The COVID-19 pandemic has hit Black and Latinx communities especially hard, and contact tracing is crucial to control the spread of this virus. At the same time, these marginalized communities are wary of participating in contact tracing efforts. Their hesitation is two-pronged: first, Black and Latinx communities have an existing distrust of government institutions because of past discrimination; and second, they worry about their information being used against them by insurance companies, employers, or law enforcement. This resistance has serious implications for controlling COVID-19 and could lead to further community resistance when a vaccine is developed.
Hoping to overcome these obstacles, Zebra Strategies teamed up with Vital Strategies to understand why exactly marginalized communities are wary of contact tracing and determine which strategies would relieve their fears.
To understand this crucial question, Zebra Strategies organized twelve focus groups of six to ten people each, with a total of 88 participants. These groups were made up of Black and Latinx people from New York City and Philadelphia. A psychologist oversaw these groups and recorded their responses.
These focus groups revealed a high level of distrust among Black and Latinx communities over contact tracing. Participants are angry about the government’s poor response to COVID-19 and feel that leaders are encouraging chaos instead of helping. This anger has magnified because of past government discrimination and the heavy toll of COVID-19 on marginalized communities.
The participants revealed that their distrust of contact tracing is rooted in Black and Latinx communities being failed by the system in the past. Common fears include a risk of surveillance or harassment from government agents or law enforcement, losing insurance or employment because of their health status, and their information being shared with unauthorized parties. They also noted that they are uncomfortable speaking to strangers about personal information and worry that people with COVID-19 will face public humiliation.
On a more positive note, the focus groups also revealed that Black and Latinx community members are very willing to help control COVID-19 for the good of their neighbors and relatives. They want to do their part, so a proper outreach strategy could overcome these hurdles.
Using the data from these focus groups, Zebra Strategies developed five main suggestions for a successful contact tracing plan in marginalized communities:
- Contact tracers should be local. Community members are much more likely to cooperate with local representatives than with the federal government and answer phone calls with local area codes.
- Cooperation with community groups is crucial. Endorsement of contact tracing from local churches, mosques, schools, and civic groups will make community members feel much safer.
- Contact tracing needs better explanation. People are more likely to cooperate if they understand exactly what contact tracing is. Participants noted that hearing this from someone who recovered from COVID-19 would make them more open to it.
- People need assurances of confidentiality. Since marginalized communities already distrust government oversight, they need extra reassurance that their information won’t be shared with anyone.
- Contract tracers must have cultural empathy. Participants prefer to work with tracers who are people of color. In all cases, the tracer should be sensitive and respectful of the people they reach out to.
With these strategies, health departments can implement more effective contact tracing programs that reach out to marginalized communities, controlling the spread of COVID-19 and saving lives.