The effects of COVID-19 on African American communities in Baltimore's health enterprise zones: a mixed-methods examination.

BACKGROUND: The CoVID-19 pandemic underscored effects of community resources on the built environment, health and health outcomes. The purpose of this study was to conduct community-engaged research and examine aspects of health, and access to healthcare from the voices of community members, as a foundation for improving health equity through the built environment. METHODS: This study utilized a convergent mixed methods design that included surveys and semi-structured interviews conducted from July 2021 to August 2022 to examine the impact of limited community resources, such as community health clinics on participants during the CoVID-19 pandemic. A convenient sample of 345 male and female African American participants represented five zip codes (21215, 21216, 21217, 21223, and 21229) in with the highest impact from CoVID 19, in Baltimore, Maryland. Quantitative and qualitative data were integrated to describe how the two types supported one another in health, healthcare and healthcare access. RESULTS: More than half of all participants reported satisfaction with overall health, quality of healthcare provided and access to health care services. However, results indicated extreme differences in factors related to health and wellness after, as comparted to before the onset of the pandemic, Semi-structured interviews, expanded on overall community health, highlighting that overall satisfaction with health does not equal satisfaction with health-related resources and suggested participants felt frustrated and left out of much-needed community health resources to improve health and mental health services for all ages, nutrition services and community activities that make communities thrive. Data integration provided a more realistic view of what participants really experience, due to the expanded analysis of semi-structured interviews, and indicated quantitative and qualitative data did not always support each other. CONCLUSIONS: Future research to improve the built environment, and to address historic health inequities, will require ongoing community engagement to better understand community needs. This study results encourage ongoing research to expand resources for community-engaged research and interventions. Researchers must remain cognoscente of changing needs, and persistent disparities that can only be addressed if policies, supported by these results, are introduced to make equitable investments to forge an environment where healthy communities thrive.

A Novel Approach to Locating Community Clinics to Promote Health Care Accessibility and Reduce Health Disparities in Baltimore, Maryland.

Baltimore, Maryland's entrenched racial residential segregation renders the city's world-class medical facilities and services inaccessible to many Black residents living in its most divested neighborhoods. Arguing the need for post-pandemic health care facilities to address health inequities as a practice of care-giving, this article describes a project funded by the National Institutes of Health (NIH) to define a novel, transdisciplinary methodology for identifying ideal vacant sites for conversion into community clinics in Baltimore's most vulnerable neighborhoods. Positioning architecture as a social determinant of health, this paper suggests ethical and methodological reorientations toward a compassionate approach to clinic design and placement.

Identifying Optimal Locations for Potential Temporary Community Clinics During Public Health Emergencies.

OBJECTIVES: This article argues that community healthcare clinics managed by dedicated medical professionals who are familiar with the special needs of the local community may serve as effective alternatives to centralized hospitals and medical facilities, which may be disconnected from these local communities. BACKGROUND: The literature indicates that socioeconomic factors that affect an individual's ability to seek medical help when needed can cause vulnerability to public health emergencies. These factors include belonging to lower income populations, being African American, being dependent due to age (below 18 or above 65) or disability, being an immigrant, English-language ability, access to transportation means, and the strength of an individual's social network. METHOD: This study aims at developing a multifaceted methodology to identify optimal locations for deployment of temporary healthcare clinics to address health disparity issues among socially vulnerable populations, especially during pandemics and public health crises. This case study looks at the Health Enterprise Zone (HEZ) in Baltimore and ranks Census tracts based on their vulnerability, using two novel health vulnerability indices and considering their locations. RESULTS: Using the proposed methodology, the optimal tracts within the HEZ are identified as potential locations for deploying temporary healthcare clinics. CONCLUSION: The analysis of vulnerabilities to public health emergencies based on socioeconomic factors can assist in identifying potential locations for setting up temporary healthcare clinics with the goal of assisting socially vulnerable populations during outbreaks and pandemics.