Sorteando ("Sorting Out") Systemic Barriers and Social Support Promoters of Women's Health: Intersectional Community-Based Participatory Research in Borderland Communities Peri- and Post-COVID-19.

OBJECTIVES

To identify systemic barriers leading to health inequities and health promoters experienced peri- and post-COVID-19 that impacted the health outcomes of women residing in geopolitical borderland communities of southern Arizona. Community-directed interventions that improve community health were sought.

METHODS

In 2023, we collected survey, interview, and focus group data documenting reported healthcare access, safety, stress, and discrimination experienced by a community of predominantly Mexican-origin women. Community-based participatory research and intersectional approaches were utilized. Data were analyzed and translated through group consensus processes.

RESULTS

Mental health was the most significant health concern, and social support was identified as the greatest promoter of health. A grounded theory model emerged depicting the overarching theme, Building Strength and Inclusion Through Connection During COVID-19 and describing lived experiences of the community. Ten community-directed intervention strategies were developed and disseminated to decision-makers for improved community health.

CONCLUSIONS

Underrepresented border communities bear the undue burden of health inequity underpinned by restrictive immigration policies and exclusion to critical resources. As communities recover from the impacts of COVID-19, intervention and prevention efforts must include organic local knowledge that accelerates public health. This study is crucial for community health practice and policy and presents emergent grounded theory, community-led praxis processes leading to effective health improvement strategies, and five key insights that inform future studies and programs.