Churches are closing in predominantly black communities – why public health officials should be concerned

For decades, churches have been central pillars of community health in predominantly black communities, compensating for a highly inequitable public health infrastructure. The current COVID-19 pandemic has highlighted the important role churches have played as trusted authorities in Black and Latino communities by disseminating information and serving as access points for COVID testing. -19 and vaccine deployments. While positive health and well-being in the communities served by these churches ultimately requires significant government investments in public health and health care access points and resources, churches integrated into predominantly black communities will continue to be important providers of basic health services in their communities.

As a result, public health officials will need to become more intentional and systematic in understanding the demographics served by these churches, how they provide services, their ability to serve as potential outreach sites for health care access and the ways in which they more generally support the social determinants of health in their communities.

Black Churches Strengthen Racial Equity in COVID-19 Prevention Outcomes

In an initial attempt to center the public health role of churches located in predominantly Black communities, we focused on two important models: the example of the role of Black churches in the fight against COVID-19 and whether narratives anecdotal reports of increases in church closings in predominantly black communities point out the challenges ahead for the delivery of health services in these communities. We wanted to understand, by observing how black churches influenced racial equity outcomes during COVID-19, what might be lost when churches in predominantly black communities close.

In general, throughout the COVID-19 pandemic, there have been many examples of official public health organizations partnering with black churches. Some of the most notable examples include Mayo Clinic’s partnership with FAITH! in Minnesota, the collaboration between Liberty Grace Church of God in Baltimore, the International Vaccine Access Center (IVAC) at Johns Hopkins University, the DC Vaccine Exchange Program and the statewide partnership of New York State Vaccine Equity Task Force with Black Churches.

To be clear, churches have not been the only sites for expanding service delivery to reach the black population. However, communities with a high burden of COVID-19 and other underlying conditions such as hypertension and insufficient access to nutritious food – a risk factor for hypertension, often have a higher proportion of first-generation immigrants of color, incomes below the federal poverty level, low English proficiency, low or no use of high-speed Internet or digital technology, and high housing instability. Many churches in these communities distributed food through pantries or soup kitchens and provided spaces for social interaction long before the pandemic. Because of the models that churches often use to address the whole person and other social needs [in contrast to the medical model that focuses on disease]; churches often remain seen as informal places of health care during the pandemic.

Trends in Church Closures in Predominantly Black Communities

So we have to ask ourselves what happens when churches in predominantly black communities close and their public health functions are disrupted. To assess the impact of these closures on health, we investigated whether stories about church closures constituted a broader geographic trend.

To answer this question, we analyzed patterns of church closures in New York between 2013 and 2019 using the Standard Industry Classification (SIC) code 866107. A church closure is defined as four consecutive years in which no data has been reported by the church. For example, “1110000” would indicate data in 2013, 2014 and 2015 but no data in 2016, 2017, 2018 and 2019 and we would code that as “closed”. We mapped this data by Black/African American population distribution using ACS 2019 5-year estimates and by COVID-19 positive test rates.

We found that the highest rates of church closures by general population were in areas with the highest percentage of black people (Figure 1). Many of these areas (zip codes) are where churches that participated in New York State’s COVID-19 testing program were located. To illustrate why churches remain an important extension site for public health collaboration, the maps reveal that a higher rate of church closures were in areas with the highest COVID-19 positivity test rate. the highest (Figure 2).

The conditions under which churches close are many, including changes in worship attendance, trends by age and race, possible internal issues, and likely gentrification or market conditions and real estate costs (and predatory development) compel churches to vacate or sell property. The closure of these churches means that marginalized demographic groups (e.g. immigrants, insecure housing, seniors, low-income people) will have to look elsewhere for health and community services. Accordingly, we must identify the myriad conditions and determinants of church closures to design policy solutions that respond to their fundamental role in communities, especially those of color.

Paving the way to equity requires collaborative faith, community and public health strategies

The COVID-19 pandemic has made it clear that existing traditional healthcare delivery sites are insufficient to quickly meet the needs of large populations. There are too few health centers, many are understaffed to serve large numbers of people, and it is prohibitively expensive to build new ones, staff and train people to provide care culturally. compassionate. Additionally, many health care delivery sites are inaccessible to racial and ethnic minorities and other marginalized groups such as those who are precariously housed. The reasons for this are many, including logistics (eg driving time or opening hours) and socio-structural barriers (eg medical mistrust due to discrimination).

To become an equitable nation and to protect all members of the population, we need public policy that prioritizes collaborations with cultural institutions that are important to people of color. Churches are at the heart of public health efforts, and various stakeholders (e.g., public health officials, racial equity organizations, members of Congress, real estate developers) need to pay attention when There are noticeable trends in the disappearance of churches in these communities. The immediate action steps our team has begun to develop include a systematic method to inventory health care access and delivery services provided by these churches by characteristics such as denomination and size. Armed with the ability to assess where needs might arise if these churches close, stakeholders can proactively engage in decisions about alternative public health arrangements and/or decisions about economic development and community priorities. town planning.

Figure 1. The relationship between church closings and the racial makeup of Black/African American neighborhoods in New York City (NYC)

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Figure 2. The relationship between church closures and COVID-19 positivity in New York (NYC)

A map comparing the COVID-19 testing rate by county against church testing site locations and church closures in New York City.
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