Practice Title: Hennepin County Community-Based Infectious Disease Team
Department: Hennepin County Public Health
Size: Large (Population of 500,000+ people)
State: Minnesota
Summary of Practice:
Public Health Department and County: Hennepin County Public Health (HCPH) is the largest public health department in Minnesota. Its vision is for all people who live, work, and play in Hennepin County to experience optimal health grounded in health and racial equity. HCPH takes a comprehensive approach that strives to respond to the unique and important needs of all residents. Its dynamic programs promote physical and mental health, reduce chronic diseases, and prevent illnesses and injury associated with communicable diseases and environmental conditions.
Hennepin County is Minnesota’s largest county (anchored by Minneapolis), with 1.27 million people calling it home, or about 23% of the entire state’s population. Hennepin County is rich with different cultures, dynamic immigrant groups, arts, and civic engagement. However, Hennepin County also struggles with institutional racism and classism at multiple levels, with the community altering murder of George Floyd in Minneapolis in 2020 bringing local inequities to the national lens.
Public Health Issue and Response: With a population larger than some states, Hennepin County has unfortunately seen firsthand the rapid spread and devastating consequences that infectious diseases can have on our residents. This is especially true for traditionally marginalized communities with fewer resources, multiple barriers to quality care, and a historic mistrust of the health care system. To reach true health equity, the diseases that most often impact underserved populations must be responded to with resources and zeal. We know crises will happen, and we know they will likely seek out the most vulnerable populations. If anything positive emerged from COVID, it was a better understanding of what could and should have been done to respond better.
After reflection and review of data, HCPH came to a solution - a response team that can be deployed quickly with an action plan in hand and resources at the ready when new infectious disease emergencies are detected, coupled with a commitment to working side by side with communities. Thus, the Community-Based Infectious Disease team (CBID) was born.
Goals and Objectives: The CBID team was created with the goal to prepare a rapid, effective, and culturally competent response to emerging infectious disease outbreaks, particularly outbreaks that heavily impact BIPoC and other marginalized communities. This goal would be met with a highly trained team, health equity tracking, and mutually beneficial staffing solutions.
Timeline: In fall 2021, HCPH leaders reflected on COVID lessons. The department saw staff burnt out from being deployed to cover duties outside of their regular positions, staff shortages created in areas, significant racial disparities in who was vaccinated and infected, and the struggle to simultaneously create and execute action plans. Thus, the CBID team was created. The proposal was approved in January 2022 and after a delay due to Omicron, the team was formed between March and May 2022. Just as soon as it was created came the Mpox outbreak, providing a crucial first experience for the team.
Results: The CBID team, even in its infancy, was able to quickly respond to the Mpox outbreak, administering 70% of Minnesota’s vaccinations. Despite a high MSM population density, the number of cases held at 161, with the last one detected on November 1. The CBID team vaccinated more BIPoC identified people than the general county demographics. However, a significant discrepancy still exists between who was vaccinated and who had Mpox, requiring ongoing work to decrease the gap and assess actions in future outbreaks.
Important Factors: The most important factor that has set up CBID is in its title – community-based. CBID puts community first so those who have been marginalized are now centered with communication, care locations, and strategic partnerships. Additionally, CBID progressively gains experience and knowledge so it can bring improved practices to the next response. CBID also confronts one of the most pressing issues in health care – staff shortage and burnout. CBID team members are hired with an understanding of what their job requires, instead of being surprised with an emergency preparedness deployment. Public health staff can continue their normal job duties and even be assisted by CBID team members between outbreaks.
Public Health Impact: The CBID team was able to respond to Mpox within a day, allowing for rapid dissemination of vaccines. A swift and organized response will be beneficial to any infectious disease outbreak. The responding staff become experts, allowing more localized responses even during national emergencies, again decreasing the lag time and enabling a response that meets the unique community dynamics of Hennepin County. It is never a question of if another outbreak will happen, it’s when, and COVID taught us that preparation is key.
Community Engagement: As community involvement is at the heart of CBID, partnerships are crucial. Because CBID is based in a strong public health department, it could fortunately build on partnerships from previous initiatives. Community partners based on outreach to those experiencing homelessness, HIV prevention, syringe exchange, and immigrant health efforts were especially beneficial as they were already focused on marginalized groups. These partners gave valuable insight into the needs and concerns of its members, localized space and access, and existing programs that could be extended to include the CBID response.
Reducing Health Disparities: CBID was created because the cycles of infectious disease outbreaks continue to disproportionally impact marginalized groups. During COVID, significantly more white people were getting vaccinated than BIPoC identified individuals while COVID was proving more serious and deadly for BIPoC communities. It became clear that there were many factors at play, including historical mistrust of health care, access barriers, and lack of trusted messengers. It took months for the government to respond to these differences and even then, the skepticism was real since it was governmental communications.
After seeing great disparities, HCPH knew it could not have that kind of learning curve again. The disparities cost countless lives. Thus, CBID leads its efforts by connecting with BIPoC and other effected communities first instead of down the line.
Website: While CBID has not yet created a website, here is the link to HCPH: https://www.hennepin.us/publichealth
Hennepin County Community-Based Infectious Disease Team
Category
Infectious Disease Prevention and Control
Description