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Community Health Workers’ Role in Advancing Health Equity During Natural Disasters

Blog
  • By Pear Suite
  • Jan 16, 2025
  • 6 min read
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Natural disasters—from hurricanes and wildfires to floods and earthquakes—impact millions of lives every year. Recent wildfires and windstorms in California have the nation in upheaval. On one side, residents face evacuations, loss of their homes and belongings, and the physical and mental health repercussions of tragedy and uncertainty, while the government and communities across the country rally to support. 

Natural disasters are not isolated to one region or demographic; people of all ages and backgrounds have faced hurricanes, floods, fires, and blizzards from coast to coast. And though nature and disasters are undiscerning, their effects are not felt equally across communities. Vulnerable populations, including low-income groups, racial and ethnic minorities, those experiencing more social determinants of health (SDOH) challenges, and those with chronic health conditions, often bear the brunt of these crises. 

This disparity underscores the critical link between health equity and natural disasters, highlighting the need for targeted interventions that prioritize the most disadvantaged. 

Unequal impacts of natural disasters

Natural disasters exacerbate existing health disparities by disproportionately affecting populations already facing systemic inequities. 

Members of Pear Suite's Pear Care Provider Network distributed meals to those impacted by Maui's fires in 2023.

Marginalized communities are often located in high-risk areas, such as floodplains or industrial zones. These areas are more susceptible to environmental hazards, increasing the likelihood of severe impacts during disasters. Consider Louisiana’s experience of Hurricanes Harvey, Irma, and Katrina, where collectively millions of people applied for FEMA assistance, many of whom were low-income and minority community members.

Wealthier communities, which often, but not always, are located away from high-risk areas, typically have greater access to resources for disaster preparedness, such as storm-resistant housing and emergency supplies. In contrast, disadvantaged populations may lack these protections and face barriers to evacuation or shelter, such as transportation or alternative housing, two social determinants of health.

People with more unmet social and economic needs often have more difficulty recovering financially from natural disasters because they may lack savings, insurance, or the ability to rebuild after a disaster. For example, in the eight counties most severely affected by Hurricane Harvey, only 17 percent of homeowners held flood insurance policies.

During and after disasters, access to healthcare becomes critical. However, underserved communities often experience limited access to healthcare facilities, transportation challenges, and language barriers, making it harder for them to get the care they need and receive it in a timely manner.

The role of community health workers (CHWs)

Community-based organizations (CBOs) and community care providers, including community health workers (CHWs) play a vital role in bridging the gap between disadvantaged populations and essential social and health services. However, during and after natural disasters, their ability to rapidly deploy, adapt to changing conditions, and provide valuable resources helps them to stand out as true healthcare heroes.

While government groups, agencies, and individuals organize to respond and support, CBOs and CHWs are already there, leveraging their skills, relationships, and partnerships to quickly and effectively address immediate and long-term needs in three key ways. 

YMCA in L.A. gathers and distributes baby care supplies to wildfire evacuees.
A Y.M.C.A. in L.A. county gathered diapers, wipes, formula, and other baby supplies to distribute to those impacted by California wildfires and windstorms.

Disaster preparedness and emergency response

Even before disaster strikes, CHWs can educate communities about risks and preparedness measures, ensuring that vulnerable populations, and especially those in high-risk areas, understand evacuation plans, emergency procedures, and the importance of disaster kits. 

Because of their familiarity with their communities and challenges, CHW recommendations are culturally and linguistically appropriate, with tailored disaster strategies that meet the specific needs of their clients.

During disasters, CHWs can connect affected populations and emergency services, helping identify individuals in need, coordinating access to shelters, distributing essential supplies, and connecting individuals to care.

In California, we’ve seen this as CBOs, such as local YMCAs, distribute aid and supplies to evacuees and those displaced from fires, and CHWs from our own Pear Cares Provider Network offer care coordination and social need support. Similarly, our CHWs were on the ground in Lahaina, Maui following the deadly wildfires that displaced thousands. 

Mental health support

The psychological impact of disasters can be profound, from the immediate loss to long-term recovery and exacerbation of pre-existing conditions. Beyond emergency and disaster services, community health workers often provide mental and behavioral health within the scope of their care services. 

This can include system navigation, which entails helping an individual access an appropriate care provider to get help. Providing care coordination and education to support clients with learning about or following an existing care plan. In some cases, CHWs may also offer lower levels of clinical support to clients who are also receiving more intensive mental health care. 

All told, CHWs can offer emotional support and provide connections to activities that help people address pre-existing and disaster-related trauma.

 Recovery and resilience building

In the aftermath of a disaster, CBOs and CHWs do what they’ve always done: Empower and uplift communities. 

Since they specialize in connecting people to social services, such as transportation, financial aid, housing assistance, and health care, including physical and mental care resources, they prioritize getting people back on their feet long after government aid and the media have shifted their focus. 

For example, some organizations may be able to offer temporary housing and immediate mental health services, but CBOs and CHWs will remain, continuing to meet the needs of their clients and advocating for equitable recovery policies that address the specific needs of underserved populations.

Improving health equity through policy and practice

Bilingual community health workers receiving training.
In 2023, Pear Suite helped train bilingual community health workers to help with virtual outreach to residents of Maui impacted by fires.

Addressing health equity in the context of natural disasters requires a multi-faceted approach, supporting policies that take care of those affected and prioritizing changes that benefit the community-based organizations and providers filling gaps in both health and social services. 

The government and CBOs must prioritize resources for high-risk communities, taking a proactive approach to ensure they have the tools and support needed to prepare for and recover from disaster. Involving vulnerable populations and those most familiar with the social and environmental nuances of an area in disaster planning can also create solutions that are culturally relevant and effective.

Finally, expanding the workforce and professional development for CHWs can enhance their ability to serve as frontline responders and advocates for health equity. While strides have been made in recent years with the expansion of a Medicaid CHW benefit, allowing CHWs and CBOs to receive reimbursement and other compensation for eligible services, the approach is inconsistent, and in some cases nonexistent, from state to state. 

Natural disasters are inevitable, but their effects need not deepen existing inequities. By prioritizing health equity, investing in community health workers and other frontline community providers and implementing inclusive policies, we can reduce the vulnerabilities of disadvantaged populations.

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