Those Facing SDoH Should be a Priority in Receiving COVID Vaccine

Healthcare workers, residents of long-term care facilities, and many public leaders have been the first to receive a Covid-19 vaccine in the U.S., but it’s essential to consider disadvantaged communities for phase 2 of vaccine deployment.

Manik Bhat, founder and CEO of Healthify, who is working to address social determinants of health, shares the importance of prioritizing minority groups and communities of color to receive the vaccine in its next deployment – which varies from state to state based on local implementation guidelines, epidemiology and demand.

These groups should be a priority because of their increased risk for infection and complications from COVID-19.

For example, studies have shown African-Americans already have higher rates and earlier onset of chronic conditions and disability than white Americans. In addition, they face a number of socioeconomic challenges that can impact overall health and wellbeing. Lastly, they have less access to COVID-19 testing, as living in less affluent areas there are fewer tests and testing sites available. This confluence of challenges in accessing care, lower rates of health insurance, and a reluctance to seek testing and care is a potentially devastating concoction, Bhat says.

Other social determinants of health that contribute to the spread of viral diseases and worsen the issues for individuals already struggling are factors such as housing, education and occupation.

For instance, growing and disproportionate unemployment rates during the COVID-19 pandemic lead to risk of eviction and homelessness or sharing of housing. Housing insecure families that live in crowded conditions makes it more challenging to follow prevention strategies, Bhat shares. Another example is people with limited job options have less flexibility to leave jobs that may put them at a higher risk of exposure to the virus that causes COVID-19.

Those in these situations often cannot afford to miss work as they are financially insecure as well so even if they’re sick it is difficult to leave and there isn't enough money saved up for essential items like food and other important living needs.

Lastly, individuals from racial and ethnic minority groups are disproportionately represented in essential work settings such as healthcare facilities, farms, factories, grocery stores and public transportation. Those who work in these settings have a higher risk of exposure to COVID-19 because of factors including close contact with the public, not being able to work from home and not having paid sick days.

However, the COVID-19 pandemic is shining a light on the link between social disparities, health outcomes, and issues for vulnerable populations that are already struggling. As the number of COVID-19 infections rise and economic hardships surge, Bhat says now is the time to invest in community-based services that right the wrongs of social disparities among minorities.

“The spread of COVID-19 in the U.S. has made stark how our fragmented care systems leaves our most vulnerable community members at heightened risk,” he says. “Unfortunately, the pandemic has disproportionately affected certain minority populations who contribute to a majority of service industry jobs which have been heavily affected by unemployment or are at an increased risk of contracting the virus. There is a clear need to invest in social service organizations and ensure treatment of these communities as a step to address social and economic issues to improve the health and wellbeing of vulnerable populations and enable them to recover.”

Investing in these organizations first starts with robust data-sharing and community networks that allow people to better understand social needs at the community and individual levels. Starting with an infrastructure that enables healthcare and social services organizationsto coordinate medical and social care, and increase access to the vaccine, also helps bring the vaccine closer to these communities.

Bridging this gap will require input, resources, commitment ,and collaboration from multiple stakeholders: payers, providers, government entities, and community service organizations, according to Bhat.

“Collaboration with community-based organizations is critical if we really want to address the indirect conditions — the social determinants of health — that affect health equity and ensure that vulnerable communities are a priority group to receive the vaccine,” he says. “Food banks, job placement services, childcare providers and other local community organizations are best poised to understand the needs of their community members and to help reach people where they live.”

Bhat adds that radically improving health outcomes for vulnerable populations requires a multifaceted, proactive, community-wide approach focused on better understanding social determinants of health and simultaneously addressing social and health inequalities. Equally important is the need to increase capacity for social services and funding for community-level support systems to ensure we can address gaps in both social needs and healthcare.

“Action needs to happen now to invest in community services to make racial health equity achievable and sustainable,” he says.