Local Responses to COVID-19: The Mediating Role of Community-based Organizations in Majority-Black Neighborhoods and Immigrant Enclaves, A Case Study of Atlanta, Georgia

Abstract

This paper will present a case study of local responses to the epidemic in immigrant enclaves and majority-black neighborhoods in Atlanta, Georgia. The COVID-19 health crisis presents an unprecedented challenge for many black and brown communities in the United States which may be particularly vulnerable to the contagion because of higher rates of certain pre-existing conditions like heart disease, lack of access to adequate healthcare services, and financial pressures to continue working despite increasingly risky conditions. In the American South where burgeoning ethnic enclaves, well-establish majority-black neighborhoods, and affluent suburbs exist side by side with vastly different healthcare concerns, disorganized governmental responses to the COVID-19 epidemic highlight the importance of efforts by CBOs (i.e. advocacy groups, neighborhood associations) to address the localized impacts of the virus. As an emerging immigrant gateway with a history of racial tension and inequality, Atlanta is a prime location to analyze the mediating role of community-based organizations in addressing health crises in communities of color in the New South. This study will examine CBOs in two prominent immigrant enclaves, Clarkston and the Buford Highway Corridor, as well as two majority-black localities, Stone Mountain and the city of Atlanta’s West Side. My analysis of Atlanta CBOs’ responses to the COVID crisis will focus on their efforts to disseminate public health information, provide resources and services addressing COVID externalities, and utilize social media platforms to engage with community members online.

Introduction

As the COVID-19 pandemic continues to rage across the United States, racial health inequities are resulting in disproportionately high rates of infection and death in black and brown communities (Dorn et al., 2020). Disorganized and delayed federal and state government responses to the virus further complicate efforts to mount an effective public health response and shift the onus of action to local actors such NGOs, Community-based organizations (CBOs), and nonprofits. This is especially true in the South, where minimal government responses from states like Florida and Georgia have left communities and CBOs scrambling to respond to emerging social, political, economic, and health issues. In recent weeks, three of the counties with the largest minority populations, Fulton, DeKalb, and Gwinnett, have posted the highest case rates in the Atlanta metropolitan statistical area (MSA) (COVID-19 Weekly Report). In Georgia, black residents represent 32.6% of the population but 44% of COVID-related deaths (COVID-19 Status Report, 2020; U.S Census Bureau Quick Facts, 2019). Unfortunately, these results are unsurprising considering the pre-existing inequality, residential segregation, and concentration of poverty which negatively impact physical and mental health as well as healthcare access in communities of color in Atlanta (Viruell-Fuentes et al., 2012). It is amidst an uncoordinated government response and the conditions of structural racism that CBOs in Atlanta’s black and brown communities endeavor to meet the specific needs of community members during the COVID crisis.

The following paper addresses how CBOs are adapting to the current circumstances in Georgia to engage communities of color by bridging the gap between those communities and health information, resources, and preventative community-based strategies. Effective COVID response efforts in China have demonstrated the important mediating role that CBOs play in each stage of the pandemic from distributing supplies, providing community services, and building collaborative relationships within vulnerable communities (Cheng et al., 2020). This paper examines the essential role that CBOs’ local relationships play in COVID responses in communities of color by disseminating health information, distributing essential supplies and resources, and engaging with the community online. CBO responses to COVID in Atlanta were measured by analyzing over 800 social media posts on Facebook, Twitter, and YouTube from 20 different organizations in the Atlanta MSA as well as each organizations’ website. The organizations examined in this study were chosen based on explicit mission statements related to providing services to communities of color as well as their location in either majority-black neighborhoods or immigrant enclaves. Qualitative data collected from social media posts and organizational websites was coded for information related to the provision of health information, distribution of resources, and community engagement all connected to the COVID crisis. The following paragraphs will present the methodology and results of the study as well as a discussion of the results, avenues for future research on the topic, and recommendations for public health policymakers. The results of this study demonstrate how CBOs are working to prevent the spread of contagion and unfavorable COVID-related social, economic, political, and health outcomes in vulnerable communities of color across Atlanta through a variety of online and in-person services and programs targeting specific community needs.

Methodology

This study relies on online information via social media (Facebook, Twitter, and YouTube) and organizational websites to measure CBO responses to COVID. Due to shelter-in-place orders around the Atlanta MSA and the inherent risks of continuing in-person services, CBOs are increasingly relying on online platforms like Facebook and Twitter to interact with community members and advertise remote or socially-distanced services and programs (Pinto & Park, 2020). Consequently, a CBOs online presence should provide a relatively accurate depiction of its services during the COVID pandemic. Moreover, past studies have demonstrated that online platforms like social media are a “major focus of web activity for low SES households” and may also be a major focus for the CBOs which operate in communities of color. (Ramanadhan et al., 2013). However, there are likely CBO services and programs that are not advertised online, and thus, the strictly online data collection in this study presents a potential limitation. In this study, CBOs are defined as non-profit organizations led by a board of directors and/or community stakeholders with services targeting a set of community needs (Ramanadhan et al., 2020). The 20 organizations examined in this study were chosen by using the selective search terms (“Atlanta” + “neighborhood name” + “community organization” OR “community health”) and (“Atlanta” + “neighborhood name” + “nonprofit”) on Google.com, Yellowpages.com, Facebook.com, Atlantaregional.org, and Greatnonprofits.org as well as using local information from community organization members in Atlanta (Ramanadhan et al., 2020). The neighborhoods searched for include the following majority-black neighborhoods, areas, and ethnic enclaves: Peoplestown, Mechanicsville, Pittsburgh, Westside, Old Fourth Ward, West End, English Avenue, Atlanta, East Point, West Atlanta, South Atlanta, Buford Highway, Summerhill, Bankhead, Kirkwood, College Park, Sandtown, Southwestern Atlanta, Washington Park, Sweet Auburn Avenue, Stone Mountain, and Clarkston. From the results of these searches, a list of over 50 organizations was compiled and subsequently reduced to 20 based on the criteria of the study’s definition of a CBO outlined above. Inactive organizations were identified by whether they had any posts on their website, Facebook, or Twitter in the last 6 months and were removed from the list. Additionally, due to the limited time frame of the study, Faith-based organizations (FBOs) were also removed from the list.

Next, a basic coding schema was developed to catalog the qualitative data collected from each organization’s website and social media pages based on criteria related to the provision of health information, distribution of essential supplies and resources, and online community engagement. Data related to best health practices, COVID-related news, and health agency/government advisories were coded as “Health Information”, data referencing the organization’s supply distribution programs or health services was coded under “Resources”, and data designed to engage a target community in fundraising, online dialogue, volunteering, or other collaborative efforts was coded as “Community Engagement”. Using the advanced search functions on Facebook and Twitter, the trending search terms “COVID-19”, “Corona”, and “Coronavirus” were used to identify COVID-related posts and then coded using the coding schema. However, there may have been additional posts that did not use these terms which presents a potential limitation to this study. The limited website and YouTube content from CBOs encountered in the study was examined in its entirety and coded accordingly. The results of the study and an analysis of the findings are presented in the following paragraphs.

Findings

Health Information

The research design of this study focused on social media data, and because social media is a primarily informational platform, health information was the most abundant category of data collected. This data depicts the role CBOs in communities of color serve as conduits for information from health officials, government agencies, and other authorities on various topics, providing a trustworthy source of information in communities which may have an otherwise tenuous connection to the healthcare system and other institutionalized authorities (Tasnim et al., 2020). This role has heightened importance during the pandemic because of the rapid spread of misinformation online as well as the challenges of searching for personally relevant information among the deluge of jargon-heavy and sometimes contradictory advisories and reports issued by public health officials from various organizations. Social media can help streamline information to find what is most relevant for an individual living in a particular community, but according to a study conducted by Kouzy et al., social media also plays a significant role in the spread of misinformation about COVID-19 (2020). However, Kouzy et al. found that NGOs’ accounts (which include CBOs) along with those of journalists and public health officials had the lowest rates of misinformation (2020). The study of Atlanta’s CBOs presented in this paper supported the findings of Kouzy et al., showing that 12 (60%) CBOs posted verifiable COVID health information and of those organizations, only 2 (10%) included unverified information (See Figures 1 & 2). This is well below the average of 24.8% of posts with COVID-related misinformation in the Kouzy et al. study and demonstrates the important role CBOs play in disseminating accurate health information during the pandemic (2020).

Figure 1.

Data results from CBOs in ethnic enclaves. CDC, Center for Disease Control, MSA, Metropolitan statistical area, GA, Georgia.

Figure 2.

Data results from CBOs in majority-black neighborhoods. CDC, Center for Disease Control, MSA, Metropolitan statistical area, GA, Georgia.

In addition to health information, the organizations examined in this study posted a variety of community-specific information. For instance, in Buford Highway, an ethnic enclave just outside the city limits known for its robust community of ethnic restaurants and small businesses, a community-service CBO, WeLoveBuHi, maintains a list of businesses and restaurants organized by their operational status (open for takeout, delivery, or dine-in). This is an important function for both residents who may rely on these businesses to obtain specific ethnic ingredients and products and for the businesses that rely on loyal customers from the community. The study also found that 12 (60%) organizations posted materials related to free COVID testing sites and at least 2 (10%) organizations were actively involved in organizing testing drives. (See Figures 1 & 2). Many advertisements for testing drives in CBO posts had been translated into multiple languages, and in one case, an organization advertised a help-wanted post for bilingual volunteers to staff their testing drive (See Figure 3). In ethnic enclaves like Buford Highway and Clarkston with numerous different immigrant and refugee populations, multilingual information and services are essential to make testing services accessible to all residents. With the current high demand for COVID tests, it can be difficult to find testing sites and may be especially problematic in communities of color where access to health is often limited (Viruell-Fuentes et al. 2012). Furthermore, communities of color in Atlanta may be among the most in need of testing as they have some of the highest rates of exposure through employment in vulnerable occupations in which contact with potential carriers is inevitable, according to a recent study by the Atlanta Regional Commission (Data Diversion: Low-Income Workers and People of Color, 2020). Thus, the advertisement and organization efforts of CBOs for COVID testing may have a powerful preventative impact in communities of color in Atlanta, although, more research needs to be conducted to measure the efficacy of such testing programs.

Figure 3.

Poster of Free COVID Testing Drive organized by multiple CBOs in Atlanta. Top left box: “You don’t need ID”. Top right box: “Confidential”. Bottom left box: “You don’t need an appointment”. Bottom right box: “In your community”.

Resources

COVID-related resource information was the second most common category of data collected in this study. There may have been less resource data available because of recent disruptions to CBO operations because of social distancing orders and health concerns that have in many cases prohibited service continuity (Pinto & Park, 2020). Nevertheless, many CBOs in Atlanta have adapted to these conditions to provide resources and services safely and address community member concerns. 5 (25%) CBOs in the study, particularly business associations and community revitalization organizations located around the downtown Atlanta commercial area, posted lists of small business loan and grant resources. This type of support is essential for small business owners who are key community stakeholders especially in majority-black neighborhoods around downtown Atlanta where gentrification and urban decay have undermined the foundations of many communities. 4 (20%) CBOs in the primarily residential suburbs posted resources for renters such as rent funds and model letters to property owners for renters struggling with payments. Considering that nearly 70% of low-income households in the Atlanta MSA are renters, these rent funds and resources may provide a lifeline for families in communities of color struggling with the financial implications of the pandemic. 2 CBOs (10%) posted resources related to domestic violence and victimization which is a growing issue as victims are trapped indoors with their abusers for long periods due to quarantine conditions (Bradbury-Jones & Isham, 2020). These findings demonstrate how CBOs in communities of color are adapting to COVID to provide resources and services that address the specific needs and challenges of their communities.

One significant concern for communities of color during the pandemic relates to obtaining basic goods and supplies which has become much riskier and more difficult. Although delivery services are available, these services may not be an option for low-income households under increased financial pressure. Some CBOs in Atlanta’s communities of color are addressing this issue by connecting community members to low or no cost delivery services and drive-up community food pantries. This study found 8 (40%) of organizations offered these services, although, 7 of these organizations were from ethnic enclave communities and only 1 was from a majority-black neighborhood (See Figures 1 & 2). This may be because most of the CBOs selected for this study from majority-black neighborhoods are located inside the city of Atlanta which has numerous well-established food bank operations (i.e. Atlanta Community, Food4Lives) while ethnic enclave CBOs are all located in the suburbs of the city where food bank services are less accessible. In addition to food-related resources, 3 (15%) organizations also offered delivery of free hygiene kits or health supplies (masks, gloves, etc.) (See Figures 1 & 2). This service represents an important preventative program that connects community members to essential health supplies and may help slow the spread of COVID in some of Atlanta’s most vulnerable communities. Furthermore, in cases where these programs employ the aid of community volunteers, they contribute to community building around the COVID-crisis as members of the community “engage together in the process of community change” (Heldman et al., 2013). This collaborative engagement is an important element of CBO resource distribution during the pandemic as well as building solidarity and a sense of community resiliency. In a study on the effectiveness of community-based health promotion in urban areas, Nickel and Knesebeck found that community participation “enhances the ‘utility’ of health promotion by fostering commitment and a synergy of action and outcome” (2019). Whether community members participate through volunteering, donating to a food drive, or visiting the drive-up community food pantry, they are engaged along with the CBO in a synergistic relationship connecting action and outcome at the local level.

Community Engagement

Community engagement data was the least common category encountered in this study. Social media engagement has the potential to allow CBOs and health officials to interact directly with vulnerable populations, however, it is also a largely untapped resource by CBOs (Heldman & Weaver, 2013). However, the pandemic presents new opportunities for CBOs to use social media to engage with vulnerable populations and disseminate valuable health information. With limited operational capacities during the pandemic, CBOs may face additional funding challenges that will require them to rely more on small business and individual donations (Pinto & Park, 2020). This study found 13 (65%) organizations used their online platforms for fundraising (See Figures 1 & 2). CBOs advertised their fundraisers for their community’s specific COVID-related crises such as rent support and local restaurant/business funds. Additionally, CBOs in this study reposted fundraisers from other organization’s pages to maximize the range of their fundraiser advertising, contributing to an online community of CBOs by promoting one another’s services. Scarcity of resources and funds for CBOs make these collaborative relationships between organizations essential for cross-promotional purposes as well as maintaining interorganizational ties (Lawlor et al., 2019). Without emergency grant funding from the government, rapid response services developed by CBOs during the pandemic would have to be funded primarily from the individual and small business donations. In this context, utilizing online platforms to raise funds may allow CBOs to provide additional targeted services and resources to communities in crisis. 8 (40%) CBOs also leveraged the interactive capabilities of social media to engage with community members through webinars, virtual meetings, or question and answer sessions. This format allows for direct online contact with community members during the pandemic in place of risky in-person contact and presents a more personal platform to communicate health information, raise awareness about available support services, and build community solidarity through engagement. These interactive functions have been underutilized in the past by CBOs and COVID may have acted as a catalyst to encourage CBOs to take advantage of their engagement potential (Ramanadhan et al., 2013).

Conclusion

The results of this study suggest that since the acceleration of the pandemic in March 2020, CBOs in Atlanta’s communities of color have developed a set of diverse responses to COVID and its community-level externalities and impacts through health information dissemination, local services and resources, and online community engagement. Furthermore, the findings showed a stark contrast between CBO responses in ethnic enclaves and majority-black neighborhoods. CBOs in ethnic enclaves were far more active on each of the online platforms examined while in some cases, CBOs in majority-black neighborhoods were entirely inactive or did not have any COVID-related posts. If these findings are generalizable, they may indicate a concerning gap in COVID information, resources, and engagement in Atlanta’s black community. However, it is possible that, as mentioned in regards to CBO food pantry and delivery services, organizations other than the CBOs examined in this study are filling those gaps in the black community while CBOs in ethnic enclaves are more active in those functions. Moreover, these results are preliminary, and more research is necessary to understand how CBOs in different communities of color are adapting to COVID as well as the efficacy of their responses. This study is qualitative, and the sample size is relatively small. Collecting quantitative data on a larger sample size of CBOs in Atlanta as well as other cities in other regions of the United States may provide a more accurate depiction of CBOs’ roles in alleviating COVID crises in communities of color. Conducting structured interviews with community members and CBOs may also provide a deeper understanding of their operations and adaptations during the pandemic. Preliminary studies on CBO COVID responses in China suggest that the local relationships are essential for collecting community health information, tracking COVID cases quickly, and providing effective relief aid (Cheng et al., 2020). These effective responses in China are the result of the collaboration between CBOs and the state, which was not a significant factor in Atlanta CBOs’ COVID responses according to the data collected in this study. Legislators and public health officials in the United States could improve their COVID responses by leveraging the local connections of CBOs to quickly address outbreaks at the local level (World Health Organization, 2020). Coproduction of COVID response could extend the reach and efficacy of both government and CBO interventions by maximizing both groups’ strengths and alleviating the enormous burden each group is carrying to address the pandemic alone.