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This chapter in a larger book on systems change dives into Human Impact Partners’s experiences centering racial justice and power-sharing at the heart of their work in public health. It offers guidance on developing shared understandings of oppressive structures and systems, relationship development, and centering the voices of people most impacted by systems in need of change.

A large school district in Cincinnati partnered with their local health department and children’s hospital to develop mitigation procedures as children returned to school. These mitigation procedures successfully limited school-based spread of COVID-19 by combining best practices in rapid testing, contact tracing, and early isolation. Procedures were regularly revisited and updated in an iterative process to respond to new information and circumstances.

Lead Local was a collaborative research project between Human Impact Partners and the Right to the City Alliance. The research focused on community power-building and its potential to address social inequities that drive health outcomes. This project was not specific to COVID-19, but its findings apply to disease response and resiliency. It found that community power-building must be central to decision-making processes for true transformation.

Johns Hopkins Health System and Baltimore community organizations collaborated to establish a bilingual COVID-19 hotline and implement free COVID-19 testing. When a vaccine became available, partnerships made within these efforts were leveraged and the coalition partnered with the state. This community-based approach was effective at expanding access to the COVID-19 vaccine among low-income Latino immigrants.

The NYC Department of Health and Mental Hygiene partnered with 45 businesses or faith-based organizations in the Northeast Bronx to increase COVID-19 and flu vaccine knowledge and uptake in predominantly Black and Hispanic areas. The program disseminated health information through trusted community leaders to address vaccine hesitancy. ZIP codes with higher involvement in the program showed greater increases in vaccination rates.

Southeast Asian Coalition of Central Massachusetts, also known as SEACMA, aims to support the Southeast Asian population in Central Massachusetts. SEACMA is a trusted local partner and hub for refugees, underserved individuals, and residents of all backgrounds. SEACMA actively provided outreach, education, and prevention to their community during the COVID-19 pandemic and center community engagement in building solutions.

The Massachusetts Executive Office of Elder Affairs (EOEA) oversees programs and services for older adults through the aging service network, and worked closely with the COVID-19 command center during the COVID-19 pandemic. EOEA worked with senior affordable housing providers and advocated for vaccines for older adult populations. They also used their network to disseminate COVID-19 information to older adults, caregivers, and those working directly with older adults.

Coalitions and partnerships are often established during times of crisis but, if maintained, can pay dividends in the long term. This toolkit offers practical steps on building and maintaining partnerships for long-term, equitable community engagement. It includes case studies within health services, public health, and other social services.

Jimenez and colleagues conducted an online survey in order to examine reluctance to follow prescribed COVID-19 preventive measures, such as social distancing and hand washing. Research is needed to understand factors underlying such reluctance, with the aim of developing targeted health interventions. The authors found that associating COVID-19 with death as a key factor. Five hundred and ninety participants completed surveys in mid-March 2020, which included attitudes toward COVID-19, preventive behavioral intentions, and sociodemographic factors. Associating coronavirus with death negatively predicted intentions to perform preventive behaviors, including social distancing and hand washing. Social distancing and hand washing were used as outcome measures in separate multivariate models. Further, associating COVID-19 with death was not evenly distributed throughout the sample and was related with a number of sociodemographic factors including age, race, and availability of sick leave.

A retrospective registry-based chart review examined the various demographic and clinical risk factors associated with COVID-19 severity among patients aged 18-29. The study was done within a metropolitan health care system in Houston, TX. In the cohort of 1,853 young adult patients diagnosed with COVID-19 infection at a hospital encounter, including 226 pregnant women, 1,438 (78%) scored 0 on the Charlson Comorbidity Index, and 833 (45%) were obese (≥30 kg/m2). Within 30 days of their diagnostic encounter, 316 (17%) patients were diagnosed with pneumonia, 148 (8%) received other severe disease diagnoses, and 268 (14%) returned to the hospital after being discharged home. In multivariate logistic regression analyses, increasing age, male gender, Hispanic ethnicity, obesity, asthma history, congestive heart failure, cerebrovascular disease, and diabetes were predictive of severe disease diagnoses within 30 days. Non-Hispanic Black race, obesity, asthma history, myocardial infarction history, and household exposure were predictive of 30-day readmission.