Graduate Studies


First Advisor

Julie A. Tippens

Date of this Version



Bearss, B. (2022) Straddling the Fissures of Vulnerability & Resilience: Immigrant & Refugee Community Health Workers on the Frontlines of a Pandemic. M.S. thesis. University of Nebraska-Lincoln.


A THESIS Presented to the Faculty of The Graduate College at the University of Nebraska In Fulfillment of Requirements For the Degree of Master of Science, Major: Child, Youth, and Family Studies, Under the supervision of Julie A. Tippens. Lincoln, Nebraska: November 2022

Copyright © 2022 Brittany L. Bearss


Refugees and immigrants were at heightened risk for poor physical, mental, and social health outcomes related to Coronavirus Disease 2019 (Covid-19). Community health workers (CHWs) from these communities played essential roles as frontline health workers and information resources during the pandemic. Despite their critical presence, CHWs’ perspectives and expertise are rarely leveraged in health workforce strengthening. This study addresses this gap by privileging immigrant and refugee CHWs’ voices during the first year of the Covid-19 pandemic in a midsized town in the Midwest United States. We conducted in-depth, semi-structured interviews with 11 CHWs representing 19 communities. Interview analysis resulted in several key findings, including (1) Inadequate multilevel communication in the context of rapidly changing information, (2) divergent staffing and funding priorities among stakeholders, (3) structural vulnerability exacerbating health inequities, and (4) the importance of CHWs’ expertise in community health planning. It is presumed that stakeholders and policymakers want the best for their communities. However, this study highlights a missing voice, CHWs, whose expertise must be included at every level, from frontline day-to-day work to policymaking. Without CHWs knowledge and experience, the best interests of the community cannot be entirely seen.

Advisor: Julie A. Tippens