Dispatches from Our Own Wisconsin: Al Castro of the United Community Center
Al Castro is the Director of Health Research Programs at the United Community Center, a nonprofit Latino community organization in Milwaukee. With an extensive background in social work, Al combines public health issues in his work at UCC, facilitating community-engaged health research in the Latino community with academic research universities, including UW-Madison. Al serves as a community-imbedded Research Ambassador for UW-Madison to help UW researchers develop and conduct health research projects in the Latino community of Milwaukee. The Wisconsin Idea Seminar visited the United Community Center in 2016 and 2018.
We caught up with Al to ask a few questions about how he and the rest of the team at the United Community Center, which is celebrating its 50th-anniversary of serving the Milwaukee Latino community, are collaborating with local organizations to address shifting healthcare needs.
Have you seen the community in Milwaukee’s South Side come together in response to COVID-19? If so, how? Yes, there are a variety of individuals, organizations, and health providers who are responding collaboratively to COVID-19 in the Latino community of Milwaukee. Entities, such as Sixteenth Street Community Health Centers, UMOS, Advocate Ascension Health Care, have established testing sites in the area. Organizations and academic partners have collaborated to apply for some of the immediate response grant funds coming from federal, state or area foundations to quickly develop public education and response activities, like Sixteenth Street Clinic, United Community Center, Southside Organizing Committee, Medical College of Wisconsin, Milwaukee Health Department, UMOS, the Hispanic Collaborative. These various initiatives are a good start, but there is still much to be done in more direct education and preventive information to be disseminated directly with many individuals in the community. Some of these groups have applied jointly and obtained response grant funding from the Advancing Healthier Wisconsin grant (from the University of Wisconsin-Madison’s Wisconsin Partnership Program and the Medical College of Wisconsin’s Healthier Wisconsin Partnership Program) for these strategies.
The United Community Center can be seen as a microcosm of our larger world: you are home to two schools, a senior center, a restaurant, a dementia center, an adult day center, and more. Education, senior living, and restaurants have experienced incredible disruption due to the pandemic and the United Community Center has all these sectors under one umbrella. What has been a guiding principle for you and your team during these past few months? Responding as an organization, our leadership took steps immediately to comply with the Governor’s Safer at Home order in mid-March, to protect our employees and our program participants, and we have continued to remain closed for non-essential services to date. Even with the recent cancellation of the state-wide Safer at Home order, UCC continues to maintain the health and safety of our staff, program participants, and the community by complying with the existing County of Milwaukee’s ongoing Safer at Home directives. However, despite the temporary closing of the physical facilities, UCC has continued to respond to the needs of our community, and to continue providing services and support as best as we can. Most program staff are working remotely, and we are continuing the residential substance abuse treatment program. We have converted the daily senior meal site program into home-delivered noon meals to our elderly participants during this time.
Like most everyone else in this country, UCC has had to quickly pivot and learn how to use teleconferencing for meetings and client support services. Our substance abuse program is now providing intake and outpatient treatment services via telemedicine; our memory diagnostic clinic is now conducting initial screenings and clinical evaluations via telemedicine; teachers continue to communicate with their class students via tele-sessions; and other UCC programs are using technology to continue communication with program participants where possible. We are glad to be able to continue providing for our community as best as we can during these unpredictable times and are very appreciative of new funding support or flexibility in current grants to be able to continue our work.
In April, we reached our 50 year anniversary milestone in serving the Milwaukee Latino community. We recently had a change in our leadership, as Mr. Ricardo Diaz retired as Executive Director. Ms. Laura Gutierrez has now assumed that position, and we had planned to celebrate this transition at our annual dinner event. While our physical event was postponed, we continue to celebrate this accomplishment and all of the individuals who have been a part of the UCC family for 50 years. We launched an online timeline to commemorate the occasion which can be viewed on our website. We and look forward to more celebrating in the future.
Over the years you have helped to facilitate valuable educational field experience for UW faculty, setting the stage for innovative efforts to improve educational and health outcomes and to minimize disparities that impact the Latino communities in Milwaukee. Has the pandemic heightened the need for particular types of research inquiry and community partnerships? I believe this a unique opportunity for everyone, even those outside the most affected areas to realize how the broader community health and well-being affects us all. As we see now, it is critical for everyone to understand that the health of all population groups has an effect on the lifestyles and health of everyone around the state. The COVID-19 pandemic has magnified the impacts of long term health inequities and racial/residential segregation in our communities. The impacts of the pandemic are being felt state-wide, and country-wide, and others are seeing how people in underserved and ethnic communities are being impacted to a greater degree. I do believe the pandemic will provide, and is providing, valuable opportunities to utilize science and research to not just understand why the pandemic is happening and who is being impacted, but what can we all learn from this to avoid repeating the same in the future. I would hope to see other researchers and stakeholders come to the table to get involved in learning more about what the research and lessons learned can tell us, and bring other stakeholders to get involved to start making some feasible systemic changes in our policies, social norms and life-styles. By this, I mean others like the business community, employers, health insurers, and new collaborations which include representatives from both urban, suburban and rural areas that tackle state-wide, systemic disparities, for the good of the all.
These are opportune times of new living research opportunities for health research students and faculty to collaborate with such entities to develop and drive research efforts that will help a greater variety of stakeholders learn how not to allow this to happen again. Otherwise, we run the risk of becoming complacent again, once this pandemic passes, and we go back to the usual norms and practices that reinforce continued inequities, and allow breeding grounds for a new costly pandemic in the future.
Have the constraints of physical distancing galvanized the exploration of new ways to approach health-related community research? I think we are too early in this phase to say new approaches have been galvanized, as this is a new phenomenon for so many of us and our communities. Some key lessons we are learning are the different levels of abilities for residents and service providers to be able to communicate and obtain health care and services, depending on the technology available at the time, their level of comfort and skills with such technology, such as virtual meeting platforms, internet connection–or shaky internet connections–the “digital divide” factor of older people not having the technology, skills or comfort in using video conferencing and internet resources, compared to younger, more tech-savvy persons; the challenges in converting or pivoting to what type of services and support can be provided remotely and what cannot; and facing moral or ethical dilemmas in having to temporarily close physical, on-site programs for so many program participants. I do see how organizations, health services, and governmental services are now going to grow and change in incorporating more technology into daily business, so as to be better prepared in a future health crisis, and how to become more nimble and flexible in order to reduce the impact of future disruption of services. These challenges and new experiences present opportunities to learn and develop new ways to conduct health-related research, whether in urban or rural areas, but will require investments in such technology by many stakeholders.
Has the United Community Center played a role in amplifying critical health messages to the Latino communities in Milwaukee? Our UCC website has quickly created a COVID-19 resource page to provide up-to-date information on the virus, about available resources and suggestions for preventive practices. We use that page to relay and share information from the CDC or other health agencies to our community and employees. In addition, UCC recently collaborated with the Sixteenth Street Community Health Centers (a local federally qualified health center) to obtain a COVID-19 response grant from Advancing Healthier Wisconsin/UW-Madison to expand a social media community education program to the Latino community of Milwaukee (Lo Que Debes Saber: What you should know about COVID 19), which is about to launch in the next few weeks. As a member of the Milwaukee Latino Health Coalition, UCC is also involved with other organizations to help support and learn from each other in our responses to COVID 19, and sharing of information and resources with each other to help our community.
The United Community Center is located in the heart of Milwaukee’s Latino community and serves a growing number of older Latino adults, including those living with Alzheimer’s disease and dementias. How has the UCC’s memory care been affected by the pandemic? Due to the pandemic, we have had to temporarily close down our adult dementia day center, where we have been serving over 60 older adults per day. I can only imagine the increased level of stress and responsibilities this is placing on the family caregivers who now are providing care 24 hours a day, with no break. On top of this care, many of our family caregivers still have children at home, who are also home due to the schools being closed. So social distancing is not much of an option for so many of our families. In addition, given the community we serve, many of our residents are those “essential workers” who work in service industries and have to continue going to work or risk losing their jobs. This can only increase the chances of bringing the virus infections home to their families and leaves such persons in such a dilemma. In addition, for a few weeks, we had to temporarily suspend our memory clinic operations of conducting home-based initial assessments and our office-based clinical assessments. However, we recently established tele-screenings and tele-assessments and are able to continue to see most of the patients that had been referred but were having to wait to be seen by our memory clinic team.
As a leader of the UCC’s Health Research Program, what is your biggest concern during these uncertain times? And what brings you hope? The pandemic has certainly interrupted some important health research activities that cannot be done remotely. This is concerning, as many of these health research efforts are for existing health disparities in the Latino community (such as, cancer, dementia, falls among the elderly, diabetes), and some of these morbidities are what is contributing to the impact of COVID-19 of persons with such diseases. This may cause significant lag in obtaining much-needed knowledge about these other morbidities, which can further contribute to the impact of COVID 19 among Latinos and other groups as well. What I do see as hopeful is the amazing responses from so many other community organizations, health officials, local businesses, local media, and the general public of trying to get through this pandemic as best as we can and helping each other out. I hope all this highly visible goodwill can be carried on and translated into continuing to collaborate with each other to support strategic and needed research in the health inequities that are contributing to the pandemic, and that new concerned stakeholders will get involved in such discussions and efforts. So I hope a large group of these people and groups will still be there after the pandemic to help us continue doing our work for better health outcomes for all.
Do you have any advice for others on keeping spirits up during times like these? Remember, you are not alone. Keep in touch with your loved ones and your working colleagues. As humans, we are social animals, and the social distancing and Safer at Home directives really goes against the grain of who we are as humans. So find ways to stay connected, by phone, video-chats, drive-by visits, video business meetings. And, don’t stop laughing! This is the time to find and experience those things and people who make us laugh (whether on TV, radio, internet or your pets and kids!). This will pass and we will all be stronger and wiser, and hopefully more appreciative of those around us.
Dispatches from Our Own Wisconsin is a profile series that showcases fresh stories, observations, and insight from our Wisconsin Idea Seminar partners who are facing, engaging, and addressing critical issues in their communities.