"America's Vaccine Rollout is Already Leaving People of Color Behind. Healthcare Providers Need to Make a Serious Effort to Change This."
America is a country that continues to confront a long history of health problems tied to centuries of racism — and our willingness to take health equity seriously is about to get a significant test.
America's disparity in health equity rears its ugly head far too often, and the lack of quality of healthcare received by ethnic minorities and the LGBTQ community during pandemics — from the 1918 flu and 2009 H1N1 flu to COVID-19 — is a stain on our healthcare system and society.
Now is the time to learn from these mistakes.
As the impact of the COVID-19 pandemic extends into a tenth month, Americans have been encouraged by the launch of vaccines. Now, healthcare organizations must be prepared to ensure this vaccine is distributed equitably in a way that protects our most vulnerable populations.
Those in healthcare governance — the boards and leaders of hospitals and other health organizations — must lead the way. They must rise to this challenge and hold themselves accountable for providing the insight and leadership that will allow us to effectively and equitably launch the COVID-19 vaccines.
The vaccine rollout is already failing to deliver equity
It's not a coincidence that Black Americans have a much higher risk of getting infected by COVID-19 — three times higher, according to some studies — and more severe complications. Many of the same social determinants that decrease overall health equity, starting with the mere availability of resources to address daily needs, negatively affect COVID-19 outcomes.
Essential resources — access to healthcare, housing, food markets, transportation, education and job training, employment and economic opportunities — are crucial to health equity. Unfortunately, these all are categories in which there is unequal access in Black communities as compared to non-minority communities. And where these resources are lacking, crime, desperation, and suffering thrive. More people are sick, and more of them have worse symptoms.
The challenge has been underscored by reports that the drugmakers have had difficulty getting minorities to participate in the vaccine trials to date. As the vaccine moves beyond the trial stage, healthcare institutions, government officials and community leaders must be purposeful in tackling the issues that can cause minority communities to be underserved throughout the vaccine rollout.
It will be essential for these groups to come together to develop community outreach plans that ensure racial and ethnic minorities are fairly and equitably included in ongoing clinical trials and the initial distribution of the vaccine.
Already, we're seeing that communities of color are falling behind in the initial rollout of the vaccine. According to the Kaiser Family Foundation in the 16 states reporting vaccinations by race, the share of Black and Hispanic Americans getting the vaccine is lagging far behind the same groups' share of overall COVID cases and deaths.
This must be corrected by a concerted effort — spearheaded by healthcare industry leaders — that includes clear and consistent education and communication with their employees, enabling entire health organizations to become educators and advocates within communities across the country.
But the education and communication can't stop there. The prevalence of misinformation on the pandemic and the vaccine has led to significant trust issues within many minority communities. To effectively counter that, it's critical that we go beyond the standard mass communication channels, engaging the people and outlets who are trusted by these communities.
Health governance teams also must take an active role in ensuring vaccine distribution is based upon the best available evidence of how to stop transmission and community spread, not on who has the most resources and influence.
Finally, we need to consider where the vaccine is administered. The places where the vaccine is given in many non-minority communities often either don't exist or aren't as readily accessible in minority communities. We can take all of the steps outlined above, but if people can't get to the place giving the vaccine, we've failed.
These actions are a crucial step in demonstrating a commitment to health equity in the handling of the COVID-19 vaccine. Absent these steps, we not only deepen long-standing societal and economic problems, but we undermine the overall health of our most vulnerable communities.
Proper handling of this situation in the months ahead is an opportunity to show that we are ready to create a society that prioritizes health equity, one in which everyone has the opportunity to live well.
Originally published in Business Insider, January 24, 2021