ROCHESTER — During a Monday summit centered around health equity, Rochester area researchers and advocates spoke about how continued studies and efforts are needed to better meet the needs of immigrant and refugee communities.

“We owe it to our community to really say, ‘We’re prioritizing your health … and we’re going to help create opportunities for you to go and seek the health care needs that you need in a culturally competent way,'” said Mohamed Ahmed, associate vice president for equity and inclusive excellence at Winona State University.

The free summit, Advancing Health Equity: Empowering Immigrant and Refugee Communities, was a joint project of WSU and Rochester Community and Technical College, which hosted the event in its Hill Theater.

The first portion of Monday’s program centered around health research that involves immigrant communities. Rodolfo Gutierrez’s organization, HACER, was built around involving Latinos in research. He noted that Minnesota’s Latino population has grown over the past few decades, now making up 6.1% of the state’s population.

“And we are so diverse,” said Gutierrez, HACER’s executive director. “We are African Latinos, we are white Latinos, we are Indigenous Americans, we are everything within the Latino world. Because of that, HACER wants to create some consciousness about these differences.”

HACER uses the community-based participatory research model for all of its projects, Gutierrez said, which lets research participants be more deeply involved in the research.

“When you are a researcher at a university or a research institute, you know very little about the community you’re going to be working with,” Gutierrez said. “This model allows you to really sense what is happening in the community.”

This topic is significant in the current political moment, with President Donald Trump’s administration carrying out efforts to cut diversity, equity and inclusion initiatives and deport undocumented immigrants.

On Friday, the National Institutes of Health announced it would restrict the amount of grant funding that goes toward researchers’ indirect costs. As of Monday, a judge has temporarily halted that change after 22 attorneys general, including Minnesota’s, sued.

“I want to acknowledge how much uncertainty we’re experiencing right now,” said Abby Lohr, assistant professor in Mayo Clinic’s Division of Epidemiology, “and say that we are going to keep doing this work. We are here to adapt, and we are flexible.”

Both Lohr and Graciela Porraz Capetillo, a medical interpreter and associate clinical research coordinator at Mayo Clinic, spoke on the behalf of the Rochester Healthy Community Partnership, a 21-year-old Rochester partnership that has produced 19 past and ongoing public health research projects focused on immigrant communities.

“We use community-engaged research to answer rigorous scientific questions and address structural racism and social determinants of health,” Lohr said.

When it comes to researching health outcomes within an immigrant community, trust is “number one,” Porraz Capetillo said.

“Second: compassion,” she said. “You have to understand where they are, and once you understand how to communicate with people in the community, then they start to believe you, that you want to do something good for them.”

That understanding and respect is also needed on the clinical side. After the RHCP and HACER presentations, a group of health care workers representing an array of specialties and cultural backgrounds spoke during a Q&A session.

Patients may come to their providers with misconceptions or fears that may be rooted in history. An example is vaccine hesitancy among Somali immigrants, said Salah Mohamed, project coordinator for the Somali American Social Services Association, mental health professional and imam. A fear that vaccines cause infertility comes from the Italian colonization of Somalia in the 19th and 20th centuries, when Mohamed said some Somali men were given medicine that made them infertile to prevent mixed-race births.

“That also comes with mistrust of the system,” Mohamed said.

Addressing fears is especially significant for mental illness and addiction — talking about one’s mental health or experience with addiction is stigmatized across immigrant groups and in U.S. society, in general. Often, people tend to avoid talking about it, or if they have a diagnosis, hide it, said Dr. Nguyen Tran, a Mayo Clinic oncologist.

“We need to have the opportunity to open up that door to say this can be a normalized process, that we just need to start talking about it,” Tran said.

Dené K. Dryden / Post Bulletin

Other barriers to seeking health care services include the fear of deportation for themselves or a family member and not knowing how the American health care and insurance systems work. Even something as deceptively simple as one’s shoes can determine whether or not they can do a health-promoting action like exercise, Porraz Capetillo said.

With problems come solutions. One is providing culturally competent mental health care, especially with the specific traumas and stressors first-generation immigrants might have, said Dr. Jissy Cyriac, a Mayo Clinic primary care physician.

“When we think about mental health in these communities, that culture, the pressures of assimilation, the pressures of maintaining their cultural heritage play a huge role,” Cyriac said.

Offering opportunities for immigrants to speak with medical providers in community settings, outside of the doctor’s office, can ease some of the discomfort around stigmatized or private health matters, Cyriac said.

“One thing I’ve always marveled at is how much more comfortable — I work with women who have questions about cervical cancer — are when I’m seeing them in a community space versus when I’m seeing them … in a clinical setting,” Cyriac said.

Access to interpreters is also beneficial. With the stigma around mental illness, Mohamed said the Somali vocabulary for that subject is limited, which can cause misunderstanding. He spoke about a Somali-speaking woman who, when another person asked about her mental health, thought she was being asked if she was “crazy.”

“To have that conversation ahead of ahead of time — what vocabulary do we use to make the person comfortable in their own language, not to call it psycho or crazy or a lunatic, but just in terms of what, really, mental illness is,” Mohamed said.

Dené K. Dryden / Post Bulletin

Practicing — and striving toward — this kind of culturally competent care will continue in the current political moment, Tran said.

“We will continue to see and continue to treat all patients coming to the door,” Tran said.