The COVID-19 vaccination rollout again highlights the systemic racism undergirding our society’s response to the pandemic. Nationwide, Latinos represent 16.7% of the U.S. population but, as of January 14, represented only 11.5% of individuals who had received at least one dose of vaccine. Numbers were even worse for African Americans, who make up 13.4% of the population but only 5.4% of those vaccinated. Those failures reflect the broader values of our society and highlight broader problems in the way government operates. Minority communities are often “underserved” because they are too often treated as an afterthought. As a society, we must do better.
To increase the uptake of COVID-19 vaccines among people of color, and to improve the health of minority communities more broadly, we need to fundamentally shift our approach to public health. There are three things that we must focus on immediately if we are to successfully control the COVID-19 pandemic and address the historic problems driving these inequities.
First, we need to commit to crafting culturally congruent messages on public health priorities. For example, we have to stop assuming that simply translating messages intended for white audiences into Spanish is enough to reach the Latino community. For one thing, many Latino immigrants do not speak or understand Spanish. For another, values, needs and preferences differ between these communities. Latino communities are more likely to respond to messages focused on the value of community and mutual respect as opposed to cold, hard data related to vaccine efficacy. Our outreach must reflect these nuances to be effective.
Second, to improve public health broadly, we have to prioritize the needs of underserved communities with policies and funding directed at minority-serving institutions. In the aftermath of Hurricane Sandy, when Latino leaders requested resources to share information and rebuild their communities, they were told there were no funds available and that, if they cared about their communities, they should volunteer their own time and resources for emergency response. This dismissive approach only added more strains to existing Latino-based organizations, which were already stretched too thin tackling myriad other social problems. The COVID-19 pandemic has laid bare the interconnectedness of our communities. Policymakers need to understand that directing substantial resources into our underserved communities will serve the broader public good.
Finally, in designing public health responses, we need to start by considering the infrastructure that exists in underserved communities. Systems that rely on people traveling to distant sites and that depend on online registrations undermine service access for minority communities, who are less likely to own cars or have home internet access. In the long term, there is a need for greater investment in transportation and technology in these communities, but for now, we need to establish systems for vaccine delivery that bring services directly into impacted communities and that prioritize access for local residents. At a recent vaccine clinic in Perth Amboy, a city with a population that is 76% Latino and 8% African American, more than 80% of individuals vaccinated were white or Asian. Running vaccine clinics through Latino community-based organizations and African American churches, allowing for walk-ins and limiting vaccine delivery to community members will facilitate vaccine uptake in these communities and prevent wealthy, white suburban residents from coming and taking a large portion of the doses.
The strategies outlined above are well-known to public health advocates. Addressing the structural barriers to COVID-19 vaccination does not require a radical new approach to service delivery. It requires policymakers to prioritize the lives of members of minority communities. To banish systemic racism, we need to embrace the cultural diversity in our communities. We need leaders who will enact policies that provide necessary resources to underserved areas. We have to focus all our attention on designing public health delivery systems that target the most isolated and least technologically adept among us. These are the immediate investments needed, not only to increase uptake of COVID-19 vaccines in minority communities, but also to ensure a more equitable public health system in general.