May 30, 2020
(HOUSTON, TX) - Since April, UH Healthy Start Program Director Eulalia Gillum (pictured above), Associate Professor and UH Healthy Start Principal Investigator Dr. McClain Sampson and the UH Healthy Start staff have been combating the rise of black maternal mortality and the spread of COVID-19 by coordinating the distribution of face masks to underserved communities in Houston.
Set with the mission to "improve the overall health of mothers, infants, and families before, during, and beyond pregnancy," the UH Healthy Start initiative provides care case management, home visits, outreach, and educational courses to increase access to prenatal care while lowering barriers to service.
Program Director Eulalia Gillum recently sat down with us to discuss how the UH Healthy Start team began their mask drive and the increased importance of a multi-pronged effort to reduce infant and maternal mortality rates during the pandemic.
Name: Eulalia Gillum, LMSW
Preferred Pronouns: she/her
Title and Program at the GCSW: Program Director of the University of Houston Healthy Start Program
What began the response to begin a mask drive at UH Healthy Start?
In April, as I was conducting my weekly grocery store outings and rode through some of the city's most vulnerable and high-risk communities, I observed that there were so many individuals with absolutely no form of a protective face covering.
Pictured above, Associate Professor and UH Healthy Start Principal Investigator Dr. McClain Sampson
The following Monday, I had a conversation with Dr. McClain Sampson, Principal Investigator with UH Healthy Start and Researcher/Faculty with the Graduate College of Social Work. I raised the concern and questioned our social responsibility as Social Workers as well as individuals who have committed their life's work to serving others and the communities around us. She agreed. Subsequently, the program submitted a request to our federal funding source (The Health Resources and Services Administration/HRSA) to contract with a local seamstress, who'd been impacted financially due to job loss and resided in one of our service zip codes (77021). The program was granted approval to allocate budget funds to contract with a local seamstress, who will craft 2,000 facemasks. We received the approval and got to work.
What are some of the hoped-for health goals of equipping face masks to mothers, fathers, and children to participants and those in the program's service area?
As the wearing of face coverings in public became required due to their ability to reduce the chances of transmission of COVID-19, it was quickly recognized an essential tool that many individuals and families were having a difficult time acquiring. Disposable paper masks became even more challenging to acquire for many we serve due to their cost, availability, and recommended one-time use, so the appeal of fabric masks and their ability to be cleaned and sanitized for re-use became apparent.
The ultimate goal of equipping face masks to families is to comply with the recommendations made by our local health officials and to help them recognize the value of having a reusable mask. Finally, in wearing the masks correctly and consistently, their use can reduce the chances of transmitting or contracting COVID-19.
Why do we see higher rates of death/spread of COVID-19 in communities of color?
In communities of color, there are and have been disparities in overall health outcomes. Several of the zip codes with the highest incidence of individuals testing positive for COVID-19 are consistent with several UH Healthy Start program zipcode services areas. These are also communities that have the highest rate of infant and maternal mortality rates, where infant mortality is an indicator of the overall health of a community. Additional statistics regarding more elevated rates of individuals with pre-existing health conditions (diabetes, hypertension, uninsured or underinsured, etc) have been highlighted in specific communities of color throughout the greater Houston area.
Lastly, if a community is unhealthy before such a public health crisis or pandemic, the health outcomes will not be better. These are the 'high-risk' groups and communities.
What do you believe are the most significant driving factors as to why Black and Latinx women are at much higher risk of health disparities, especially before/during/after pregnancy?
Research indicates that no one factor puts Black and Latinx women at higher risk for disparities during pregnancy and postpartum. But that doesn't mean we should stop trying to eliminate the gaps. It means we need a multi-pronged approach. Being Black or Latinx isn't what puts you at risk. We must recognize the risk factors that correlate to the disproportional disparities in birth and health outcomes for Black women: having an income at or under the federal poverty line, living in areas with food and medical deserts, and experiencing multiple barriers to quality prenatal, birthing and postnatal care are all risk factors. In Texas, Black and Latinx families are more than twice as likely to live below the poverty line. In Texas, more than half of all births are Medicaid paid. Medicaid ends at 60 days postpartum, and we know based on scientific evidence that around 40% of maternal deaths occur after the mother leaves the hospital. Mothers who don't have continuous access to quality healthcare insurance or services from pregnancy to one year after giving birth are at much higher risk for complications and potentially fatal birth outcomes.
What is something you would like those who are unaware of the implicit bias faced by people of color seeking health care to know?
First, there must be an awareness that implicit and systemic bias exists! Efforts to create messaging and establish rapport and trust is also imperative. And while the actions mentioned above are essential, they are merely a start. The real work is delivering compassionate, person-centered healthcare that makes every human being feel respected, valued, and equal, regardless of their socioeconomic status, race/ethnicity, education, or zip code.
How does the UH Healthy Start Mask Drive fit in with the GCSW’s vision of achieving racial and social justice?
By targeting communities who suffer high health disparities, we have a chance to bring some equity to Houston's COVID-19 response. By partnering with the City of Houston and Harris County Public Health to provide testing, we are practicing health inclusivity in neighborhoods that are often left out of supplies or efforts to prevent illness and death. All masks distribution will take place in an open setting and with protective gear in place for program staff. As of this week*, UH Healthy Start has provided 200 face masks and other essential items (hand sanitizer, digital thermometers) and program marketing and educational materials to the City of Houston's Third Ward Multi-Service Center (3611 Ennis St., 77004) where FREE COVID-19 testing is taking place May 12-16, 2020. Additionally, 200 face masks have been distributed to two (2) Apartment complexes in the Greenspoint area (zipcode 77067).
This Mask Drive and distribution by UH Healthy Start fits in with the GCSW's vision of achieving racial and social justice, by meeting individuals and families where they are.... in their communities. Our goal is to make an impact at the micro-level and reiterate the messaging of expert Health officials. We want to support these efforts by meeting a basic need; while encouraging individuals to access FREE testing sites throughout the greater Houston area, continue social distancing, and continue wearing a face covering or face mask correctly!
*-This Q&A was conducted on May 15.