Minority populations struggle with getting the COVID-19 vaccination. BlackPressUS photo
The Center for Closing the Health Gap – in partnership with Hamilton County – has completed comprehensive research into the local impact of COVID-19 on marginalized populations (Black and Hispanic) in Hamilton County and Greater Cincinnati.
The Health Gap, which has been addressing racial and ethnic disparities in health care for more than 15 years, conducted research with the goal of raising awareness, building knowledge, and expanding capacity to mitigate the impact of COVID-19 on vulnerable Black and Brown communities.
Xavier University was the project quantitative partner, and over 60 community organizations helped to recruit participants for the critical six-week project that included 3,000 survey responses and qualitative interviews with almost 80 residents.
Renee Mahaffey Harris, President and CEO of the Center for Closing the Health Gap and lead architect of the scope, said the results show that African Americans have been disproportionately impacted by COVID-19 in every aspect, including higher death and sickness rates, greater losses in income. She also shared the reasons why there is significant hesitation that makes it challenging for African Americans, including:
• Respondents noted the difference between an anti-vaccine stance versus their COVID-19 vaccine hesitancy. All recognize benefit of various successful vaccines (polio, smallpox, tetanus, mumps).
• Years of racial discrimination, experimentation without consent and ignoring the specific needs of African Americans led to mistrust in healthcare and government systems.
• Respondents cited government-led efforts like the Tuskegee Experiment that used African Americans unwillingly and horrifically to further medical progress. The “egregious harm and trauma” has served as generational warnings.
• The legacy continues for many of these respondents. As known from previous research, trust has been impossible to build with many being underserved, feeling disconnected, not listened to or/and dismissed by medical professionals.
• African Americans are twice as concerned about a bad reaction to the vaccine compared to the total sample.
“The issue of health disparities along racial and ethnic lines has been pervasive in the U.S. for centuries,” said Harris. “COVID -19 is simply a reflection of that reality, and the negative impact we’re seeing in this study has been as clear as it is heartbreaking. With COVID-19, Black people are getting sicker and dying faster. Their income is disproportionately lower. Their access to quality information and care is significantly narrower. And it’s all related to the long history of health disparities in the U.S. that has plagued our social, economic and cultural frameworks for far too long. The results of this study give us a clear mandate on educating and engaging impacted communities to improve health outcomes related to COVID and improve health disparities for future generations.”
The study also found disparities for Hispanic residents, though not as severe as those for the African American community. Overall, the qualitative and quantitative research produced several key findings:
· African Americans and Hispanics are significantly more likely to have known someone who died from COVID-19 (consistent with local and national data), and therefore believe it is a serious threat to their health.
· The majority of respondents understand how the virus is spread, its risks and prevention basics. Both African Americans and Hispanics perceive their risk to be lower due to the precautions taken.
· While more than half of total survey respondents are extremely likely to get the vaccine when it becomes available, African American respondents are significantly least likely to get the vaccine when available.
· There are concerns regarding the COVID-19 vaccine safety and how quickly it has been developed. The speed at which it was approved incites hesitation and concerns about the efficacy, side effects, negative reactions and long-term consequences. Many respondents are taking a wait and see approach – waiting a few months (or more) to observe others’ reactions to the vaccine.
· Hispanics are also concerned about accessibility of the vaccine. Many respondents noted the challenge of reaching undocumented residents and the cost.
· The Cincinnati Health Department garners the most trust to deliver COVID-19 vaccine information.
· Even with a survey sample of higher-educated people with higher incomes compared to Hamilton County’s medians, respondents of color experienced greater loss in income during the pandemic.
· Trust of the medical field and vaccine developers is not a factor for Hispanic and Asian populations. Adversely, it is a significant barrier for African Americans. Years of racial discrimination and the experimentation without consent noted above has led to mistrust in the medical and government systems.
This research and media campaign effort was completed between November 17 and December 31 during a pandemic and the holiday season. The research analysis led to The Health Gap proposing a number of recommendations to improve outcomes going forward:
1. Create full transparency communication materials that detail the vaccine’s development, side effects, risks, and unknowns, including Spanish translated information and visuals, and share that information via a variety of channels, including door-to-door, social media, newspapers and more.
2. Enroll health departments, doctor/organizations and faith leaders who support the vaccine and why, and share those endorsements with community residents.
3. Continue to quantitatively track perceptions and attitudes to determine if/how messaging is resonating and effective. This will be important as the political environment and federal response to the pandemic changes.
4. Periodically conduct qualitative interviews/focus groups to provide context for quantitative data.
5. Continue Community Support Groups given their effectiveness. In the midst of the study, from December 5-22, support groups across Hamilton County were conducted to help residents manage increased stress and anxiety due to the pandemic, coping with loss of family/loved ones, caregiver fatigue, the racially tenuous environment of the country and managing chronic diseases. Pre and post-tests were administered to assess their mental and emotional well-being, perceived stress and COVID related anxiety. All were significantly improved as a result of the support groups.
6. Many respondents think African American doctors should work with trusted community organizations and leaders to help deliver creditable information to help address concerns and fears. People want someone locally to lead them through this pandemic – someone “on the ground” who knows the community and is trusted.
“The study has confirmed many historical realities related to ethnic health disparities and shined a light on new insights and paths to improve the lives of marginalized people right here in Cincinnati,” added Harris. “COVID-19 has raised our collective consciousness about life-and-death issues facing the Black community, and now is the time for our leaders to come together to make systemic changes and improvements. Now is the time to save lives, reduce suffering and rally our resources to make access to information and care more equitable.”
To access the full research report and learn more about the community impact efforts, visit https://covid19communityresources.com/.