COVID-19: The Role of the Public Health Leaders

Today, there are over 72 million reported cases of COVID-19 and approximately 850,000 related deaths due to COVID-19 in the U.S. At the beginning of the pandemic, there were national surveillance reports that showed stark disparities in hospitalization and death rates among Black and Brown populations. At times, 40% of all COVID-19 hospitalizations were Black Americans.

Today those statistics are more reflective of the population sizes of Black and Brown communities in the U.S., but the disparities continue to exist when referring to vaccination rates. Only 39% and 49% of Black and Brown people respectively are fully vaccinated in this country. The recent availability of COVID-19 vaccinations for elementary-age children has exposed other downfalls in the nation’s efforts to address pandemic inequalities. For instance, only a handful of states have public data about COVID-19 vaccinations by race and age, and the CDC does not compile racial breakdowns either. We do know that in Michigan, Connecticut and Washington, D.C., white children were vaccinated at much higher rates than their Black counterparts. In the city of Chicago, for example, majority Black high schools had an average vaccination rate of 28%, compared to majority Latino high schools which averaged 57%, or predominantly white high schools reaching as high as 83% vaccination rate.

Throughout history, Black and Brown people have been impacted far worse by acute and chronic diseases (cancer, diabetes, high blood pressure, HIV, etc.), high poverty/low-resourced communities and lack of employment. This is not newsworthy to most Americans, but well-known among many of our local and national public health policy officials, elected and appointed. What this continues to suggest is a historical lack of prioritization for equity in the places where people live, learn, work, play and worship. These conditions, which affect a wide range of health risks and outcomes, such as COVID-19 infection, severe illness and death, are known as social determinants of health.

Social determinants of health may influence risk of exposure, vaccination rate, and treatment of COVID-19, and includes physical environment, housing, occupation, education and economic stability. Discrimination, which includes racism, shapes the social and economic factors that put people at increased risk for COVID-19 infection. Unfortunately, discrimination exists in systems meant to protect well-being and health, such as housing, education, criminal justice and finance.

Public health officials should not only understand the origins and pathways to disparities but translate this information into practice when providing care for high-need communities. This includes local and national government support of frontline providers, healthcare professionals, community health workers and public health leaders.

As public health professionals continue to work in high-burdened communities impacted by health disparities, including COVID-19, these are some suggested actions to take:

1. Take care of yourself. First, get vaccinated if you are not already. If you can complete your communal tasks virtually, do so. Provide health education and home assessments with technology (cell phones, computers, and tablets). Wear a mask and gloves and wash your hands continually, before and after seeing members of the community. Being an example goes a long way.
2. Break down COVID-19 terminology into understandable components. “Quarantine,” “mitigation,” “vaccination,” and “social distancing” may be usual language for us but should be communicated differently in the community.
3. Always provide the most relevant and culturally-sensitive information. Many communities of color live in dense, culturally-affirming geographic areas, often living close to one another. Provide information regarding how easily the virus is transmitted and how it’s affecting our community. Demonstrate visually what six feet looks like, encourage limited in-person shopping, communicate the danger of small and large gatherings, and relay the importance of washing your hands with soap and water frequently. Communicate the importance of vaccination in any work you do. Let people know your vaccination status. Most cities have vaccination hubs and places like Chicago offer at-home vaccinations. Always be prepared to discuss where you can get vaccinated.

If we as health activists and public health leaders can impart these critical health education facts to our community, we can do our part in changing the tide of COVID-19 and its subsequent wave of health disparities.