HJAR Mar/Apr 2021

34 MAR / APR 2021 I  HEALTHCARE JOURNAL OF ARKANSAS POLICY than white people—myths that can lead to African American patients receiving ineq- uitable care. 6 COVID-19 has shone a light on a dark reality within our nation. We must work to eradicate the systemic racism that has cre- ated and perpetuated disadvantages faced by people of color. We must also recognize and seek to eliminate our personal racial biases, both explicit and implicit. African American, Hispanic and Native American people are dying from COVID-19 at nearly three times the rate of white people, accord- ing to the Centers for Disease Control and Prevention. This is not because the disease differentiates by skin color, but because so- cial, political and economic inequalities have placed some populations more at risk than others. People of color tend to have more underlying health conditions and less ac- cess to healthcare than their white coun- terparts. They are also more likely to have jobs that cannot be done remotely, increas- ing the likelihood for exposure to the virus that causes COVID-19. In the food and agri- culture sector, 50% of essential workers are people of color, according to the Economic Policy Institute. As we work to get Americans vaccinated against this deadly disease, here are some things that can be done to improve equity: • The clinical community must recog- nize that there are historical reasons for African American people to have suspicions regarding public health ef- forts. Healthcare professionals should be willing to listen to and discuss these concerns, however uncomfortable the discussions may be. • Vaccine outreach must include a spe- cial focus on low-income communities and communities of color with limited access to healthcare. • Local African American leaders, in- cluding faith leaders, should help with vaccine outreach in their communities. Getting vaccinated publicly is a great way to lead by example. • In every location where a vaccine is made available, people should not have to have internet access or electronic devices to sign up. Such a requirement disadvantages low-income groups and further expands the digital divide. • Healthcare professionals and commu- nity leaders should be educated about the COVID-19 vaccines and prepared to dispel myths. We need to get the word out that despite the unprecedented speed with which the vaccines were developed, no safety corners were cut, that participants in clinical trials for the vaccines were racially diverse, that severe reactions have been extremely rare and that the risk of serious health outcomes from COVID-19 far out- weighs the risk of temporary side ef- fects from being vaccinated. Health disparities existed inAmerica long before COVID-19, but there is evidence that the pandemic is exacerbating them, and they could be exacerbated even further by an in- equitable vaccine rollout. As a nation and a state, we must not allow this to happen. Our performance indicator should be that low- income communities and communities of color receive more vaccinations, not fewer. This requires an intentional effort to recog- nize the past, rebuild trust in the present and demonstrate commitment for the future. n REFERENCES 1 Hamel L, Kirzinger A, Munana C, et al. KFF CO- VID-19 Vaccine Monitor: December 2020. KFF. Dec. 15, 2020. https://www.kff.org/coronavirus- covid-19/report/kff-covid-19-vaccine-monitor- december-2020/ 2 Painter E, Ussery E, Patel A, et al. Demographic Characteristics of Persons Vaccinated During the First Month of the COVID-19 Vaccination Pro- gram—United States, December 14, 2020—Janu- ary 14, 2021. CDC. Feb. 1, 2021. https://www.cdc . gov/mmwr/volumes/70/wr/mm7005e1.htm?s_ cid=mm7005e1_x 3 Johnson C, Kastanis A, and Stafford K. AP Analysis: Racial disparity seen in US vaccina- tion drive. Associated Press. Jan. 30, 2021. https://apnews.com/article/race-and-ethnic- ity-health-coronavirus-pandemic-hispanics- d0746b028cf56231dbcdeda0fba24314 4 Arora S, Stouffer G, Kucharaska-Newton A, et al. Fifteen-Year Trends in Management and Out- comes of Non-ST-Segment-Elevation Myocardial Among African American and White Patients: The ARIC Community Surveillance Study, 2000— 2014. Am Heart J. Sept. 20, 2018. https://www. ahajournals.org/doi/10.1161/JAHA.118.010203 5 Singhal A, Tien Y, and Hsia R. Racial-Ethnic Dis- parities in Opioid Prescriptions at Emergency De- partment Visits for Conditions Commonly Asso- ciated with Prescription Drug Abuse. PLoS One. Aug. 8, 2016. https://journals.plos.org/plosone/ article?id=10.1371%2Fjournal.pone.0159224 6 Hoffman K, Trawalter S, Axt J, et al. Racial bias in pain assessment and treatment recommenda- tions, and false beliefs about biological differenc- es between African Americans and whites. Proc Natl Acad Sci USA. April 19, 2016. https://www. pnas.org/content/113/16/4296 “Our performance indicator should be that low-income communities and communities of color receive more vaccinations, not fewer.”