Walk-Up Vaccination Clinics in Hartford are the First Step to Equitable Distribution, Experts Say

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Hart­ford Reduc­ing Bar­ri­ers to COVID-19 Vac­cine Access in Minor­i­ty Communities

By Julia Gintof
Jour­nal­ism 2001
May 2021

 

On April 6, mobile units pulled into the park­ing lot of the Swift Fac­to­ry in Hart­ford with one mis­sion: to deliv­er COVID-19 vac­cines to the community.
 
Hun­dreds of res­i­dents lined the street for the no-appoint­ment vac­ci­na­tion cen­ter await­ing a shot that may end up sav­ing their lives.

“It’s impor­tant to have walk-up clin­ics so peo­ple can have access to it… for us to carve out spaces for those who actu­al­ly live in the city,” Ayesha Clarke, deputy direc­tor at Health Equi­ty Solu­tions, said.

The North End of Hart­ford, home to a minor­i­ty-dense pop­u­la­tion, has seen a low­er per­cent­age of vac­ci­nat­ed indi­vid­u­als dur­ing the ini­tial stage of rollout. 

Accord­ing to Con­necti­cut Depart­ment of Health Sta­tis­tics, first dose cov­er­age across the state by Feb­ru­ary saw Black and His­pan­ic res­i­dents at a sig­nif­i­cant deficit, receiv­ing half the vac­ci­na­tions on aver­age in com­par­i­son to their white counterparts.

 

 

This reflects CDC data across the coun­try. With­in the first two months of roll­out, white indi­vid­u­als across the U.S were vac­ci­nat­ed at almost twice the rate of Black Amer­i­cans and near­ly two-and-a-half that of His­pan­ic Americans.

The dis­par­i­ty has raised wider con­cern sur­round­ing equi­ty with­in the Amer­i­can health­care sys­tem, as orga­ni­za­tions push local and state gov­ern­ments to address the issue. 

“The biggest cause of this is the sys­temic racism in all of our poli­cies and prac­tices that go back his­tor­i­cal­ly,” Com­mu­ni­ca­tions Direc­tor of Race For­ward Cheryl Blake­more said. A nation­al orga­ni­za­tion ded­i­cat­ed to work­ing with local gov­ern­ments to pro­vide equal oppor­tu­ni­ty for com­mu­ni­ties of col­or, Race For­ward has been vocal in expos­ing vac­cine inequity.

While the Unit­ed States Black and His­pan­ic pop­u­la­tion has been adverse­ly impact­ed by the virus, post­ing greater infec­tion and death rates, the gov­ern­men­t’s ini­tial meth­ods of vac­cine roll­out seemed to dis­re­gard some of those who need it most.

“If you don’t have a com­put­er, or access to inter­net, or a phone that you would have that type of capa­bil­i­ty, then you can’t sign up for the vac­cine… you can’t get noti­fi­ca­tions like oth­er peo­ple can,” Blake­more said.

The main under­ly­ing issue is access. Clarke empha­sized that the inabil­i­ty to reg­is­ter for a vac­cine due to fac­tors such as time con­flicts, lim­it­ed day­care options, or lack of trans­porta­tion is a real issue for many minor­i­ty residents.

“I live in an inner-city and the indi­vid­u­als who are going to our local CVS and mak­ing appoint­ments are not those who live in the city,” she said. 

Ayesha Clarke, deputy direc­tor at Health Equi­ty Solu­tions. / Pho­to cour­tesy of Ayesha Clarke

Clarke added that peo­ple out­side of her com­mu­ni­ty have greater advan­tages such as access to tech­nol­o­gy and knowl­edge of vac­ci­na­tion sites. This inhibits oth­er minori­ties and res­i­dents of the city from being able to fill those slots.

In an effort to remove these bar­ri­ers to access, Hart­ford May­or Luke Bronin tweet­ed that the Con­necti­cut Health Depart­ment is mak­ing walk-up clin­ics more of a pri­or­i­ty, as Gov. Ned Lam­ont recent­ly announced a part­ner­ship with Health Equi­ty Solutions.

“They’re hear­ing it now,” Clarke said. “I under­stand that’s why they now have the fund­ing that’s appro­pri­ate to help pro­vide resources to ensure that we are reach­ing those minor­i­ty populations.”

A local orga­ni­za­tion ded­i­cat­ed to achiev­ing equal­i­ty with­in the health­care sys­tem, Health Equi­ty Solu­tions has brought the need to vac­ci­nate com­mu­ni­ties of col­or to the fore­front of conversation. 

“Hav­ing these mobile sites is bring­ing it to where they are and giv­ing them oppor­tu­ni­ty,” Clarke said.

But deliv­er­ing the vac­cine to high-need areas is only one hur­dle in reach­ing the indi­vid­u­als with­in them.

“There is a long­stand­ing mis­trust in com­mu­ni­ties of col­or,” Blake­more said. 

The Tuskegee Exper­i­ment, an U.S study con­duct­ed in the 1930’s, is just one exam­ple of uneth­i­cal pub­lic health exper­i­ments con­duct­ed on minor­i­ty com­mu­ni­ties. Through­out a peri­od of near­ly 40 years, researchers used hun­dreds of African Amer­i­can men as guinea pigs as they observed the dead­ly pro­gres­sion of syphilis and neglect­ed to offer aid. 

It is his­tor­i­cal exam­ples such as this for the Black pop­u­la­tion as well as immi­gra­tion con­cerns for those with­in the His­pan­ic com­mu­ni­ty that have caused sig­nif­i­cant wari­ness of the Amer­i­can health­care system.

Mis­trust is wide­spread across the state of Con­necti­cut, Clarke said, empha­siz­ing the impor­tance of work­ing to dis­pel hes­i­ta­tions with­in these minor­i­ty communities.

“You have to be able to get peo­ple to feel like they can trust the vac­cine and under­stand the con­se­quences of why they need to take it — to save their life, their fam­i­lies lives, lives of peo­ple in their com­mu­ni­ty,” Blake­more added.

Sta­tis­ti­cian for the UConn Health Dis­par­i­ties Insti­tute Emil Coman said mend­ing the bridge between the minor­i­ty com­mu­ni­ty and the health­care sys­tem needs to come from com­mu­ni­ty-trust­ed sources. 

“Minori­ties, hav­ing a high­er lev­el of dis­trust, should be reached more direct­ly,” he said, cit­ing pas­tors, min­is­ters, and even bar­bers as pos­si­ble change-makers.

Clarke said that much of the hes­i­tan­cy with­in the minor­i­ty com­mu­ni­ty is not sole­ly root­ed in past expe­ri­ence, rather a lack of trust in unknown doc­tors who most com­mon­ly don’t look like them.

“I feel like we use the hes­i­tan­cy as an excuse not to help sup­port the minor­i­ty com­mu­ni­ty,” she said. “If you real­ly talk to them they just want ques­tions answered and they want to see a clin­ic in their own city.” 

She out­lined the strides that Health Equi­ty Solu­tions has made toward pro­mot­ing greater edu­ca­tion and rebuild­ing trust among minor­i­ty indi­vid­u­als across Connecticut.

“We have clin­i­cians of col­or, whether they are med­ical doc­tors or APRNs, and have cre­at­ed a speak­ers bureau to help have their ques­tions answered,” she said.

Blake­more empha­sized the impor­tance of edu­ca­tion and out­reach as well. She com­mend­ed the Biden Admin­is­tra­tion, which recent­ly released $250 mil­lion in grants to local gov­ern­ments across the coun­try. These funds are being allo­cat­ed to local orga­ni­za­tions to aid in health edu­ca­tion efforts.

As the COVID-19 vac­cine is now active­ly being deliv­ered to adverse­ly affect­ed com­mu­ni­ties, Blake­more and Clarke touched on the ini­tial unequal dis­tri­b­u­tion as a wider issue among the Amer­i­can health­care system.

Vac­ci­na­tion efforts are under­way. / Pho­to by Lynne Slad­ky, Asso­ci­at­ed Press

“It is based in sys­temic racism. How our soci­ety as a whole for­gets about minor­i­ty com­mu­ni­ties,” Clarke said. “There are always bar­ri­ers to health, COVID just height­ened it, and exac­er­bat­ed it.” 

The walk-up clin­ics in the North End of Hart­ford are just one step in tack­ling a much more per­va­sive issue, one that HES is work­ing on diligently.

As of April 22, the per­cent­age of Connecticut’s Black and His­pan­ic pop­u­la­tion that have received at least one dose of the COVID-19 vac­cine is still low­er in near­ly every age brack­et when com­pared with the white pop­u­la­tion, accord­ing to gov­ern­ment data.

This out­lines that there is still work to be done to ensure equi­table distribution.

Blake­more hopes the COVID-19 pan­dem­ic can be yet anoth­er step towards change in terms of clos­ing the health­care gap.

Part of this effort, she said, is “bring­ing com­mu­ni­ties to the table with gov­ern­ment to address what issues already exist,” a large part of what Race For­ward has ded­i­cat­ed itself to. 

“Where they think their poli­cies are fine and equi­table they absolute­ly aren’t and we need to help devel­op solu­tions,” she said.