Context The SARS-CoV-2 pandemic and recent economic inflation has disproportionately impacted underserved and marginalized communities already facing low financial resources. Objective The objectives are to 1. Assess the prevalence of chronic diseases at the community level 2. Identify barriers that community members face in accessing medical care, and 3. Understand the socioeconomic resources they need. Methods Design Cross sectional design Setting The CEAL team partnered with 17 established and trusted community and health-based organizations based in Bexar, Frio, Karnes, and Atascosa County for distribution of the CEAL “Common Survey” between March to July 2024. The partner organizations included nonprofits, South Central Area Health Education Center, the local health authority, Alamo Colleges, rural hospital systems, and rural community health centers. Participants CEAL partners serve a wide range of communities, including African American, Latine, Spanish-speaking, rural, and immigrant/refugee populations, and they gathered surveys from these diverse groups. Exclusion criteria those under age 18 years and those with cognitive impairments that prevented them from understanding the survey. Intervention/Instrument The CEAL “Common Survey”. The survey was written at a 7th grade reading level and translated into Spanish. One organization providing refugee services administered the survey to Afghan refugees using an interpreter. Surveys were distributed through an email link or completed on paper. Outcome: 658 surveys were completed by community members Results Majority of participants were Hispanic. Roughly 30% of participants had a high school education or less and reported a household income of less than 35, 000. Seventy-one percent of participants reported at least one chronic condition, while 34% reported having at least 3 conditions. About 40% of participants reported waiting to get medical care due to cost. Thirty-four percent reported worrying about running out of food before receiving money to buy more in the past 12 months. Top 5 chronic diseases community members were interested in learning about were 1. Diabetes 2. Hypertension 3. Heart Disease 4. Cancer 5. Mental health/ Domestic Violence Conclusions There is a substantial burden of chronic disease in Bexar County and surrounding rural counties. However, the communities face significant barriers to timely medical care and encounter socioeconomic challenges, which have been shown to negatively impact their ability to effectively manage their chronic conditions. Future Bexar County CEAL initiatives include increasing awareness and connection to appropriate health and socioeconomic resources for target communities.
Ravi et al. (Sun,) studied this question.