Massachusetts Department of Public Health: Building Rural Infrastructure, It Starts with Community

Overview

During the COVID-19 pandemic, rural communities in Massachusetts faced disproportionate health challenges compared to their urban counterparts. The Massachusetts Department of Public Health funded community-based organizations to mobilize local partnerships and provide tailored interventions to local communities.

Challenge

Rural communities in Massachusetts faced disproportionate health challenges during the COVID-19 pandemic compared to their urban counterparts. Vaccination rates were below the state average and only 33% of the eligible rural population had received a COVID-19 booster in October 20221.

Access to crucial public health resources such as information, testing facilities, and healthcare services was limited, while social determinants of health like isolation, housing insecurity, and transportation challenges further impacted health outcomes for rural residents. Addressing these issues was much more than the state health department could do alone.

Solution

In rural communities where public health infrastructure and services are often lacking, interpersonal relationships and strong community ties serve as vital assets for achieving public health goals. This is supported by a robust network of community-based organizations (CBOs) which are typically service-based organizations that meet unique needs of local communities. Tapping into this network to mobilize local partnerships and provide tailored interventions, the Massachusetts Department of Public Health utilized funding from the Centers for Disease Control and Prevention's National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities Grant to allocate $75,000 each to 12 rural CBOs serving 14 regions in the state. These CBOs convened over 900 community stakeholders to address immediate public health needs, enhance vaccination outreach and access, and tackle broader health determinants such as food insecurity and transportation barriers. Through mobile vaccination outreach and targeted initiatives, they successfully surpassed statewide vaccination rates by January of 2023 with 66% of the eligible rural population boosted (a 33% increase) and closed the gap on COVID-19 2 dose vaccination from 4.3% below the state average, while also addressing underlying social determinants of health and advancing health equity.

Impact

Directly investing in rural CBOs to convene partners to address immediate and long-term public health needs due to COVID-19 has been instrumental in building the public health infrastructure for rural areas in Massachusetts. Several funded participants noted that the grant “is helping us build capacity in our community program work” and increase engagement through diversity trainings and improved community outreach. CBOs have engaged with diverse stakeholders and leveraged local expertise to address pressing health concerns -- not just COVID-19, but also broader access to all vaccinations, disease testing, and healthcare choices, while also laying the groundwork for sustainable, resilient and healthy rural communities. Because of this seed funding, many CBOs were able to increase staffing and apply for additional grants, foster new relationships with over 900 partners engaged - all elements that will ensure the sustainability of this work.