by Silas Rutherford
BIPOC medical and social workers are leading a project to expand accessible healthcare in Brockton, MA through a mobile clinic that serves historically marginalized groups disproportionately affected by the opioid crisis. This project, Community Care in Reach, was created to develop the mobile care unit, drawing insights from HEALing communities studies and work with community coalitions in Brockton. Leaders in Community Care in Reach are aware of the inaccessibility of health services for marginalized populations and they use this awareness, expertise, as well as data gathered at the Brockton Neighborhood Health center to provide relevant solutions that will provide sustainable improvement in the area.
A major component of sustainable solutions to addiction involves evidence-based practices that prevent overdose deaths, such as wound care, distribution of safe supplies, and medications for managing detox. The diversity of identities, spoken languages, and backgrounds among the health care professionals involved in the mobile care unit are vital to overcoming the barriers in the Brockton community to opioid abuse disorder treatment, which stem from racial discrimination and social stigmas. The care team at Community Care in Reach consists of a family nurse practitioner, a licensed practical nurse, peer recovery coaches, community health workers, and case management services that offer culturally competent and non-judgemental harm reduction and responsible use practices. Outreach staff is responsible for sociological research and they engage directly with local community members to most efficiently and effectively address their needs.
Similarly, the team includes individuals with past lived experiences of addiction, recovery, homelessness, and psychiatric conditions, bringing invaluable perspectives that help identify and address barriers to accessible healthcare in underserved communities. Furthermore, supporting policy and organizations that fund initiatives benefiting BIPOC who pursue higher education is a priority. When members of marginalized groups have access to these resources and enhanced autonomy their ability to utilize their knowledge to uplift their communities expands greatly. Education funds play an essential part in healing the infrastructural damages caused by racism.
Prior to the launch of Community Care in Reach’s mobile care unit, people experiencing opioid abuse disorder in danger of fatal overdose from drugs such as heroin, illicit fentanyl, and prescription painkillers did not have access to evidence-based first line treatment. For instance, “census block groups with majority indigenous populations experience the longest median road distance to a buprenorphine provider among any racial or ethnic group census block population” (https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1407522/full) . The efforts of the mobile healthcare providers to bring care to areas that face economic disparity embodies the idea of healthcare as a fundamental human right. In addition, providers are honorably committed to health equity. They attend anti racism and trauma informed care training on a consistent basis.
Under capitalism, many medical practitioners struggle to provide personalized care for their patients in areas such as Brockton due to overstressed providers and prescribers, caseload limitations, and underfunded resources. Systemic racism, prejudice, and discrimination decrease trust between patients and providers, creating uncomfortable circumstances for many, which inhibit treatment. . Introducing more providers with diverse experiences, identities, and language speaking skills combats these issues and alleviates the strain of healthcare facilities in areas like Brockton.
Medicaid and inadequate private insurance companies push working class people with low income or limited resources away from addiction treatment. People are often forced to forgo treatment for addiction under a for-profit medical system, especially if they experience other urgent chronic illnesses or comorbid health issues. In cases involving youth, parents who face dire financial concerns are less likely to admit their children to inpatient mental health services, despite noticing suicidal tendencies or symptoms of depression. This is especially concerning because BIPOC youth experience mental health struggles at higher rates than white youth due to the psychological effects of racism and generational trauma that has been perpetuated by exploitative colonial/imperialistic institutions. Studies have found that medical expense cost sharing as low as one dollar decreases the use of evidence based treatment prescriptions. Justice is everyone in the United States having the ability to live and thrive regardless of their ability to pay out of pocket for health care. Data collected from the Community Care in Reach mobile care unit show that the patients being served are more representative of historically marginalized racial groups, ethnic groups, as well as unhoused people. This demonstrates that the work of members of the Community Care in Reach program has successfully aided those in need.