Older Black American Man

In December 2020, the Food and Drug Administration (FDA) issued emergency use authorization for two new vaccines to protect against COVID-19. One vaccine is from Pfizer/BioNTech, and the other is from Moderna. On Feb. 27, 2021, a vaccine developed by Johnson & Johnson/Janssen also received EUA.

Pennsylvania and the Centers for Disease Control and Prevention (CDC) set guidelines for distributing the vaccines. UPMC is distributing the vaccine following these guidelines. In the coming months, the distribution will expand to the general public.

As the vaccine distribution happens, it’s critical to ensure no disparities in who receives the vaccine.

Many Black Americans and underserved communities continue to face health disparities. These disparities can affect their access to the COVID-19 vaccine. Vaccination is critical to stop the spread of COVID-19 and prevent the occurrence of severe illness and death.

How do health disparities affect minority communities, and what does that mean for COVID-19 vaccination efforts?

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What Are Health Disparities?

Health disparities are preventable and disproportionate health conditions and inequalities among all ages in a certain population.

In certain populations, health disparities can happen for a variety of reasons, such as:

  • Individual and behavioral factors
  • Inadequate access to health care
  • Education inequalities
  • Environmental threats
  • Poverty

“When you don’t have good grocery stores or access to exercise facilities, of course, there’s going to be a disparity there just because of someone’s zip code. That is unacceptable,” says Tracey Conti, MD, executive vice chair, Department of Family Medicine, University of Pittsburgh School of Medicine.

Health disparities can range from conditions like heart disease to hypertension and can cause more vulnerability to COVID-19.

How Has COVID-19 Affected Black Americans?

The CDC reports that, compared to white Americans, Black Americans are:

  • 1.4 times more likely to be infected by COVID-19
  • 3.7 times more likely to be hospitalized from COVID-19
  • 2.8 times more likely to die from COVID-19

Black Americans are more vulnerable to COVID-19 for several reasons.

1. Black Americans are more likely to be exposed to COVID-19.

Black Americans are more likely to be exposed to COVID-19 because of factors including:

  • Occupation
  • Transportation methods
  • Neighborhoods
  • Historical and structural racism

“It goes back to structural racism,” Dr. Conti says. “It goes back to how people lived in certain communities. Structural racism has a lot to do with the health of communities.”

Structural racism is a combination of public policies, institutional practices, social forces, ideologies, and processes that generate and perpetuate inequities among races.

One example of systemic racism: The “redlining” system that banks and the real estate industry once leveraged, using red ink to outline the neighborhoods where people of color lived. Granting loans to those inside the red lines was considered risky, so banks were less likely to offer loans or investments.

2. Underlying health conditions and health disparities

The elderly and those with underlying health conditions are at the highest risk of severe COVID-19.

Black Americans are more likely to get hypertension, diabetes, and heart disease than other American populations. This puts them at risk for severe COVID-19.

3. Access to health care and distrust in health care systems

Inequalities in health care access make it challenging for many Black Americans to get both adequate health care and preventive care.

Lack of preventive care can result in more hospitalizations, worsened chronic conditions, and undiagnosed illnesses.

In addition, Black Americans may have a deep-rooted distrust in health care systems due to historical events like the unethical Tuskegee experiment.

“(COVID-19) has really highlighted the impact of health disparities and brought it to the current conversation,” Dr. Conti says. “I think this is always in the community, but just not really talked about. Now, I think there’s a more open conversation because people see that Black and Brown communities are being affected more and dying more.”

Why COVID-19 Vaccination Is so Important for Black Americans

Since Black Americans are more vulnerable to COVID-19, it’s important to help make sure these communities get the vaccine when able.

Dr. Conti says Black Americans may be hesitant to get the COVID-19 vaccine for many reasons. This includes the speedy development of the vaccines, along with general distrust in health care systems.

“Every person might have a different reason for being skeptical,” she says.

Dr. Conti stresses it is important for community, health care, and government leaders to have a consistent message about why the vaccine is important. The message also has to be regularly reinforced.

“There has to be a recognition that you’re not going to be able to convince everybody with just one conversation,” Dr. Conti says. “We have to build relationships, and it takes time to develop trust. It can’t just be a one and done.”

Dr. Conti advises that it’s important for leaders — especially if they’re minorities themselves — to share facts about the COVID-19 vaccine. This includes getting the vaccine when it’s available.

“Leaders should advocate for equal vaccine access, the same way they advocated for COVID-19 testing,” she says.

How Can Health Disparities Be Addressed?

While health disparities may be difficult to address, especially during a pandemic, they are preventable. There are many things the community and elected officials can do to help, beginning with education.

“Knowledge is power,” Dr. Conti says. “When you start educating people and educating them in a way that they’re understanding it, and breaking down how we came to the vaccine, why were they able to get this vaccine quickly … I believe in educating people as much as possible, so they have the information to make a good, informed decisions.”

UPMC is working with community organizations and leaders at every level. We are developing health education, programming, and services to ensure equity in health care and the well-being of all people.

Learn more at UPMC.com/HealthDisparities.

Sources

https://www.sciencenews.org/article/coronavirus-why-african-americans-vulnerable-covid-19-health-race

https://www.aspeninstitute.org/blog-posts/structural-racism-definition/

About UPMC

Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 700 doctors’ offices and outpatient centers, with locations in central and western Pennsylvania, Maryland, New York, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals.