COVID-19 vaccine rollout lacks racial equity
Among its many impacts, COVID-19 has exposed the lack of health equity that has existed for decades.
Evidence clearly shows that some of the worst health outcomes occur in populations struggling with economic stability, education levels, social and community context, health and health care access, neighborhood factors, and the built environment. These are the social determinants of health, SDOH.
SDOH issues constitute 70% of health care outcomes, revealing that it's not the genetic code that primary affects health outcomes, it's the zip code.
Unfortunately, many of the people affected by these challenges are from non-white ethnic and racial groups. Data from the CDC shows that Black, Hispanic, and Native American Americans are dying from COVID-19 at nearly 3 times the rate of White Americans.
Dire need for racial equity during fight against COVID-19
After bearing the brunt of hospitalizations and deaths from COVID-19, they are already falling behind in vaccination rates.
For example, in Tennessee, 17% of residents are Black Americans, yet they represent only 6% of vaccines delivered. In contrast, 71% of the vaccines in Tennessee have gone to White Americans.
Beyond the health equity and morality issues, the pandemic's economic cost includes enormous financial burdens in hospital care, ranging from $51,000 to $78,000 per admission. With hundreds of thousands of deaths in 2020, the CDC estimates 4.1 million hospitalizations, which would represent more than $200 billion dollars.
How can we reach our most vulnerable residents to improve outcomes across the nation?
An innovative combination of available technology, local social services, and telehealth could rapidly overcome these issues.
Utilizing tech that’ll help create equity
Analytics tools have helped public health officials gain unprecedented insight into the pandemic. They can also help pinpoint areas of focus for vaccination programs. Health care insurance claims and demographic data can be used to prioritize higher risk, underserved individuals.
Are the individual's chronic conditions placing them at higher risk for COVID-19 hospitalization? What is the individual's medication adherence rates for these conditions? Where does the individual live? Answering these questions with data will help us be comprehensive, proactive, and objective about designing vaccination initiatives.
Telehealth utilization is up by an incredible 3000% year-over-year increase as patients seek safe, effective ways to access health care. Telehealth clinicians can be trained in COVID-19 vaccination prescreening, health literacy education, and social services.
Many vulnerable Americans face significant barriers to care that deprioritize vaccinations until addressed. What many people take for granted are insurmountable problems that will get in the way of completing a vaccination appointment. High-risk Americans need the support of experienced telehealth clinicians to get vaccinated.
Telehealth clinicians are also well positioned to connect underserved populations with non-emergency medical transportation services, medication adherence support, access to a physician, or food security resources. When these SDOH barriers are addressed, people are more likely to be able to focus on getting a preventive vaccine.
It is morally ethical and fiscally responsible to vaccinate the most vulnerable. The solution needs to be a combination of public-private partnership to pivot our nation from a dark period in history.
By focusing on the SDOH as a central issue for COVID-19 vaccination, the highest-risk and marginalized populations can overcome barriers to care. Furthermore, vaccinating the most vulnerable populations could be our nation's catalyst for finally prioritizing health equity issues.
Jasonz.rose, MHSA, is Chief Executive Officer of Adherehealth, a healthcare technology company addressing the estimated $500 billion of unnecessary annual medical costs due to medication adherence issues.