Funding for community health navigators is needed now more than ever

It hardly counts as a silver lining, but policymakers and the press are finally calling out racial disparities in both income and health that have intensified with the COVID-19 pandemic.

Every single life lost to this disease is a tragedy, no matter the individual’s background.  But African-Americans, at 6% of California’s population, suffer 10% of the deaths.  Latinos bear more than 50% of the cases but are only 38% of the population. In San Francisco, half the deaths are among elderly Asian-Americans.  

 As community health navigators know, people of color have had to deal with decades of systemic challenges, institutionally racist policies, and a significant lack of resources and support services.

Reaching out to low-income, marginalized communities of all ethnicities, navigators provide information about affordable health care and other programs; guide people through the often-daunting application process; and help families achieve access to services.  Working through community-based organizations, clinics, schools and faith-based institutions, navigators are trusted community resources.  They speak first languages and assist in culturally competent ways. These are all huge assets for promoting community engagement. 

This is needed now more than ever.  Without information about testing and treatment or assistance with enrollment, keeping and using health insurance programs, all communities are less safe, less stable, less prosperous.  Yet the governor’s proposed May budget revise would cut funding for these critical services. The Legislature did the right thing by putting the funds back in, and the final budget agreement for June 15 should preserve the health navigator funds, to promote  community health and well-being during and beyond the current crisis.  

Latinos and African-Americans are far more likely to have low-paying jobs without health insurance in “essential” sectors, where going on unemployment or effectively distancing to avoid contracting COVID-19 are not an option. 

 As for the millions of California’s low-wage workers who have recently lost jobs and health insurance, learning whether they qualify and how to apply for affordable health coverage or other services (e.g., unemployment benefits, food assistance or mental health counseling) is immensely important for surviving this crisis and beyond. Health navigators have been there, providing much-needed information and assistance with enrollment and access to supportive services.

Many immigrant families steer clear of public programs for fear of losing green cards or even getting deported – an understandable reaction under a virulently hostile federal government.  Health navigators explain how the federal rules actually work and who is exempt – the basis for immigrant families to make informed decisions on how to seek medical care not only for COVID-19 but for so many other serious medical conditions.  

As with many infections, delaying testing for COVID-19 until getting so sick you wind up in the emergency room can lead to succumbing to the disease, as a recent study of hospitalizations and deaths among African-Americans by Sutter Health found.  Most health messaging instructs the public to “contact your doctor first” if experiencing symptoms of COVID-19 – a contact uninsured people typically lack. 

By assisting African-American communities to enroll in coverage, health navigators help eliminate a barrier to accessing testing and treatment before a visit to the ER becomes inescapable and COVID-19 has begun its worst damage.  Promoting early testing also helps control community spread.

Women have suffered greater job loss in California during the pandemic than men, and recently added to the frightful list of COVID-19 impacts is the risk of miscarriage in the second trimester.  By helping women get coverage and access to medical care, navigators help mitigate such risks. For California’s African-American community, with a maternal mortality rate four times that of white people and infant mortality rate two times greater, the stakes could not be higher.   

We are acutely aware that California must close funding gaps created by the COVID-19 pandemic.  But ending support for health navigators would sink, not rescue, our health care ship.  The Legislature and governor should retain vital navigation services, for the health and safety of us all.

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Lynn Kersey is executive director of Maternal and Child Health Access, lynnk@mchaccess.org. Veronica Flores is the CEO of Community Health Councils, vflores@chc-inc.org. They wrote this commentary for CalMatters.