The Impact of COVID-19 on Underserved Communities: Charlestown, MA and the Charlestown Coalition

There is no doubt that the COVID-19 pandemic has had a disproportionate impact on underserved communities. From poverty, to job and food insecurity, to housing instability, many challenges that have been historically prevalent in low-resourced communities have been greatly exacerbated by the COVID pandemic.

In a three-part series, Massachusetts General Hospital explores the frontline efforts of three community coalitions supported by Mass General's Center for Community Health Improvement—in Chelsea, Revere and Charlestown—places where residents have been severely impacted by the virus. 

One such community coalition is the Charlestown Coalition. Launched in 2004 in response to the opioid epidemic—the community’s top health concern at the time—the coalition has since expanded to address other social determinants of health including stable housing, healthy food, race equity and access to mental health services. 

SUDs & the Charlestown Coalition

The COVID-19 pandemic exacerbated existing challenges for those experiencing substance use disorders (SUDs) in many hard-hit communities, including Charlestown, MA. During a time when recovery and SUDs support services are difficult to provide in person, the Charlestown Coalition has adapted to provide essential services as safely as possible.

"People are appreciating the power of connection now more than they were before," says Sarah Coughlin, director of the Charlestown Coalition. "Genuine connection is instrumental in the recovery of substance use disorders."

How Things Changed During COVID

The coalition is built on the foundation of relationships formed with members of the community. For those in need of recovery and SUDs support, it was difficult at first to maintain such close connections without being able to meet in person.

Some of the challenges the coalition faced during the pandemic include:

• COVID outbreaks in treatment programs
• The transition of the Charlestown Drug Court from in-person to virtual
• Difficulty engaging with people remotely—many did not have access to digital resources such as Internet, electronic devices and experience with video conferencing
• Lack of compliance with eviction moratorium on the part of sober living houses
• Increase in early release from incarceration

The coalition employed several approaches to address these obstacles, including:

• Worked with the Drug Court to be more accommodating during COVID
• Set up virtual meetings for prevention programs, such as an alternative suspension program for students
• Distributed tablets to the community
• Compiled a "Zoom 101" document to help teach people how to connect
• Created a video in which hundreds of people held signs describing how they are sustaining recovery while under the constraints and isolation of physical distancing

Meetings as Medicine

One of the biggest challenges the recovery community has faced during the pandemic is the lack of in-person connections—an essential tool for recovery. However, there have been newfound positives stemming from the alternative ways people are meeting. For example, people are making connections outside of the local community by attending virtual Alcoholics Anonymous (AA) meetings in other parts of the world.

While many in-person meetings have been canceled during the pandemic, AA meetings have continued in Charlestown. In the beginning, a small group met outdoors and were careful to follow all precautions, such as using masks, gloves and hand sanitizer. Now, as many as 80 people meet at the Charlestown football field stadium for AA meetings, with physical distancing precautions in place. They take place at 12:00 pm and 7:00 pm EST each day.

While large gatherings are generally on hold for public health reasons, AA is an exception. The Charlestown Coalition has worked tirelessly to help people understand that, for people with SUDs, these meetings are medicine. In the first week of the pandemic, Charlestown lost two people to overdose fatalities. For many people fighting substance use disorders, the benefits of the meetings are life-saving, especially when risk of COVID can be minimized.

"We've had 21 people complete a year of recovery during COVID," says Coughlin. "I don't know where people would have ended up without these meetings. It really is their medicine."

Resources for Recovery During the Pandemic

As the pandemic continues, the Charlestown Coalition is preparing to provide services throughout the year. Information and details about meetings and how to get help if you or a loved one is struggling with substance use disorders during the pandemic can be found on their website, which updates several times every week.

"None of our programming has ended," says Coughlin. "It has all been tweaked virtually."

If you would like to support their efforts, here are some ways to help:

• Volunteer, even virtually
• Assist with food and mask deliveries
• Give financial support

Go to the Charleston Coalition website or contact Sarah Coughlin directly at scoughlin1@partners.org to volunteer to help.