Isolation.

That is the biggest single obstacle to delivering health services and life-sustaining supplies to senior populations who often live on the margins of mainstream society.

Alan Hoshino, executive director of Wisteria View Housing, grapples with the phenomenon of isolation every day. His organization operates an 86-unit Section 8 apartment building at Rainier Avenue and Jackson Street in Seattle.

The sense of community disconnection was already a hurdle before the coronavirus pandemic, he said, and the past year has only exacerbated the problem.

“Access to both health care and quality information upon which good decisions can be made is critical,” he said. “A well-connected community with embedded health-care service providers helps fills these needs.”  

One nonprofit that successfully serves the senior population is International Community Health Services, which provides medical and dental care to thousands of people in the area’s Asian and Pacific Islander communities.

As the diversity in the Puget Sound region has soared, ICHS has profoundly expanded its services and its reach to 11 clinics and service sites in Seattle’s Chinatown-International District and Holly Park neighborhoods, and in the cities of Bellevue and Shoreline.

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At ICHS clinics, you will see a diversity of patients: 78% are persons of color, 52% have limited English proficiency and need interpretation services with more than 50 languages served, 73% are low income and 10% are homeless.

In February 2020, ICHS was the nation’s first community health center with a positive COVID-19 diagnosis. In response, the organization quickly pivoted into new ways to connect to clients, including telehealth and in-home visits, prescription deliveries, drive-through testing sites and testing targeted to the hard-hit Pacific Islander community.

Kuang Suying, 60, who works in a noodle factory in the Chinatown-International District, reacts after getting a COVID-19 vaccination shot at a pop-up clinic run by International Community Health Services at the Bush Asia Center in Seattle on March 18. (Photo by Karen Ducey)
Kuang Suying, 60, who works in a noodle factory in the Chinatown-International District, reacts after getting a COVID-19 vaccination shot at a pop-up clinic run by International Community Health Services at the Bush Asia Center in Seattle on March 18. (Photo by Karen Ducey)

“ICHS staff are committed and passionate about serving our community,” said Sherryl Grey, ICHS Director of Community Health Services, who is currently helping ICHS partner with community groups to vaccinate seniors living in low-income housing in the Chinatown-International District and other BIPOC communities in Seattle. Many lack internet access and most do not speak English.

“Our community health services team has been focusing on social equity on all levels — from making every effort to reach those with the most barriers with vaccines, to our vaccinators who take extra care and time to answer questions and address concerns,” she said.

Washington is the third most linguistically diverse state in America, with 163 languages spoken. More than 25 percent of King County residents speak a language other than English.

“Language is definitely an obstacle for the non-English speaking communities,” Hoshino said. “Obtaining information, accessing and navigating the health-care systems, communicating with providers and the ability to properly follow up on issues are extremely hard to do when there is a language barrier.”

Besides the language barrier, Hoshino said many factors contribute to the isolation of seniors, including a worldwide movement toward online services, which leaves behind seniors who aren’t computer-literate.

“One of our partners told us that when they called an elderly woman who was identified by their organization, she started crying and said she didn’t know how to make an appointment and she thought that she had been forgotten,” Grey said. “Comments like these really made me stop and pause and take a moment to be really proud of my team for fully stepping up to this challenge.”

Despite these types of situations, there are ways to overcome linguistic and cultural barriers.

• Recruit bilingual providers and staff from the target communities.

• Become sensitive to the cultural differences of the targeted populations. 

• Develop partnerships with social service agencies, and equipping case managers with lists of providers who are multilingual/cultural to improve referral efficiency.

• Establish connections with local organizations such as churches, community groups and community centers.

• Expand marketing efforts to include targeted languages.

ICHS relies on a diverse and multilingual staff — many of whom belong to the communities they serve. They have been pivotal in helping to increase vaccine equity among communities of color, and have helped dispel vaccine conspiracies and answer questions to build trust. Those relationships have allowed ICHS to quickly mobilize resources to create pop-up vaccine events and other outreach efforts.  

Within the Chinatown-International District, ICHS has expanded its business model to operate Legacy House, a 75-unit facility offering assisted-living services. Beyond the neighborhood, ICHS has also operated pop-up clinics serving Islamic communities.

ICHS provides health care for everyone, regardless of income, or insurance or immigration status. Affordable medical, dental, behavioral health, vision and pharmacy services with multilingual doctors, nurses and staff meet the needs of King County’s diverse and multicultural communities.