Equitable Access to Resources and Services

• Those who are most affected by food insecurity often don’t have a seat at the decision-making table,  2012 RHS Presentation 
• Locally produced food and fresh produce are more expensive,  2012 RHS Presentation 
• In 2011 pantry access required a doctor’s note, a social worker’s recommendation, or a written referral from a clergy member (what if someone doesn’t have access to healthcare or is not part of a church community?),  2012 RHS Presentation 
• A lack of affordable housing disproportionately affects communities of color, people with disabilities, single people, elders, and families with children,  2015 RHS Presentation 

• Recommended make SNAP and WIC usable at farmer’s markets,  2012 RHS Presentation ‡

Summary of the Community's response so far SNAP and WIC are now included as tender at farmer's markets on MV.

(Updated 6.17.2022)

• It's important for program administrators to remember not all seniors have access to Medicare,  2013 RHS Presentation ,  2014 
• Limited dental providers accept tribal reimbursements, Medicare/Medicaid, other common forms of insurance,  2013 RHS Presentation 
• There needs to be improved access to care for underrepresented groups – women, Brazilian population, Indigenous population, LGBTQ,  2017 RHS Presentation 
• Needs to be better transparency for Sexual and Reproductive health services,  2017 RHS Presentation 
• Thoughts on abortion access on the Island,  2017 RHS Presentation 
  • Fortunately, in MA options are available even if they’re off Island
  • It would be nice to offer the option locally
  • It’s questionable whether women would feel comfortable having such a procedure on the Island given the small community and tight-knit nature

• Recommended make mental health/postpartum depression screening more accessible to diverse populations,  2017 RHS Presentation ‡
• Recommended have a sexual assault nurse examiner for patients who have experienced sexual assault – telehealth nursing available, as well as SANE nurse online training,  2017 RHS Presentation 
• Recommended enlisting a mobile van to provide screening and prevention services across all Island towns, could be through a MA DPH opportunity, would also improve access for underage or homebound population, including elders,  2017 RHS Presentation 

Summary of the Commuity's response so far

The Public Health Nurses contracted through the Island towns conduct the Edinburgh post-partum depression screener during their well baby visits throughout the community.

(Updated 6.17.2022)

• Only one dental office is ADA compliant,  2013 RHS Presentation 
• There needs to be more training and competency among the provider community for LGBTQA-sensitive care,  2017 RHS Presentation 
• A lack of assistive technology available on MV has created a barrier to the health and wellbeing of those living with disabilities on MV,  2019 RHS Presentation 
• Current IDC efforts include strengthening the capacity of the community and community partners to offer inclusive opportunities and experiences,  2019 RHS Presentation 
• Youth living with disabilities have lower levels of physical fitness compared to their non-disabled peers,  2019 RHS Presentation 
  • Nationally, 30% or less participate in some form of physical activity
  • This can lead to further health challenges as an adult such as obesity
  • Access to these activities are important for social, physical, and mental health

• Physical barriers to inclusive physical activity include wheelchair accessible parks, fields, and playgrounds, hard to traverse grass surfaces, and climbing structures without ramps,  2019 RHS 

• Programmatic barriers to inclusive physical activity include hiring staff with the necessary skills to physically accommodate a child living with disabilities as well as staff who know how to adapt games and activities to be more inclusive of different abilities,  2019 RHS 
• Attitudinal barriers to inclusive physical activity include focusing on activities centered around competition or winning, additionally excluding a child from a competitive activity can make them the subject of ridicule or verbal abuse from other children, 2019 RHS

• Recommended utilizing free webinars on competent LGBT care delivery offered by the National LGBT Health Education Center via the Fenway Institute for CME/CEU credits,  2017 RHS Presentation 
• Recommended make clinical spaces welcoming to LGBTQA community members by integrating flags and symbols that represent inclusivity,  2017 RHS Presentation ‡
  • Family Planning is a good local leader in this, but there’s more work to be done
• Recommended expansion of the Peer Support and Buddies Program,  2019 RHS Presentation 
  • Include more outside of school activities
  • Expand to the upper grades of middle school to prepare children for high school
  • Seek greater financial support
• Recommended improvements to staff training,  2019 RHS Presentation 
  • Continue to identify partner organizations
  • Continually identify new sources of training to disseminate to the community
  • Continue to foster collaboration among youth groups on MV
  • Create a means of continued support (online and appoint a key contact person)
  • Increase collaboration with schools and professional development opportunities
• Recommended improve accessibility to recreation,  2019 RHS Presentation 
  • Increase access to public transportation
  • Expand awareness of the Island’s Lift program
  • Provide resources on the IDC website for ADA compliance
  • Provide beach-friendly wheelchairs
  • Increase advocacy for accessible spaces
  • Provide audio messages in Portuguese to increase reach of promotional materials
  • Only 33% of adolescents and adults living with disabilities drive
  • 78% of adolescents and adults living with disabilities use public transportation
  • 24% of parents and 53% of community members said accessible transportation was one of the most important factors for daily activities, leisure, and recreation
  • There are lower levels of participation in these activities among the Brazilian and Wampanoag communities
• Recommended increase accessibility of Support Groups – improve knowledge and access to respite care, assess the needs of caregivers, combine with other elder adult programing,  2014 RHS Presentatio n
  • Design of these programs should be mindful of disease progress, gender, culture, etc.

Summary of the Community's response so far

Health Imperitives (Family Planning) is a local leader in creating a welcoming office for all bacgrounds, orientations, genders, etc., but more work needs to be done Island-wide.

(Updated 6.17.2022)

"In 2011, 25% of the Island Food Pantry visitors were from the Brazilian Community.", 2012 RHS Presentation

• Healthy Vida program helped Brazilians and other Islanders with nutrition education, label literacy, lifestyle choices, and physical activity,  2012 RHS Presentation 
• Immigrant populations are especially weary or absent from advanced care planning discussions for fear of deportation, lack of insurance, low access to healthcare, cultural differences around these topics, language barriers, and lack of understanding,  2018 RHS Presentation 
• Brazilian barriers to food security, fears with documentation, time needed to procure food from pantry or other outlets, lack of drivers licenses/ability to access the public transit system, language barrier – ESL, low-income restrictions accompanied by high food prices on the Island, cultural barriers to nutrition security – traditional Brazilian diet does not include produce beyond salad (?),  2020 RHS Presentation 
• Undocumented youth aren’t eligible for compensation through the work study or Co-Op program at the high school,  2021 RHS Presentation 

• Recommended grocery store and farmer’s market tours for new arrivals,  2012 RHS Presentation 
• Recommended cultural events can be a good setting to provide translated information about STI/HIV screening and other services available on the Island,  2017 RHS Presentation 
• Recommended create paid opportunities for undocumented students to participate in work studies, internships, and Co-Ops (scholarships?),  2021 RHS Presentation 

Summary of the Community's response so far

No updates at this time (6.17.2022)