Expanding our ecosystem: Building relationships in rural South Jersey
Our outreach efforts in Camden helped the county achieve a COVID-19 vaccination rate of 74 percent by May 2022, compared to 4% when we started in June 2021. Due to this success, we were approached by the New Jersey Department of Health (NJDOH) to expand our outreach to Salem and Cumberland counties with a goal of increasing vaccination rates in these rural counties on the southern border of New Jersey.
After looking at the data from NJDOH , we noticed that the COVID vaccination rates in these counties were surprisingly low . In April 2022, 56% of adults in Salem county were fully vaccinated, and 53% of adults in Cumberland County were fully vaccinated, compared with 66% nationwide.
When deciding on an approach to the outreach work in Salem and Cumberland counties, we sought to not only increase the number of vaccines provided but understand why there was such a hesitation around getting the vaccine in these areas. We also knew that we wouldn’t be able to do this work on our own.
Progress through partnerships
Through our work in Camden, we have learned that strong partnerships are crucial to building ecosystems of care that can truly serve individuals with multiple needs. As such, we were determined to forge strong working relationships with organizations that already had roots within Salem and Cumberland counties.
We were so fortunate to partner with Southern New Jersey Family Medical Centers (SJFMC), which has been serving the Salem and Cumberland communities for 40 years and has deep expertise in patient-centered care. We partnered with SJFMC to host events throughout the region, including health fairs and vaccination events where we’ve had the opportunity to ask community members about their thoughts and concerns around the vaccine.
We learned that the main concern for those that remain unvaccinated is mistrust. At the Camden Coalition we respect individual anatomy, but we encourage vaccination and do all we can to educate and answer any questions people may have.
At one event, we spoke to a woman who was interested in getting vaccinated but had some concerns. Her husband had been vaccinated the week prior and had to miss work for a few days due to side effects like fatigue, headache, and sneezing, and she was worried about experiencing these same symptoms.
We let her know that some people experience no side effects from the vaccine, but many do experience mild to moderate symptoms like her husband experienced. We reassured her that these side effects were completely normal and a good sign that your body is building protection against the virus that causes COVID-19. She thanked us for the information and said she wanted more time to think about getting vaccinated. We praised her for being thoughtful and taking the time to make an informed decision.
The next day we were in the same location doing a pop-up clinic, and the woman came back, along with her two children, to get vaccinated.
We’ve seen that conversations like this one have led to many individuals shifting their perspective on the vaccine. Though some people we talk to may still choose to remain unvaccinated, we leave them with resources and education to help them make an informed decision.
Reaching new populations
Working in Salem and Cumberland counties opened our eyes to rural communities and health issues that we weren’t previously aware of, including those experienced by communities of Native Americans as well as Latin American and Ukrainian immigrants that are being under-served and neglected in this region.
One relationship that has blossomed and helped expand our reach has been with the COVID Tribal Coordinator of the Nanticoke Lenni-Lenape tribe. Through our conversations with the Tribal Coordinator and other members of the Nanticoke Lenni-Lenape community, we learned that there are many reasons for mistrust and low utilization of the healthcare system, including lack of Indigenous doctors, high rates of poverty and lack of health insurance, and lack of adequate knowledge and health literacy around preventable diseases.
After speaking with the Tribal Coordinator about the unmet needs of their community and lack of education about the vaccine, we had the privilege to be invited and attend the Nanticoke Lenni-Lenape Pow-Wow. At the Pow-Wow we shared information about COVID to thousands of Indigenous Americans from all over the county who attended the two-day event.
We were able to vaccinate a substantial number of individuals through our partnership with SJFMC, and were able to talk with community members about their needs and help connect them to care. One woman who was vaccinated at the event had very high blood pressure. In talking with her, we found out that she had not seen a primary care provider in years because she did not have insurance. Because of that conversation, we were able to connect her to a primary care provider through SJFMC.
Sharing lessons from Camden
In addition to hosting vaccine events, we have also had the opportunity to speak to youth and other community members in Salem and Cumberland through town hall meetings and presentations. These opportunities have been made possible through our growing relationships with Southern New Jersey Perinatal Cooperative (SNJPC) and Puerto Rican Action Committee of Southern New Jersey (PRAC of Southern New Jersey).
Our partnership with SJNPC provided us the opportunity to showcase our work to the Salem Human Advisory Council (HSAC), a county-based planning, advisory, and advocacy organization that collaborates with community members and private and state organizations to enhance the distribution of human services. We walked the council members through on our collective COVID response in Camden, including our vaccine confidence trainings, Youth and Community Ambassador programs, and our use of My Resource Pal to connect individuals to resources in their area.
PRAC of Southern New Jersey worked with us to organize a presentation to youth in Salem County, where we spoke alongside a local pastor who is also a nurse. The presentation was an open and honest conversation during which healthcare professionals answered pressing questions sent in by youth in the area, including things like how to stay safe and protect others from COVID-19, and what the eligibility requirements and side effects of the vaccine are. When questions were asked that we did not have a clear answer to we were honest about that, explaining we do not have all of the answers about this newly emergent disease. We knew it was important to show the youth that we are all still learning and in this together.
The presentation was not only useful for the youth involved but also for us as professionals. We were able to obtain clear insight into what questions and/or concerns young people have and we provided them with the most current and up to date information related to their questions.
Lessons from community outreach in rural South Jersey
We knew that our experience working with an urban population in Camden would not necessarily translate 100 percent to the needs and experiences of those in a more rural area. We didn’t want to “play the hero,” and instead intentionally built relationships and started conversations from a place of humility.
Through these conversations and partnerships, we learned that so many people in rural South Jersey either cannot afford primary care or just do not have access or knowledge to connect with a primary doctor — something we often take for granted. Those we spoke to said they felt ignored and overlooked by healthcare systems, and that funding for programming and care specific to their communities is scarce. We also heard about their struggles accessing food and transportation due to language barriers, lack of public transportation, and fewer resources in their area dedicated to combatting food insecurity. While our Camden community experiences the same issues, we have comparably more resources that individuals can access when in need.
At the Camden Coalition, we want to support and help the communities we serve in any way possible. Being welcomed and accepted by community members in Salem and Cumberland only cemented how important it is to build relationships with other communities and organizations as we build an ecosystem of care in South Jersey.