A Systems Approach to Addressing Covid-19 Health Inequities

WilkinsConsuelo, H; FriedmanElisa, C; ChurchwellAndré, L; SlaytonJennifer, M; JonesPam,; PulleyJill, M; KripalaniSunil,

doi:10.1056/cat.20.0374

Cited by 46 publications

(53 citation statements)

References 27 publications

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“…The coronavirus disease 2019 (COVID-19) pandemic has caused enormous morbidity and mortality across the United States (US), with older adults and racial and ethnic minorities disproportionately affected. 1,2 The first two vaccines were approved by the Food and Drug Administration (FDA) and recommended by the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control (CDC) in December 2020; 3 a third was approved in February 2021, 4 and more approvals will likely come in the near future. Resolution of the pandemic depends on public acceptance and uptake of COVID-19 vaccines.…”

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confidence: 99%

Likelihood of COVID-19 vaccination by subgroups across the US: post-election trends and disparities

Szilâgyi

Thomas

Shah

et al. 2021

Human Vaccines & Immunotherapeutics

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The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted older individuals, those with lower educational attainment, and Black and Hispanic populations, yet vaccine hesitancy remains prevalent. Because widespread uptake of COVID-19 vaccines is critical to end the pandemic, addressing vaccine hesitancy is an important public health priority. Between April 1, 2020 and March 16, 2021, we have repeatedly surveyed a nationally representative online panel of adults and have tracked their stated likelihood of getting COVID-19 vaccinations. We present new evidence that in recent months disparities in self-reported likelihood of COVID-19 vaccination have narrowed by race/ethnicity, with an increasing proportion of Black individuals and Hispanic individuals indicating that they are likely to get a vaccine. At the same time, younger adults have progressively become less likely than older adults to state they will get a COVID-19 vaccine. Most vaccine-hesitant individuals are concerned about both vaccine efficacy and safety and do not trust the vaccine development or vaccine approval process. We conclude that outreach efforts to minority populations may be achieving their objectives in raising confidence in COVID-19 vaccines, but special outreach efforts are needed to address both vaccine hesitancy among younger adults and mistrust in the vaccine development and approval process.

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confidence: 99%

Likelihood of COVID-19 vaccination by subgroups across the US: post-election trends and disparities

Szilâgyi

Thomas

Shah

et al. 2021

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

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“…According to Béland (2021), a continuous information system on the organization of prevention and control measures in the settings must already exist and operate before pandemics occur. The importance of this data to understanding COVID-19 cannot be overstated (Wilkins et al, 2021). Immigrant and racialized health inequities will only be eliminated if there is high-quality information by which to track immediate problems and the underlying social determinants of health, to guide the design and implementation of equity-specific medical and public health approaches (Policy Link, 2019).…”

Section: Discussionmentioning

confidence: 99%

Strengthening the Collection and Use of Disaggregated Data to Understand and Monitor the Risk and Burden of COVID-19 Among Racialized Populations

et al. 2021

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There is growing evidence that the risk and burden of COVID-19 infections are not equally distributed across population subgroups and that racialized communities are experiencing disproportionately higher morbidity and mortality rates. However, due to the absence of large-scale race-based data, it is impossible to measure the extent to which immigrant and racialized communities are experiencing the pandemic and the impact of measures taken (or not) to mitigate these impacts, especially at a local level. To address this issue, the Ottawa Local Immigration Partnership partnered with the Collaborative Critical Research for Equity and Transformation in Health lab at the University of Ottawa and the Canadians of African Descent Health Organization to implement a project to build local organizational capacities to understand, monitor, and mitigate the impact of the COVID-19 pandemic on immigrant and racialized populations. This research note describes the working framework used for this project, proposed indicators for measuring the determinants of health among immigrant and racialized populations, and the data gaps we encountered. Recommendations are made to policymakers, and community and health stakeholders at all levels on how to collect and use data to address COVID-19 health inequities, including data collection strategies aimed at community engagement in the collection of disaggregated data, improving methods for collecting and analyzing data on immigrants and racialized groups and policies to enable and enhance data disaggregation.RésuméDes plus en plus d’études montrent que le risque et le fardeau des infections à la COVID-19 ne sont pas également répartis dans la population et que les communautés racialisées connaissent des taux de morbidité et de mortalité disproportionnellement plus élevés. Cependant, en raison de l’absence de données ventilés selon le statut ethnique, il est impossible de mesurer comment les communautés immigrantes et racialisées vivent la pandémie et quel est l’impact des mesures prises (ou non) pour atténuer ces effets, surtout à un niveau local. Pour résoudre ce problème, le Partenariat local pour l’immigration d’Ottawa (PLIO) s’est associé au Laboratoire de recherche critique collaborative pour l’équité et la transformation en santé (CO-CREATH) de l’Université d’Ottawa et l’Organisation de la santé des Canadiens d’ascendance africaine (CADHO) aux fins de mettre en œuvre un projet visant à renforcer les capacités organisationnelles locales pour comprendre, surveiller et atténuer l’impact de la pandémie de la COVID-19 sur les populations immigrantes et racialisées. Cette note de recherche décrit le cadre de travail utilisé pour ce projet, les indicateurs proposés pour mesurer les déterminants de la santé chez les populations immigrantes et racialisées, et les lacunes que nous avons identifiés dans les données existants. Des recommandations sont faites aux décideurs politiques et aux acteurs communautaires et de la santé à tous les niveaux sur comment collecter et utiliser les données pour remédier aux inégalités en matière de santé liées à la COVID-19. Ces recommandations font référence aux stratégies de collecte de données visant à impliquer les communautés, à l’amélioration des méthodes de collecte et d’analyse des données sur les immigrants et les groupes racialisés, et aux politiques nécessaires pour permettre et améliorer la désagrégation des données selon le statut ethnique.

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“…Moreover, in reflecting upon the Consortium's broader work throughout the pandemic and looking towards the post-COVID-19 future, our successful linkage of EHR data across multiple health systems has become a powerful data source for surveillance of other public health priorities, 13 , 15 an opportunity for cross-sector linkages with social services, housing, and criminal justice agencies, 22 and a mechanism to tie disease outcomes and population health metrics with place-based vulnerability indices. 14 , 23 …”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9] In the United States, the implementation and uptake of NPIs varied widely between states, age groups, and time periods, demonstrating a persistent need for locally targeted public health monitoring and policy response mechanisms. [10][11][12] Electronic health records (EHR) are a promising tool for public health surveillance, [13][14][15] but the vast majority of public health agencies in the United States are not readily able to access the breadth or depth of EHR data. 15 In March 2020, the Minnesota EHR Consortium (hereafter -the Consortium‖) was created by Minnesota's largest health systems, statewide health care organizations with expertise in systems-level collaboration and public health measurement, and the Minnesota Department of Health.…”

Section: Introductionmentioning

confidence: 99%

“…Electronic health records (EHR) are a promising tool for public health surveillance, 13 , 14 , 15 but the vast majority of public health agencies in the United States are not readily able to access the breadth or depth of EHR data. 15 In March 2020, the Minnesota EHR Consortium (hereafter “the Consortium”) was created by Minnesota's largest health systems, statewide health care organizations with expertise in systems-level collaboration and public health measurement, and the Minnesota Department of Health.…”

Section: Introductionmentioning

confidence: 99%

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Trends in Pediatric Viral Symptoms, Influenza Testing, and SARS-CoV-2 Testing From a Statewide Electronic Health Record Consortium, January 2017 to July 2021

Khazanchi

Spaulding

Bodurtha

et al. 2021

Academic Pediatrics

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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A Systems Approach to Addressing Covid-19 Health Inequities

Abstract: The development of a dashboard to track racial, ethnic, and language metrics as they are related to patients with coronavirus within the community and within the health care organization is an essential tool for discovering, addressing, and resolving health disparities.

Cited by 46 publications

References 27 publications

Likelihood of COVID-19 vaccination by subgroups across the US: post-election trends and disparities

Likelihood of COVID-19 vaccination by subgroups across the US: post-election trends and disparities

Strengthening the Collection and Use of Disaggregated Data to Understand and Monitor the Risk and Burden of COVID-19 Among Racialized Populations

Trends in Pediatric Viral Symptoms, Influenza Testing, and SARS-CoV-2 Testing From a Statewide Electronic Health Record Consortium, January 2017 to July 2021

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