HJAR Jan/Feb 2021

52 JAN / FEB 2021 I  HEALTHCARE JOURNAL OF ARKANSAS COMMUNITY HEALTH COVID-19 Vaccine: ATime to Believe in Science DIALOGUE COLUMN COMMUNITY HEALTH THE COVID-19 vaccines have been approved by the Food and DrugAdministration (FDA), and front-line healthcare workers will start receiving the vaccines soon. Many people are overjoyed and can’t wait to get in line for their shot. But there remains skepticism in some quarters — especially among African Ameri- cans where distrust remains extremely high. That toxic hesitancy has spread thoroughly through many different racial groups, espe- cially among people who live in our nation’s rural communities. Healthcare executives, heads of states and public health officials are struggling with ad- ministering best practices for controlling the spread of COVID-19, including encourag- ing people to take the COVID vaccine, yet racial distrust remains a primary issue. The coronavirus pandemic has highlighted exist- ing strengths and weaknesses and the lack of confidence by individual races for the healthcare system in general. According to anAugust 2020 Centers for Disease Control and Prevention (CDC) article, positive cases proliferated in racially diverse rural com- munities, because many deliberately avoid adequately tailored to rural communities. Retention of health messaging is lower in rural areas than in urban or suburban areas, suggesting that there is no such thing as a “one-size-fits-all”approach to disseminating crucial health information to the public. It is a challenge to create effective prevention- related messaging when targeted groups dismiss such warnings, believing their risk to be low. WithAfricanAmericans, historical trauma impacts how they view COVID-19. There is a lack of trust in science and medicine, es- pecially when the government is playing a primary role. There is no quick fix for resolv- ing widespread distrust — the rationale varies depending on the group. AfricanAmericans distrust science and medicine, because they have been wronged by the government and scientists in the past. One example is the in- famous Tuskegee Study, which enrolled hun- dreds of AfricanAmerican men with syphilis who were then told they would get treatment. Instead, researchers secretly withheld that treatment. Many of these men died. The study lasted over 40 years and ended in the early “We cannot be one America when a whole segment of our nation has no trust in America.” –President Bill Clinton wearing masks. The data illustrates how so- cial determinants of health – disparities in education, economics and social standing — play a factor when public health special- ists try to help vulnerable populations, some of which have been the hardest hit by the pandemic. Vulnerable populations who reside in ru- ral Arkansas face numerous health dispari- ties and economic disadvantages compared with their urban counterparts. Because of that, they often don’t understand the im- portance of heeding national public health messaging on curbing COVID-19. It’s hard to social distance by at least 6 feet apart and shelter in place for some members of black and brown populations who often live with multiple generations under the same roof. Many rural family members are considered essential workers, especially those inArkan- sas’ poultry industry, and cannot work from home. There is continued distrust even in rural white communities, with some believing COVID-19 is a hoax and wearing masks as a further belief of infringed freedoms. Public health messaging must be more