COVID-19 deaths are declining, but health workers who provide vaccine outreach and education in their communities say it’s still important to relay the importance of protecting yourself against the virus, especially for seniors of color.
Anyone who contracts COVID-19 is at risk of severe illness, death, heart problems, and long COVID. However, people 75 and older are about nine times as likely to die from the virus, compared to people between the ages of 18 and 39.
To better understand how health workers might reach older adults from marginalized neighborhoods, Public Good News spoke with Corin Reyes, director of health equity at the YWCA of San Antonio, Texas. Reyes shared some strategies that work at YWCA, and the family structures their team keeps in mind when working with seniors.
Here’s what Reyes said.
[Editor’s note: This interview has been edited for clarity and length.]
PGN: Can you share more about the seniors and communities you serve through YWCA San Antonio’s vaccine and preventative health services? What are some factors your health workers keep in mind?
C.R.: We’ve had a health program at the YWCA that dates back at least a decade and focuses on women’s health services and adult preventative services.
During the pandemic, we realized that we needed to do more. We started with a large grant to help us do vaccine outreach, then we expanded it to be able to do our own pop-up clinics. And now we’re expanding even more to go directly into people’s homes. There are people who just can’t leave their home for a variety of reasons: they are elderly, they are infirm, or they have disabilities.
The majority are Black or brown. Typically, they’re low-income—those are the neighborhoods that we have a tendency to serve first and foremost because of the highest need.
They also tend to be very family oriented. A lot of them live in a multi-generational home. So there are children and grandchildren also living there.
The older population, right now, comes from a generation where maybe mom did not work outside the home. A lot of times they don’t have access to some of the things that we would expect a person who worked to have access to—such as Medicare. They may not have access to Social Security.
They may not be able to drive. It’s not atypical for a homemaker to not have a driver’s license. Because that was not something they needed to do. Our society undervalues women in general, and then we even further undervalue homemakers and their contribution to our society. Because of that, we forget that there may have been some things that they might not have done, like, handle the bank account, drive around, have a license.
So when we go in, we need to make sure that we’re addressing all of those things.
PGN: In the early months of the COVID-19 pandemic, data showed that COVID-19 disproportionately infected, hospitalized, and killed Black, Latine, and Native American people the most. Now, new data shows COVID-19 mortality rates are shifting across demographics.
Can you offer any insight about what this looks like in your community?
C.R.: Interestingly enough, minority populations were the most vaccinated in Texas.
To give some historical context to what I’m saying, a long time ago, doctors were trained by many different methods. There was no consistency.
At some point, the American Medical Association determined that they wanted all doctors to be trained exactly the same, which sounds like a great thing, except for, in that timeframe, we still lived in an overtly racist society. So, when they went to make all medical schools the same, they also closed down schools that trained physicians of color.
That’s the start of our medical system. And we’ve never changed the way we do that.
[During the pandemic,] we put a bunch of shots in arms, and we offered these crazy incentives.
So on the plus side, yes, the mortality rates from COVID-19, specifically in those areas, is lower. But the downside is we didn’t address any of the other issues, [like systemic inequities to access health care] that were putting [people from marginalized communities] at higher risk in the first place.
We didn’t address their housing issues, we didn’t address their lack of access to healthy foods, their lack of access to preventative health care services—the uninsured rate in Texas is twice the national rate.
PGN: As your organization continues to provide vaccination education and outreach in 2024, where are you focusing your efforts next?
C.R.: When we first started, we were mostly focused on mass vaccination because we were in an emergency state. But now that things have slowed down—most people have been vaccinated at least once—it’s time to look at true prevention.
We would not have ended up in the emergency state that we were in if we had properly funded our public health systems; if we had looked at the social determinants of health of our communities, and made sure that people were actually OK. We wouldn’t have ended up in a situation where we have our most vulnerable population at risk for death.
It’s not okay to just be like, ‘Well, you know they’re older…’
I feel like that was our stance when the pandemic happened. COVID-19 kills mostly older people because they have a weaker immune system. And I don’t understand how, as a country, we’re okay with that somehow.
Because without this older generation, where would we even be? They laid the groundwork for all of us. We need to take care of them the same way we would want somebody to take care of us when we get to that age.
So, we’re thinking about vaccination as a preventative measure, and also about what are the other things we need to do to keep people healthy so that we don’t end up back in an emergency state.
Seniors are typically on a fixed income. They typically have multiple chronic conditions that they have to manage. They often make choices between should I get this medication, or do I feed myself? That’s not a choice that people should have to make. But many do every single day. Medicare isn’t enough to cover everything.
We have the capacity now to start to think more holistically.
PGN: What strategies have worked to reach more seniors to stay up to date on their vaccines?
C.R.: We started by going to community rooms in housing complexes that were senior focused. Merced Housing, for instance, houses a lot of people who are either seniors or disabled.
But we started to notice that there were some people who wouldn’t come. And it was because they couldn’t leave their apartment. So, we said, ‘OK, pack up. We’ll go to their apartment, we’re already here. Why not?’
It ticked something in our head. Like, if these people can’t leave their apartment, what about people who are out there in the houses surrounding here?
So, we started working with Meals on Wheels and Metro Health to start asking people as their meals were delivered: ‘Have you been vaccinated?’ If not, ‘do you want somebody to come to your home and vaccinate [you]?’
And there was a huge response out of that.
The other part about working with seniors is [that] just because you vaccinate abuelita—if the grandkids, or the kids, or anybody else comes into the home, and they’re sick— she’s still at risk. A vaccine doesn’t do everything.
You have to educate the family to get vaccinated too. And that’s where it gets a little bit more difficult.
That’s what I find amazing about our community health workers. As a nurse, I have learned so much from them about the way that they talk to people, and the way that they educate people. They never talk down to people. They never make assumptions about what they know, or what they don’t know. They meet people where they’re at truly and fully. And that’s a special skill.
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