Reducing inequity, increasing health

When I last wrote, I wrote about wrapping up my first semester of school in seventeen years. Without ever using the words “health equity,” I also touched on that: a state in which “everyone has a fair and just opportunity to be as healthy as possible.”

For my final assignment in one of my courses, I noted, I wrote my assigned letter to the editor on vaccine inequity in my local community. As COVID-19 continues to spread and mutate, vaccine inequity continues to enhance existing health inequities in ways both profound and consequential–most of all, for those already incredibly vulnerable.

The local COVID-19 vaccination gap I described has narrowed slightly since I submitted this assignment in late May. This morning, the gap I addressed in-assignment is now down to around 27 percentage points, which you can see for yourself on the “Vaccines” tab of my city’s COVID-19 dashboard.

Reducing COVID-19 vaccine inequity; increasing health

Over the last several months, the City of Long Beach has made incredible
strides vaccinating its citizens against COVID-19. In a few short months,
fully 50.4% of Long Beach citizens have been vaccinated. Unfortunately,
these vaccinations have not been equitably distributed; those areas with
citizens most desperately in need of vaccinations are the very areas with
the lowest proportion of vaccinated residents. Failure to quickly bridge this
lethal vaccine equity gap could result in ongoing devastation, not only to
residents of these areas but to all those with whom they connect.

Within the United States, COVID-19 infection rates are three times higher
among Black, Latinx, and indigenous individuals. This national inequity is
replicated locally. For example, in Long Beach’s 90813 zip code, which has
both substantial Black, Latinx, and indigenous populations and the city’s
lowest life expectancy, COVID-19 infection rates are nearly the city’s
highest. By tragic contrast, its vaccination rates are the city’s lowest. Today,
only 35.5% of 90813’s residents have been vaccinated. This stands in stark
contrast to the comparatively white, wealthy 90815 zip code, where 67.4%
of residents are vaccinated. This 30-point disparity is about more than
abstract numbers; it is about life and death for those most at risk of
infection.

Sadly, the Long Beach citizens most at risk of infection—those very people
underrepresented in vaccinations to date—are those with the fewest
resources to successfully fend off a COVID-19 infection. For those who
have managed to retain their jobs in the economic devastation wreaked by
COVID-19, their jobs are typically low-wage, low-autonomy ones requiring
face-to-face contact with members of the broader public; for those who
were unable to retain their jobs, enhanced economic precariousness
breeds physical vulnerabilities that also greatly contribute to the severity of
COVID-19 infection. With or without job, these citizens are the ones least
likely to have the resources—such as time, reliable transportation, and
internet access for appointment scheduling—required to obtain vaccination.

Happily, there is much that can be done to begin bridging this gap at little
cost; the costs are certainly much lesser than those correlated with not
acting quickly to bridge them, and thereby continuing to see both infections
and mutations spread! One option is to scale up mobile vaccination clinics;
for people without access to reliable transportation, dramatically increasing
the reach of mobile clinics would reduce the impact of both transportation
and time accessibility issues that greatly contribute to Long Beach vaccine
inequity. Another option includes partnering with sizable local employers—
especially public-facing ones, like grocery stores—to bring vaccinations
directly to where those most vulnerable work; ideally, vaccinations in such
places could also be made available to members of the public. Still another
option involves partnering with local faith organizations to simultaneously
build trust in and make accessible COVID-19 vaccines.

What I’ve written here barely scratches the surface of either the problem or
possible solutions. My hope, though, is not to solve the problem alone, but
to help inspire others to join in solving this eminently solvable problem.
_____

SOURCES

• American Journal of Public Health, November 2020 (https://
ajph.aphapublications.org/doi/10.2105/AJPH.2020.306087)
• Davis, Mike: The Monster Enters: COVID-19, Avian Flu and the
Plagues of Capitalism, 2020
• Los Angeles Times, May 2021 (https://www.latimes.com/science/
newsletter/2021-05-10/vaccine-campaign-canvassing-incentivescoronavirus-
today)
• USC Annenberg Center for Health Journalism, April 2021 (https://
centerforhealthjournalism.org/2021/04/12/covid-19-exposes-longstanding-
health-inequities-california-s-seventh-largest-city)

On COVID-19 & a semester concluded

In the week since finishing my first semester in seventeen years, I’ve wanted to write about the semester. I’ve simultaneously been too bone-weary to muster additional words and unsure what, exactly, I wanted to write about the semester: the period that began my formal journey toward a public health career. I haven’t known what to say, at least not in a handful of words.

Wednesday evening, I came across an article that helped me clarify what I want to say, for now. The article movingly wove together themes showing up throughout the semester in both my classes; most noteworthy, however, was how it explicitly joined themes from final assignments in both my Spring 2021 courses. Continue reading “On COVID-19 & a semester concluded”