The Rev. Ofa Langi was new to Auburn City Adventist Church when COVID-19 hit. He hadn’t gotten to know his congregants or even the area where the church is located, just outside of Seattle — a city that was an early ground zero for the coronavirus in America.

But he immediately realized the pandemic demanded that he pivot from the spiritual toward the corporeal. 

His first step was to figure out the immediate needs of the surrounding community. “We talked to our neighborhood when COVID-19 hit and they said, ‘We need food, pastor’” the Rev. Langi recalled. “Some folks were also concerned about COVID testing so (they) could go back to work.”

After hearing the community’s concerns, the Rev. Langi said, “I prayed about it and God provided. … We started COVID testing and food distribution on the same day.” 

The food distribution program grew into a five-day-a-week service, involving multiple churches, and COVID testing still takes place every Tuesday at this church, which is situated in an immigrant-heavy neighborhood. 

Both are a form of ministry, according to the Rev. Langi. “We’re doing our best to be the hands and feet of Jesus during this pandemic.” 

Similar scenarios are playing out across the country. With many houses of worship either shut down or offering limited spiritual services, they are, instead, using their parking lots as makeshift COVID-19 testing centers. In many cases, they are offering free coronavirus tests in hopes of helping the most vulnerable groups — minorities and immigrants. Churches also serve as a point of contact between public health departments and marginalized communities, making them conduits of information about the disease and prevention. 

On the surface, it seems like a simple story about good deeds and pastors rising to the moment. But public health experts and pastors alike explain that some churches are offering COVID testing in part because the communities they serve are mistrustful of the medical industry.  

A history of health care 

Charitable social welfare work has been central to Christianity from its earliest days, said Adam Davis, a history professor at Denison University, “Health care was a part of the charitable tradition” of all faiths.

From Western Europe to North Africa and the Middle East, Davis said, bishops often had hospitals attached to their residences. The bishops’ helpers would “run this hospital that might only have a few beds but that symbolically showed that the bishop was taking on this role of the father, of shepherding the flock, by caring for (their physical) needs.”  

These hospitals were present as early as the fifth century and were parallel, Davis explains, to monasteries ranging all the way to North Africa and Central Asia that had infirmaries for the monks and nuns that lived there as well as pilgrims and refugees.

“Monasteries and bishops both played a really significant role in health care in the religious context,” he said. “Then in the 1100s in Western and Southern Europe, there was an explosion of hospitals in the cities.”  

States were beginning to form around this time and new, secular hospitals reflected this shift. But as various services were institutionalized and bureaucracies sprung up, churches followed suit and became increasingly regimented, too.  

“The papacy became a bureaucratic regime,” Davis said. “Within the Catholic Church a whole system of governance with multiple layers and accountability and record-keeping emerged … they were experimenting with new forms and new structures.” And religious hospitals emerged as a “new kind of charitable institute.” 

Davis emphasizes that medical institutions weren’t “top down from the pope,” and it wasn’t just the kings, either. For lay townspeople, helping the sick was a form of piety, “based on the belief that in helping the sick and the poor you are imitating Jesus and that the sick might be Jesus in disguise,” Davis reflects. “The religious expressions of ordinary people were an important part of the (hospital) movement.” 

He points out that, still today, many hospitals are named after saints and that a large number of hospitals are affiliated with religious institutions. 

“In terms of religious spaces and health care spaces there has long been an overlap and a sharing of space,” Davis said. “Those two have a shared mission, too, they’re not separate... in terms of health care, from a Christian perspective, the spiritual and the corporeal were seen as very much intertwined. Receiving the sacrament was seen as very important to one’s bodily health.”

Speaking of the use of churches themselves for health care, Davis adds, “In the U.S. during the Civil War, churches were regularly used as field hospitals and that was certainly true in 1918” in the influenza pandemic.

So turning churches into COVID testing sites makes sense. “What is such a shock to all of us in 2020 would have been the norm in most centuries,” Davis said. 

A trusted place

COVID-19 testing initially began at the Rev. Langi’s church through an initiative of the Seattle and King County Public Health Department. 

The county used data to identify areas “where people had been exposed,” explains Francisco Arias-Reyes, a leader of Testing and Coordination Strategy. “The highest impact had been in low-income communities.” Particularly hard-hit were immigrant heavy areas, Arias-Reyes said, where the people work essential jobs. 

In addition to offering testing, officials realized that they needed to provide information for these communities. Now, the county distributes information about COVID-19 in 21 languages.

Focusing on “certain areas where the rates were higher,” said Arias-Reyes, but “where the access to testing was lower,” the Public Health Department reached out to local organizations “to create partnerships in order to be able to provide more community-based testing.” These places distribute the county’s informational materials, as well. 

The Public Health Department focused on community centers and churches, Arias-Reyes explains, because with everyone home, the sites would likely be available. Now, through churches and other organizations, the county is offering quick response tests that offer results in 24 to 48 hours — a speed that can help stop the spread, Arias-Reyes said. 

Putting the testing sites in church parking lots and other places that immigrants know and trust — in South Florida, for example, a community organization set up both COVID-19 testing and food distribution in the parking lot of a popular Latino supermarket — is one way of dealing with the fear some have about approaching authorities or institutions for tests. 

“Churches are really a way to break down some of those barriers,” remarked Tiffany Joseph, a professor of sociology and international affairs at Northeastern University, who has done extensive research on immigrants’ access to health care. 

“One of the things that I found from my research is that churches and trusted local organizations are really key to getting out information in general and particularly health information because these institutions have already established relationships with these communities,” Joseph said.  

She calls churches “a very important place — an ideal place … for people to get tested and to get accurate info that is not only linguistically appropriate but also culturally sensitive.”

But putting the test sites in church parking lots doesn’t always guarantee that the people officials intend to serve will come. In the case of St. Peter’s African Methodist Episcopal Church in Minneapolis, only about 5% of the people coming to the site were from the local community, according to LaToya Turk, a nurse and member of the congregation who is working with local organizations and the Minnesota Department of Health to coordinate the testing. 

“We were servicing people who were driving brand new Audis,” said Turk. 

The problem, Turk and pastors explain, has to do more with the process. While drive-through sites enable social distancing, many people in low income communities don’t have cars — leaving them unable to use the sites placed in their own neighborhoods. In some instances, this has been remedied by offering a walk-up option, as well. 

But offering pedestrian access isn’t always enough. Testing efforts in marginalized communities can also be hindered by who conducts the testing. 

“In some of (Minnesota’s) rural areas the National Guard has been in charge of some of the swabbing,” said Turk. “And that’s very scary — to be an undocumented worker in those communities and to approach the National Guard for swabbing. It’s not what you want to do.”  

Tackling medical mistrust

For many in the Black community a church parking lot also doesn’t address mistrust based on a troubled history with the health care industry.

Traci Blackmon, senior pastor of Christ the King United Church of Christ in Florissant, Missouri, has heard her congregants say everything from “that testing is giving you something” to ‘“they’re just trying to get Black people to test on this.” 

“There are many different reasons people are not getting testing. It wasn’t until the early 1970s in St. Louis that all the hospitals were integrated,” she said. “There are reasons for Black people to be suspicious of things that come to the neighborhood that are foreign.” 

Mistrust of medical authorities is rooted in numerous historical events, including the Tuskegee experiment, in which Black men in Alabama were monitored for syphilis without consent or treatment. Research has shown that Tuskegee made an impact on the Black community, likely influencing public health outcomes.  

But Thomas LaVeist, dean of Tulane University’s School of Public Health and Tropical Medicine and a co-chairman of Louisiana’s COVID-19 Health Equity Task Force, said the distrust is more likely rooted in people’s own, or those they know, experiences with health care.  

“With medical care there is an aspect of it that is about the patient and what the patient does,” LaVeist adds, “and if the patient is provided with disincentives, they’re going to do what any person does when they’re given disincentives” to seek medical establishment.  

Mistrust has only been exacerbated, LaVeist said, by the way COVID-19 testing and vaccine development have been managed.

According to LaVeist, federal officials and Louisiana have indicated that “communities that have been disproportionately impacted should get the vaccine first.” Some Black people, he said, sum this up as: “You’re going to give us the vaccine you created in 10 months so you can see whether or not people are harmed by it.” 

The plan, he reflects, simply “expands the mistrust.” 

“It’s bigger than medical care,” LaVeist reflects. “African Americans have a distrust of the country (that dates back) 401 years,” he said, referring to the origins of slavery in North America. “Anyone with some critical thinking skills is going to have some measure of mistrust.” 

A new ministry

As churches attempt to bridge the gap between underserved neighborhoods and the medical community, their work could begin to heal some of these historic wounds. 

While some members of the Rev. Blackmon’s congregation have remained weary about the testing the church offers, the church’s initiative to distribute personal protective equipment was met with enthusiasm. 

“People who live in lower income communities are essential workers who don’t get designated as such,” she explains, adding that they’re nursing assistants, bus drivers, grocery store workers and others who often can’t quarantine for fear of losing their jobs.

“If you’re living in an economically distressed situation already and you work an hourly wage job ... (personal protective equipment) becomes a means of survival,” the Rev. Blackmon said. 

“Distributing PPE, especially during times when such items were scarce met the people’s needs. Meeting people’s, or at least being present with them in their needs even when we cannot meet them, teaches the people the church can be trusted to show up,” the Rev. Blackmon said. “It builds trust in our communities because it positions the church as neighbor.”

“That does not always translate to trust in systems or services provided through the church such as COVID (testing) or vaccines,” she adds. “But sometimes it does.”

After the church began distributing masks, they were approached by a local organization to offer testing in the church’s parking lot. The Rev. Blackmon said yes “because COVID testing decreases the spread of the virus and saves lives.” 

And that’s ministry, Rev. Blackmon said, “Serving and meeting the needs of people is holy.”