Biden Administration’s Rapid-Test Rollout Doesn’t Easily Reach Those Who Need It Most

Biden Administration’s Rapid-Test Rollout Doesn’t Easily Reach Those Who Need It Most

In the past week, the Biden administration launched two programs that aim to get rapid covid tests into the hands of every American. But the design of both efforts disadvantages people who already face the greatest barriers to testing.

From the limit placed on test orders to the languages available on websites, the programs stand to leave out many people who don’t speak English or don’t have internet access, as well as those who live in multifamily households. All these barriers are more common for non-white Americans, who have also been hit hardest by covid. The White House told KHN it will address these problems but did not give specifics.

It launched a federally run website on Jan. 18 where people can order free tests sent directly to their homes. But there is a four-test limit per household. Many homes could quickly exceed their allotments — more than a third of Hispanic Americans plus about a quarter of Asian and Black Americans live in households with at least five residents, according to an analysis of Census Bureau data by KFF. Only 17% of white Americans live in these larger groups.

“There are challenges that they have to work on for sure,” said Dr. Georges Benjamin, executive director of the American Public Health Association.

Also, as of Jan. 15, the federal government requires private insurers to reimburse consumers who purchase rapid tests.

When the federal website — with orders fulfilled and shipped through the United States Postal Service — went live this week, the first wave of sign-ups exposed serious issues.

Some people who live in multifamily residences, such as condos, dorms, and houses sectioned off into apartments, reported on social media that if one resident had already ordered tests to their address, the website didn’t allow for a second person to place an order.

“They’re going to have to figure out how to resolve it when you have multiple families living in the same dwelling and each member of the family needs at least one test. I don’t know the answer to that yet,” Benjamin said.

USPS spokesperson David Partenheimer said that while this seems to be a problem for only a small share of orders, people who encounter the issue should file a service request or contact the help desk at 1-800-ASK-USPS.

A White House official said 20% of shipments will be directed every day to people who live in vulnerable ZIP codes, as determined by the Centers for Disease Control and Prevention’s social vulnerability index, which identifies communities most in need of resources.

Another potential obstacle: Currently, only those with access to the internet can order the free rapid tests directly to their homes. Although some people can access the website on smartphones, the online-only access could still exclude millions of Americans: 27% of Native American households and 20% of Black households don’t have an internet subscription, according to a KHN analysis of Census Bureau data.

The federal website is currently available only in English, Spanish, and Chinese.

According to the White House, a phone line is also being launched to ease these types of issues. An aide said it is expected to be up and running by Jan. 21. But details are pending about the hours it will operate and whether translators will be available for people who don’t speak English.

However, the website is reaching one group left behind in the initial vaccine rollout: blind and low-vision Americans who use screen-reading technology. Jared Smith, associate director of WebAIM, a nonprofit web accessibility organization, said the federal site “is very accessible. I see only a very few minor nitpicky things I might tweak.”

The Biden administration emphasized that people have options beyond the rapid-testing website. There are free federal testing locations, for instance, as well as testing capacity at homeless shelters and other congregate settings.

Many Americans with private health plans could get help with the cost of tests from the Biden administration reimbursement directive. In the days since its unveiling, insurers said they have moved quickly to implement the federal requirements. But the new systems have proved difficult to navigate.

Consumers can obtain rapid tests — up to eight a month are covered — at retail stores and pharmacies. If the store is part of their health plan’s rapid-test network, the test is free. If not, they can buy it and seek reimbursement.

The program does not cover the 61 million beneficiaries who get health care through Medicare, or the estimated 31 million people who are uninsured. Medicaid and the Children’s Health Insurance Program are required to cover at-home rapid tests, but rules for those programs vary by state.

And the steps involved are complicated.

First, consumers must figure out which retailers are partnering with their health plans and then pick up the tests at the pharmacy counter. As of Jan. 19, however, only a few insurance companies had set up that direct-purchase option — and nearly all the major participating pharmacies were sold out of eligible rapid tests.

Instead, Americans are left to track down and buy rapid tests on their own and then send receipts to their insurance providers.

Many of the country’s largest insurance companies provide paper forms that customers must print, fill out, and mail along with a receipt and copy of the box’s product code. Only a few, including UnitedHealthcare and Anthem, have online submission options. Highmark, one of the largest Blue Cross and Blue Shield affiliates, for instance, has 16-step instructions for its online submission process that involves printing out a PDF form, signing it, and scanning and uploading it to its portal.

Nearly 1 in 4 households don’t own a desktop or laptop computer, according to the Census Bureau. Half of U.S. households where no adults speak English don’t have computers.

A KHN reporter checked the websites of several top private insurers and didn’t find information from any of them on alternatives for customers who don’t have computers, don’t speak English, or are unable to access the forms due to disabilities.

UnitedHealthcare and CareFirst spokespeople said that members can call their customer service lines for help with translation or submitting receipts. Several other major insurance companies did not respond to questions.

Once people make it through the submission process, the waiting begins. A month or more after a claim is processed, most insurers send a check in the mail covering the costs.

And that leads to another wrinkle. Not everyone can easily deposit a check. About 1 in 7 Black and 1 in 8 Hispanic households don’t have checking or savings accounts, compared with 1 in 40 white households, according to a federal report. Disabled Americans are also especially likely to be “unbanked.” They would have to pay high fees at check-cashing shops to claim their money.

“It’s critically important that we are getting testing out, but there are limitations with this program,” said Dr. Utibe Essien, an assistant professor of medicine at the University of Pittsburgh School of Medicine. “These challenges around getting tests to individuals with language barriers or who are homeless are sadly the same drivers of disparities that we see with other health conditions.”

KHN Midwest correspondent Lauren Weber contributed to this report.

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Why an HBCU Med School Decided to Put CARES Act Money Into Students’ Pockets

Why an HBCU Med School Decided to Put CARES Act Money Into Students’ Pockets

NASHVILLE, Tenn. — Just before students at Meharry Medical College went home for Thanksgiving, Dr. James Hildreth, the school’s president, emailed them a video message that he acknowledged seemed hard to believe. Or at least they had to give it a second listen.

“We’ll gift each of you $10,000 in cash,” he said, looking at the camera. “You heard me right.”

They were told to expect a direct deposit the next day or pick up a check in person. Hildreth, an expert in infectious diseases who helped lead Nashville’s pandemic response, explained that this gift with no strings attached was money from the CARES Act, a major covid-19 relief law passed by Congress in 2020. He asked only that they be “good stewards” of the windfall.

After deep consideration, Meharry’s administration decided to give roughly a third of its CARES Act funding — $10 million — directly to its future doctors, dentists and public health researchers. All told, 956 students received payments.

Meharry’s students had already been heavily involved in the pandemic response, staffing Nashville’s mass covid testing and vaccination sites. But the money isn’t so much surprise compensation for volunteer efforts as it is an investment in a future career — and an assist in overcoming financial hurdles Black students especially face to become medical professionals.

While Black Americans make up roughly 13% of the population, the Association of American Medical Colleges finds Black doctors account for just 5% of the nation’s working physicians — a figure that has grown slowly over more than a century. And studies have found that Black patients often want to be cared for by someone whom they consider culturally competent in acknowledging their heritage, beliefs and values during treatment.

Meharry graduates more Black physicians than almost any other U.S. school. And half of its M.D.s enter the high-demand but lower-paying specialty of primary care.

“We felt that there was no better way to begin distributing these funds than by giving to our students who will soon give so much to our world,” Hildreth said.

Cheers erupted in the library as students clicked the video link.

Andreas Nelson fell silent, he recalled later. He went to his banking app and stared in disbelief. “$10,000 was sitting just in my bank account. It was astonishing,” he said. “I was literally lost for words.”

The Chicago native is finishing a master’s degree in health and science at Meharry with hopes of entering its dental school. The average student loan debt in the program totals more than $280,000. So, undoubtedly, 10 grand won’t make much of a dent in the debt.

But the money in his pocket eases his top concern of making rent each month. Nelson said it feels as though he’s being treated like an adult, allowing him to decide what his greatest needs are in getting through school.

“It’s motivating,” Nelson said. “Because that means they have trust in us to do with this money whatever the cause may be — whether it be student debt, investing or just personal enjoyment.”

Across the board, students at HBCUs rely more on student loans than students at historically white institutions. Roughly 80% take out student loans, according to an analysis by UNCF, formerly known as the United Negro College Fund, and they borrow considerably more.

Meharry was founded a decade after the Civil War to help those who had been enslaved. But the 145-year-old institution has always struggled financially, and so have its students.

The reasons are rooted in the country’s racist past, which has left the institutions with less money potentially available for scholarships than other universities. And students’ families generally have less wealth to tap into since Black households across the country have averaged around $17,000 in net worth — about a tenth of the average for white families.

Meharry’s average student debt is far higher than other area schools of medicine at Vanderbilt University and the University of Tennessee, representing both private and public institutions.

Virtually all colleges and universities received allotments under the CARES Act, but HBCUs have been much more aggressive about funneling substantial amounts directly to students, who tend to have greater need. More than 20 HBCUs have erased outstanding tuition balances. Some have canceled student fees.

But Meharry, one of the few stand-alone HBCU graduate schools, is a rare case in cutting checks for students.

“These young people are rising to medical school against all odds,” said Lodriguez Murray, who leads public policy and government affairs at UNCF. “Of course, they have to borrow more because people who look like them have less.”

During the pandemic, major philanthropists have taken new interest in supporting the few HBCU medical schools. Michael Bloomberg committed $100 million to four institutions, including Meharry, to help educate more Black doctors.

Students at Meharry can now apply for $100,000 scholarships. The $34 million from Bloomberg Philanthropies is also going toward other kinds of financial support.

The school is now offering, for no additional fee, expensive test-prep services through a Boston-based company, MedSchoolCoach. The service, which entails paying a doctor by the hour to help with studying, can cost thousands of dollars.

While the price is often out of reach for students tight on cash, acing the benchmark exams toward board licensure is key to landing coveted fellowships, qualifying for lucrative specialties or just finishing on time. And Meharry’s four-year completion rate of roughly 70% is below most schools. The most up-to-date national average is around 82%.

For some, Murray said, a $10,000 windfall may make all the difference in whether they cross the finish line and become a doctor who can afford all their medical school debt.

“Many of those students are borrowing a lot of money to complete their dream, and to become relatively high earners in the future,” Murray said. “The fact that these students are largely coming from lower socioeconomic backgrounds means that the funds that Meharry turned around and gave to the students are particularly impactful.”

This story is from a partnership that includes Nashville Public Radio and KHN.

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Stress is contagious in relationships

Stress is contagious in relationships

Stress is contagious in relationships – here’s what you can do to support your partner and boost your own health during the holidays and beyond

Relationship stress can hit new highs during the holidays. Aaron Amat/iStock via Getty Images Plus
Rosie Shrout, Purdue University

With the flurry of shopping, spending money and traveling to see family, stress can feel inevitable during the holidays.

You might already know stress can affect your own health, but what you may not realize is that your stress – and how you manage it – is catching. Your stress can spread around, particularly to your loved ones.

As a social-health psychologist, I have developed a model on how partners and their stress influence each other’s psychological and biological health. Through that and my other research, I’ve learned that the quality of intimate relationships is crucial to people’s health.

Here’s just a sample: Relationship stress can alter the immune, endocrine and cardiovascular systems. A study of newlyweds found levels of stress hormones were higher when couples were hostile during a conflict – that is, when they were critical, sarcastic, spoke with an unpleasant tone and used aggravating facial expressions, like eyerolls.

Likewise, in another study, people in hostile relationships had slower wound healing, higher inflammation, higher blood pressure and greater heart rate changes during conflict. Middle-aged and older men had higher blood pressure at times when their wives reported greater stress. And partners who felt they weren’t being cared-for or understood had poorer well-being and higher mortality rates 10 years later when compared with those who felt more cared-for and appreciated by their partners.

“How to deal with holiday stress.”

Conflict and cortisol

Cortisol is a hormone that plays a key role in the body’s stress response. Cortisol has a diurnal rhythm, so its levels are usually highest soon after waking and then gradually decline during the day. But chronic stress can lead to unhealthy cortisol patterns, such as low cortisol levels upon waking or cortisol not tapering off much by the end of the day. These patterns are associated with an increase in disease development and mortality risks.

My colleagues and I found that conflict altered cortisol levels of couples on the day they had a dispute; people with stressed partners who used negative behaviors during the conflict had higher cortisol levels even four hours after the conflict ended.

These findings suggest that arguing with a partner who is already stressed could have lasting biological health effects for ourselves.

Managing stress

Here are three ways you can reduce the stress in your relationship, during and after the holidays.

First, talk to and validate each other. Tell your partner you understand their feelings. Talk about big and little things before they escalate. Sometimes partners hide problems to protect each other, but this can actually make things worse. Share your feelings, and when your partner shares in return, don’t interrupt. Remember, feeling cared-for and understood by a partner is good for your emotional well-being and promotes healthier cortisol patterns, so being there for each other and listening to each other can have good health effects for both you and your partner.

Next, show your love. Hug each other, hold hands and be kind. This too lowers cortisol and can make you feel happier. One study found that a satisfying relationship can even help improve vaccination response.

Then remind yourself that you’re part of a team. Brainstorm solutions, be each other’s cheerleaders and celebrate the wins together. Couples who unite to tackle stress are healthier and more satisfied with their relationships. Some examples: Make dinner or run errands when your partner is stressed; relax and reminisce together; or try a new restaurant, dance or exercise class together.

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That said, it’s also true that sometimes these steps aren’t enough. Many couples will still need help managing stress and overcoming difficulties. Couples therapy helps partners learn to communicate and resolve conflicts effectively. It’s critical to be proactive and seek help from someone who is trained to deal with ongoing relationship difficulties.

So this holiday season, tell your partner that you’re there for them, preferably while you’re hugging. Take each other’s stress seriously, and no more eyerolls. It’s not so much the stress itself; it’s the way that both of you manage the stress together. Working as an open and honest team is the key ingredient to a healthy and happy relationship, during holiday season and into the new year.The Conversation

Rosie Shrout, Assistant Professor of Human Development and Family Studies, Purdue University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

BLACK TECH FOUNDERS WANT TO CHANGE THE CULTURE OF HEALTH CARE, ONE CLICK AT A TIME

BLACK TECH FOUNDERS WANT TO CHANGE THE CULTURE OF HEALTH CARE, ONE CLICK AT A TIME

When Ashlee Wisdom launched an early version of her health and wellness website, more than 34,000 users — most of them Black — visited the platform in the first two weeks.

“It wasn’t the most fully functioning platform,” recalled Wisdom, 31. “It was not sexy.”

But the launch was successful. Now, more than a year later, Wisdom’s company, Health in Her Hue, connects Black women and other women of color to culturally sensitive doctors, doulas, nurses and therapists nationally.

As more patients seek culturally competent care — the acknowledgment of a patient’s heritage, beliefs and values during treatment — a new wave of Black tech founders like Wisdom want to help. In the same way Uber Eats and Grubhub revolutionized food delivery, Black tech health startups across the United States want to change how people exercise, how they eat and how they communicate with doctors.

Inspired by their own experiences, plus those of their parents and grandparents, Black entrepreneurs are launching startups that aim to close the cultural gap in health care with technology — and create profitable businesses at the same time.

“One of the most exciting growth opportunities across health innovation is to back underrepresented founders building health companies focusing on underserved markets,” said Unity Stoakes, president and co-founder of StartUp Health, a company headquartered in San Francisco that has invested in a number of health companies led by people of color. He said those leaders have “an essential and powerful understanding of how to solve some of the biggest challenges in health care.”

Platforms created by Black founders for Black people and communities of color continue to blossom because those entrepreneurs often see problems and solutions others might miss. Without diverse voices, entire categories and products simply would not exist in critical areas like health care, business experts say.

“We’re really speaking to a need,” said Kevin Dedner, 45, founder of the mental health startup Hurdle. “Mission alone is not enough. You have to solve a problem.”

Dedner’s company, headquartered in Washington, D.C., pairs patients with therapists who “honor culture instead of ignoring it,” he said. He started the company three years ago, but more people turned to Hurdle after the killing of George Floyd.

In Memphis, Tennessee, Erica Plybeah, 33, is focused on providing transportation. Her company, MedHaul, works with providers and patients to secure low-cost rides to get people to and from their medical appointments. Caregivers, patients or providers fill out a form on MedHaul’s website, then Plybeah’s team helps them schedule a ride.

While MedHaul is for everyone, Plybeah knows people of color, anyone with a low income and residents of rural areas are more likely to face transportation hurdles. She founded the company in 2017 after years of watching her mother take care of her grandmother, who had lost two limbs to Type 2 diabetes. They lived in the Mississippi Delta, where transportation options were scarce.

“For years, my family struggled with our transportation because my mom was her primary transporter,” Plybeah said. “Trying to schedule all of her doctor’s appointments around her work schedule was just a nightmare.”

Plybeah’s company recently received funding from Citi, the banking giant.

“I’m more than proud of her,” said Plybeah’s mother, Annie Steele. “Every step amazes me. What she is doing is going to help people for many years to come.”

Health in Her Hue launched in 2018 with just six doctors on the roster. Two years later, users can download the app at no cost and then scroll through roughly 1,000 providers.

“People are constantly talking about Black women’s poor health outcomes, and that’s where the conversation stops,” said Wisdom, who lives in New York City. “I didn’t see anyone building anything to empower us.”

As her business continues to grow, Wisdom draws inspiration from friends such as Nathan Pelzer, 37, another Black tech founder, who has launched a company in Chicago. Clinify Health works with community health centers and independent clinics in underserved communities. The company analyzes medical and social data to help doctors identify their most at-risk patients and those they haven’t seen in awhile. By focusing on getting those patients preventive care, the medical providers can help them improve their health and avoid trips to the emergency room.

“You can think of Clinify Health as a company that supports triage outside of the emergency room,” Pelzer said.

Pelzer said he started the company by printing out online slideshows he’d made and throwing them in the trunk of his car. “I was driving around the South Side of Chicago, knocking on doors, saying, ‘Hey, this is my idea,’” he said.

Wisdom got her app idea from being so stressed while working a job during grad school that she broke out in hives.

“It was really bad,” Wisdom recalled. “My hand would just swell up, and I couldn’t figure out what it was.”

The breakouts also baffled her allergist, a white woman, who told Wisdom to take two Allegra every day to manage the discomfort. “I remember thinking if she was a Black woman, I might have shared a bit more about what was going on in my life,” Wisdom said.

The moment inspired her to build an online community. Her idea started off small. She found health content in academic journals, searched for eye-catching photos that would complement the text and then posted the information on Instagram.

Things took off from there. This fall, Health in Her Hue launched “care squads” for users who want to discuss their health with doctors or with other women interested in the same topics.

“The last thing you want to do when you go into the doctor’s office is feel like you have to put on an armor and feel like you have to fight the person or, like, you know, be at odds with the person who’s supposed to be helping you on your health journey,” Wisdom said. “And that’s oftentimes the position that Black people, and largely also Black women, are having to deal with as they’re navigating health care. And it just should not be the case.”

As Black tech founders, Wisdom, Dedner, Pelzer and Plybeah look for ways to support one another by trading advice, chatting about funding and looking for ways to come together. Pelzer and Wisdom met a few years ago as participants in a competition sponsored by Johnson & Johnson. They reconnected at a different event for Black founders of technology companies and decided to help each other.

“We’re each other’s therapists,” Pelzer said. “It can get lonely out here as a Black founder.”

In the future, Plybeah wants to offer transportation services and additional assistance to people caring for aging family members. She also hopes to expand the service to include dropping off customers for grocery and pharmacy runs, workouts at gyms and other basic errands.

Pelzer wants Clinify Health to make tracking health care more fun — possibly with incentives to keep users engaged. He is developing plans and wants to tap into the same competitive energy that fitness companies do.

Wisdom wants to support physicians who seek to improve their relationships with patients of color. The company plans to build a library of resources that professionals could use as a guide.

“We’re not the first people to try to solve these problems,” Dedner said. Yet he and the other three feel the pressure to succeed for more than just themselves and those who came before them.

“I feel like, if I fail, that’s potentially going to shut the door for other Black women who are trying to build in this space,” Wisdom said. “But I try not to think about that too much.”

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African faith leaders combat misleading theologies that promise cures for COVID-19

African faith leaders combat misleading theologies that promise cures for COVID-19

Participants at the 3rd Symposium on Misleading Theologies sit in a session on Nov. 22, 2021, in Nairobi, Kenya. RNS photo by Fredrick Nzwili

NAIROBI, Kenya (RNS) — When some African church pastors ordered their followers to eat grass or gulp petrol or even drink poison-laced water, their congregations have obeyed the instructions, thinking the practices would bring them closer to God.

Many other pastors take their wellness advice a notch higher, claiming to heal conditions such as disability and barrenness and diseases such as HIV and AIDS, and, more recently, coronavirus. It’s not unheard of for pastors to hold their congregations spellbound as they promise to bring the dead back to life.

In recent years the All Africa Conference of Churches, an umbrella group for several Protestant denominations on the continent, has moved to combat theological claims that harm Christians, holding a series of symposiums to educate clergy and unify their churches against faith healing and other practices.

“All these pronunciations, fake testimonies and things like these are really destructive. They are not life-giving, but life frustrating,” said the Rev. Fidon Mwombeki, a Tanzanian Lutheran pastor who is the general secretary of the AACC.

Based in Nairobi, the AACC is the continent’s largest association of Protestant, Anglican, Orthodox and Indigenous churches and has a presence in 42 countries. It brings together churches, national councils of churches, theological and lay training institutions and other Christian organizations.

Since 2019, the group has organized three symposiums in which theologians, clerics and lay Christians have met to explore the subject of misinformation. Some of the themes tackled in the prior conferences include power and authority, wealth and poverty, government regulation of religious organizations, and health and healing.

“If we don’t pay attention, (misleading theologies) will undermine human dignity and put the lives of people at stake. You see in some churches the minister sending people out to eat grass. This is unacceptable,” said the Rev. Bosela Eale of the Democratic Republic of the Congo, AACC’s director of theology, interfaith relations and leadership, at the most recent Nov. 22-24 symposium, held in Nairobi.

Participants at the 3rd Symposium on Misleading Theologies in Nairobi, Kenya, hold group discussions on Nov. 22, 2021. RNS photo by Fredrick Nzwili

The theologians are warning against dangerous teachings and practices, such as: the prosperity gospel; sexual abuses in demonic exorcism and blessing for fertility; the use of toxic substances and liquids in religious rites; and demanding huge sums of money for prayers and pastoral services, among others.

Religious observers say many of the worst abuses of theology come in faith healing.

The Rev. Simangaliso Kumalo, an associate professor of religion and governance at the University of KwaZulu-Natal-Pietermaritzburg, warns that the popular belief that Jesus cures every sickness poses challenges for managing epidemics, pointing to Pentecostal churches that have, he said, spiritualized COVID-19.

“For them, the corona is not a mere virus,” Kumalo told the conference. Pastors preach that, “because members of Pentecostal churches are children of God, the virus would not infect them, or if it does, they would be healed by Jesus, the physician.”

He highlighted conspiracy theories that say viruses such as COVID-19 are God’s punishment to disobedient humanity.

Monica Nambaba, an official at the Africa Christian Health Associations Platform, said spurious teachings about health have hurt Africans in the past. “Some people with conditions such as HIV have died after religious leaders told them to stop medication after attending healing prayers,” she said.

Pastors should instead be conscious of their power to sway people’s attitudes about health measures. “If the religious leaders can use their platforms to correct this, it will go a long way in helping the communities,” Nambaba said.

According to Veronica Ngum Ndi, a disability and development professional from Cameroon, people with disabilities are particularly vulnerable to faith healing attempts. Telling a person with a permanent disability that God will one day allow them to walk again is destructive, she said, and commanding them to drop their crutches because they have been cured, as some pastors do, can only worsen their problems. “Some have been injured badly in the process,” said Ndi.

At the same time, some of the church leaders and theologians at the symposium advocated for a reconsideration of African traditional healing practices, many of which have been suppressed or lost in the continent’s missionary era.

“We are referring to those aspects that make traditional healing practices beneficial. These aspects must be recovered because they are not incompatible with the gospel,” said the Rev. Herve Djilo Kuate, a pastor in the Evangelical Church of Cameroon.

 

Americans are in a mental health crisis – especially African Americans. Can churches help?

Americans are in a mental health crisis – especially African Americans. Can churches help?

Americans are in a mental health crisis – especially African Americans. Can churches help?

The 160-year-old John Wesley AME Zion Church is one of the few predominantly African American churches that still exists in downtown Washington, D.C. Marvin Joseph/The Washington Post via Getty Images
Brad R. Fulton, Indiana University

Centuries of systemic racism and everyday discrimination in the U.S. have left a major mental health burden on African American communities, and the past few years have dealt especially heavy blows.

Data from the Centers for Disease Control and Prevention indicate that Black Americans are twice as likely to die of COVID-19, compared with white Americans. Their communities have also been hit disproportionately by job losses, food insecurity and homelessness as a result of the pandemic.

Meanwhile, racial injustice and high-profile police killings of Black men have amplified stress. During the summer of 2020, amid both the pandemic and Black Lives Matter protests, a CDC survey found that 15% of Black respondents had “seriously considered suicide in the past 30 days,” compared with 8% of white respondents.

For a variety of reasons, many African Americans face barriers to mental health care. But as a sociologist who focuses on community-based organizations, I find that strengthening relationships between churches and mental health providers can be one way to increase access to needed services. In research with my collaborators Eunice Wong and Kathryn Derose, I analyzed data on the prevalence of mental health care provision among religious congregations and found that many African American congregations offer such programs.

Need versus access

Roughly 1 in 5 Americans experience mental illness in a given year. Yet fewer than half of adults with a mental health condition receive mental health services.

African Americans utilize mental health services at about one-half the rate of white Americans. In part, this underuse may stem from African Americans’ often fraught relationship with medical establishments in the U.S., given their histories of racial bias and malpractice against people of color. Part of the reason may also derive from stigma among some African Americans perceiving mental illness and seeking help as signs of weakness. Treatment “deserts” where mental health providers are scarce may also be a factor.

Students participate in an activity about mental health and suicide prevention at Uplift Hampton Preparatory School in Dallas.
Students participate in an activity about mental health and suicide prevention at Uplift Hampton Preparatory School in Dallas in 2018. AP Photo/Benny Snyder

Care at church

One often overlooked resource for mental health care, however, are churches. For the past decade, the National Congregations Study has documented the prevalence of mental health care provision among places of worship in the U.S. Based on data from the NCS’ 2018 survey, 26% of congregations provide mental health programming, and 37% of people who attend religious services attend one of these congregations. Such programming can include support groups, meetings and classes focused on addressing mental health concerns.

Previously, my co-researchers and I analyzed 2012 NCS data to better understand mental health resources within religious congregations. One of our goals was to identify factors that contribute to a congregation offering mental health care. These factors include having more members, employing staff for social service programs and providing health-focused programs. Other significant predictors include conducting community needs assessments, hosting speakers from social service organizations and being located in a predominantly African American community.

Based on the new 2018 survey, 45% percent of African American congregations offer some form of mental health service and nearly half of all African American churchgoers attend a congregation with such programs. These rates show an increase since 2012, and are roughly 50% greater than those among predominantly white congregations.

This research supports longstanding observations about African American congregations as critical sources of spiritual, emotional and social support for their communities. Many religious people see their spiritual health and mental health as intertwined, and research indicates that spiritual practices, such as prayer and meditation, can also support mental health.

Strengthening support

Our research suggests that building collaborations between African American congregations and the mental health sector is a promising strategy to increase access to needed services. Given that 61% of African Americans say they attend worship services at least a few times a year, congregations may provide an accessible resource.

At times, pairing religion and mental health may prove harmful. Some congregations see mental health problems as a product of personal sin, for example, and stigmatize people suffering from mental illness.

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But congregations can also be helpful environments. When clinical treatment is supplemented with social support, the likelihood of successful outcomes is greater, and houses of worship often provide built-in social networks. People participating in a congregation-led grief recovery group, for example, can be involved in the congregation beyond their weekly meeting. In addition, some mental health professionals provide pro bono services for congregation-based programs.

Social worker Victor Armstrong, the director of North Carolina’s Division of Mental Health, Developmental Disabilities and Substance Abuse Services, asserts that African American faith leaders can play a “pivotal role” in mental wellness. He suggests shifting language to focus on “wellness” rather than “illness” in order to decrease stigma, among other recommendations.

Greater collaboration between congregations and mental health providers could help stem the growing mental health crisis, particularly within African American communities.The Conversation

Brad R. Fulton, Associate Professor, Indiana University

This article is republished from The Conversation under a Creative Commons license. Read the original article.