Farhiya Farah, Ph.D.

Farhiya Farah, Ph.D., program director for the Master of Public Health, has been working with Somali populations in the Twin Cities area to promote public health actions and improve communications. This article details how public health promotion of social distancing aimed at reducing the impact of COVID-19 requires a crisis communication strategy aware and respectful of deeply entrenched values and norms of the targeted community.

By: Farhiya Farah, Ph.D.

COVID-19 has ushered the world into a precarious predicament demanding urgent interventions and community mobilization to successfully contain, mitigate, or suppress the spread of the virus. Numerous models have emerged simulating infection course trajectories examining the consequences of various intervention policies (Neil, 2020; Childs 2020; Kucharski 2020). However, model inputs and assumptions assume a uniform application of intervention policies and homogenous human behavior. Similar models using different target populations considering their unique attributes would yield starkly different infection spread outcomes.

Human behavior is extremely complex, with many factors contributing to public health intervention observance. It’s important to remember how intervention adherent subtleties could result in profoundly different outcomes, most often unfavorable, and especially with disenfranchised communities. Immigrants and refugees are often from such a community.

For example, crisis communications pertaining to social isolation directed to the refugee and immigrant community. The direction is to keep a 6-foot distance from one another, preferably accomplished by staying home and reducing non-essential trips. A homogenous society with the same cultural tendency would perhaps respond in a like manner to this directive. Unfortunately, this is not the reality of our heterogeneous society.

Health communication is the quintessential influencing tool of public health in promoting health and preventing diseases. The Centers for Disease Control and Prevention describes health communication as the vehicle “to inform and influence individual and community decisions that enhance health” (CDC 2020). Health communications experts have long recognized the success of health communication campaigns dependent on the dynamics of ‘interpersonal, group, organizational…” for effective health messaging (Kreps, 2008).

We can use the Somali community as an example. The Somali cultural concept of personal space is starkly different from mainstream America, as the cultural application of social distancing is gender-dependent. Most Somali interactions are typically tightly nested, infiltrated by hugs, cheek kissing, and kisses on the hands or heads of elders. Therefore, the public health promotion of social distancing aimed at reducing the impact of COVID-19 requires a crisis communication strategy aware and respectful of deeply entrenched values and norms of the targeted community. Moreover, the majority of the Somali community’s deeply-seated fatalistic attitudes negatively impacts reception to preventive messages if proper measures are not taken to respectfully address it. Considering the messaging urgency of COVID-19, public health and health care providers must be aware of the practical guidelines available, informed by the theoretical foundation for successful crisis communication with new Americans.

Below is a summary of such guidelines helpful for public health professionals to implement during the current pandemic. These guidelines are adapted from the 10 crisis and risk communication tips for public health professions working with native and new Americans (Littlefield, 2007).

  1. Involve multicultural specialists in communicating about public health risks.
  2. Use cultural agents as links to multiple communities.
  3. Take time to build relationships with multiple communities before the crisis.
  4. Utilize different ways to listen to and become involved with different communities.
  5. Realize that views about a public health crisis vary across cultures.
  6. Be mindful of religion and culture when communicating about risks with multiple communities.
  7. Be mindful about cultural learning styles when communicating about risks with multiple communities.
  8. Be mindful of literacy levels when communicating about risks with multiple communities.
  9. Be sensitive to cultural groups’ feelings about disclosing information and talking with public health agencies and officials.
  10. Exhaust the ways to communicate what you learn about cultural groups with other cooperating agencies.
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