Confined community health: reflections and experiences from the local public health

ABSTRACT

This paper aims to share the reflections related to the community actions in which the Agencia de Salut Publica de Barcelona has been involved during the emergency of COVID-19. The tasks carried out can be arranged in three stages, frequently overlapping detection of needs and problems;contact with key stakeholders to assess what to do and how to do it;adaptation of the interventions to the "new normal" and generation of new responses. The emerging problems included not being able to do the confinement (due to homelessness, material conditions, living in a situation of violence);digital gap (lack of knowledge, devices, access to Wifi);greater exposure to COVID-19 in the essential but precarious, feminized and racialized jobs (care, cleaning, food shops) that are the most frequent in the neighborhoods in where we work;language and cultural barriers that preclude to follow recommendations;to lose employment;insufficient income to cover basic needs;social isolation;and the deterioration of emotional health caused by the situation. During the process, some interventions were adapted to be delivered on-line. Solidarity networks and local resources were key to meet basic needs, but also other needs related to lack of digital knowledge or device. Community action in health, from a critical, intersectional and local perspective, and with intersectoral work and community participation, can contribute to facilitate a contextualized response in the event of a health crisis;mitigate the effects derived from its economic and social crisis.