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• W4386583921 abstract "Figure: community engagement, relationship buildingFigureCommunity engagement is central in the work of an emergency physician. Two impactful lessons learned from the COVID-19 pandemic were recognizing the degree of interconnectedness of people in local, national, and global communities and of the huge role that emergency physicians played in community engagement, which affected the health and well-being of societies across the world. More emergency physicians were featured on national and international news platforms throughout the COVID-19 pandemic than in any other time in modern history. Their role is well defined in emergency preparedness, readiness, response, and recovery during public health emergencies and medical crises. Community engagement should be viewed as a crucial part of each phase of the emergency response, and particular attention must be paid to engaging with vulnerable and historically marginalized populations. The relationships that emergency physicians forge, nurture, and maintain today will have a lasting impact on the overall health and well-being of the communities served tomorrow. The World Health Organization defines community engagement as a process of developing relationships that enable stakeholders to work together to address health-related issues and promote well-being to achieve positive health outcomes. (World Health Organization. 2017; https://bit.ly/3RUoBnR.) The COVID-19 pandemic, along with prior pandemics and epidemics like Ebola, SARS, and H1N1, all demonstrated the importance of community engagement. (Health Promot Int. 2021;36[Suppl 1]:i24; https://bit.ly/3T6ZeQO.) The WHO published guidelines for implementing community engagement strategies in emergency situations. The overarching goal of these strategies focuses on creating people-centered and community-led approaches to increase trust and social cohesion, while mitigating the negative health impact of a disaster. (World Health Organization. Dec. 23, 2020; https://bit.ly/3SXaYpk.) Marginalized Populations Additional tenets of this approach include being collaborative to better optimize high-quality integration while being data-driven and considering the unique cultural and social determinants affecting the well-being of each community. These guidelines promote a shift from one-way directives to collaborative communication approaches that have been proven to help control and eliminate outbreaks across the globe. Disease outbreaks can only be fully addressed by helping people empower themselves rather than trying to change their behavior. (Health Promot Int. 2021;36[Suppl 1]:i24; https://bit.ly/3T6ZeQO.) A significant difference in health outcomes has been seen when engaging members of the community with attention to cultural context when addressing public health crises rather than employing one-directional, one-size-fit-all directives to the public. This is particularly true for vulnerable and historically marginalized populations. Lessons learned from COVID-19 showed that individuals who are Black, Indigenous, incarcerated, and from Latin America and the Pacific Islands were the most affected by COVID-19 during the pandemic and were among the least likely to take a COVID-19 vaccine. (Front Public Health. 2021;9:770985; https://bit.ly/3enc8vp; JAMA Netw Open. 2021;4[10]:e2128575; https://bit.ly/3CuvQgu; J Behav Med. 2022;1; https://bit.ly/3fQzSbp; Health Equity. 2022;6[1]:616; https://bit.ly/3CkS6JO; Prev Med Rep. 2022;27:101771; https://bit.ly/3CSjwIt; New York Times. Dec. 30, 2020; https://nyti.ms/3SWE745.) This vaccine hesitancy was directly connected with a history and culture of medical exploitation, abuse, and neglect of members from these communities. Examples include the decimation of Indigenous communities by smallpox and measles introduced by colonizers and the nonconsensual experimentation by medical professionals on enslaved Africans, Black Americans, and incarcerated people throughout history. Contemporary reminders are reflected in the many health disparities experienced by individuals from these communities every day. These communities experienced disproportionately higher COVID-19 rates and subsequently higher morbidity and mortality from the coronavirus, and several lessons can be learned from the community engagement efforts deployed to address these health disparities. The most successful engagement efforts were built on existing relationships with community partners, existing community advisory boards, and other community leaders such as faith-based leaders and local officials. A Community Microcosm Many have described narrative and open discussion forums as effective strategies that allow bidirectional discussions around determinants of health and misinformation. Successful engagement efforts by physicians were achieved when race and ethnic concordance was achieved between the target community group and the physician leaders. Community engagement work is fundamental to the work of the emergency physician and the emergency department, which is a microcosm of the community and an intersection of community members, law enforcement, prehospital providers, and a broad array of consultants throughout the hospital. Emergency physicians were appropriately placed on center stage of one of the largest international platforms with the COVID-19 pandemic as a backdrop, speaking directly to communities. The global community is diving deeper into the recovery and rebuilding phase of the pandemic, and emergency physicians should continue to nurture the relationships built during its more acute phases. The connection with marginalized and vulnerable communities should be strengthened and well maintained because this work is crucial in dismantling health disparities for the overall well-being of these communities. It is important to embrace the concept of “kapwa,” which is rooted in Filipino culture. Kapwa speaks to recognition of a shared identity or an inner self shared with others. Implicit in this inclusive concept is the moral obligation to treat one another as equal fellow human beings. This type of work has the potential to affect overall work experience positively and to reduce high burnout rates experienced across the globe in emergency medicine. The more emergency physicians start to see themselves in the communities served, the deeper the capacity will be for meaningful community engagement, which will be pivotal in uplifting the overall wellness of the global community. Dr. Knightis the director of faculty experience at Zuckerberg San Francisco General Hospital and Trauma Center, the associate chair of diversity and inclusion in the department of emergency medicine, and an emergency medicine diversity, equity, and inclusion endowed professor at the University of California, San Francisco. Follow her on Twitter@StarrKnightMD." @default.
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• W4386583921 date "2022-12-01" @default.
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• W4386583921 title "Diversity Matters" @default.
• W4386583921 doi "https://doi.org/10.1097/01.eem.0000904616.21145.72" @default.
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