able to provide accurate public benefit information to community members and not unwittingly expose them to immigration dangers. Two project members have trained to be Certified Application Counselors, which is even more important now that the Biden Administration announced that there will be a new open enrollment period soon. WIPPS/H2N is grateful for the partnership and support from Covering Wisconsin.

“Our church and WIPPS have been strong supporters of getting health information out to people, regardless of their immigration status. So, even if someone is undocumented, they still are a part of our community and are still a fabric of our area.”

– Jeffrey Todd
WIPPS Senior Public Health Fellow in an interview with WSAW-TV

Through the end of October, H2N was funded through grants from CFONCW/United Way COVID-19 Community Response Fund, Aspirus, Ascension WI, Abby Bank Foundation, Northcentral WI Area Health Education Centers, Church Mutual, and Marshfield Clinic Health System. Additionally, July-October we received funding through United Way of Wisconsin for the project with a focus on getting word out about 211 in Hmong and Hispanic communities and to hear insights from CHWs about experiences accessing resources in these communities. New funding partnerships beginning in November include Wisconsin Department of Health Services and Covering Wisconsin. H2N was also awarded a CARES City of Wausau Community Development Block Grant for work in Wausau in 2021.

H2N in the News

Local immigration program responds to Biden’s executive orders – WSAW-TV

$200,000 grant helps community health outreach initiative in Hmong and Hispanic communities in central Wis. – WSAW-TV

Region V Public Health Training Center: COVID-19: Engaging Hmong and Hispanic Populations in Bi-Directional Communication (On Demand)