How SDoH and Health Inequities Impact Vaccination Rates


vaccine bandaid

The higher the vaccination rate within a population, the less danger a virus will pose over time. The problem is that gaining herd immunity to COVID-19 and blocking transmission seems unlikely, especially with so many Americans facing social barriers to vaccine access.

The incentives are expanding every day, with vaccinated individuals getting offered million-dollar cash lotteries, free airline flights, and free gift cards, but the rates are still increasingly low in vulnerable communities, suggesting that social issues–like missing work, hiring child care, or obtaining the right paperwork–need to be prioritized.

The barriers to vaccination

As of May 17, 2021, only 17 percent of Hispanic Americans, 12 percent of Black Americans, and six percent of Asian Americans have received at least one dose of the vaccine, according to the Kaiser Family Foundation. Among those who have not yet been vaccinated, many have lower-incomes, no insurance, and are undocumented. 

Multiple studies have found that populations lacking housing, reliable transportation, and food security experience significant barriers to getting vaccinated. In California, for instance, the University of California Merced found: 

  • Lack of information and misinformation affected by racism reinforces hesitancy, making it difficult to access vaccination.
  • The documentation requirements at vaccine sites instill fear of deportation and mistreatment for people of color and immigrant populations.
  • Individuals who work minimum wage jobs could lose hourly income, if they get vaccinated during the day when most vaccine sites are open.
  • Individuals who cannot afford transportation are unable to get to the vaccine site if it is further than walking distance.
  • There is not culturally and linguistically appropriate, sensitive, and competent support available at the vaccination sites for those who are unable to communicate in English. 

Other barriers include poor internet access, lack of childcare, and misinformation.

Funding community efforts

Local community organizations have long bridged the care gap and are now driving vaccine rollout efforts in their local communities. They understand the social issues affecting the most vulnerable populations and are using their on-the-ground insight to alleviate the barriers linked to vaccine access. 

In Michigan, for instance, where just nine percent of Black Michiganders are vaccinated compared to 77 percent of white Michiganders, funds are being allocated to support CBOs with the goal of increasing vaccination rates in the Black community and other communities of color. 

In early April, The Centers for Disease Control and Prevention (CDC) awarded the state of Michigan over 90 million dollars to build partnerships with CBOs to increase vaccine uptake, especially for underserved populations. Some of the funds will be used to increase door-to-door outreach from trusted community members and hiring bilingual community health workers to support those who don’t speak English. 

Meanwhile, in Florida, only eight percent of Black Floridians and 25 percent of Hispanic Floridians are vaccinated compared to 78 percent of white Floridians. The CDC awarded the state 194 million dollars, requiring 60 percent of the funding be allocated to supporting local health departments, community-based organizations, and community health centers. Some of the funds have been used to work with CBOs by installing pop-up clinics in community centers, shelters, and food banks located in minority communities. 

Many companies and organizations have awarded funds to CBOs in order to expand their vaccine outreach efforts. On May 13th, 2021, for instance, Blue Cross and Blue Shield of Illinois (BCBSIL) awarded a portion of over half a million dollars to 16 CBOs across Illinois to increase access to COVID-19 testing, education, and vaccines for local communities. 

Maximizing local outreach

Many CBOs are working beyond their means and utilizing their services in new ways to get their communities vaccinated. As we look forward to building a new post-pandemic normal, we need to make sure we’re financially supporting the local organizations, giving them the necessary resources to allow them to continue serving members in need. 

At Healthify, we believe partnerships are the key to creating this new reality. We work with numerous payers, providers, and CBOs to ensure that social barriers are removed and community organizations are supported. To achieve meaningful progress and reach herd immunity, we must work together to break the barriers to vaccine access. 

We're is dedicated to facilitating long-term, beneficial partnerships between CBOs and payers, with the mission of addressing health inequalities and improving health outcomes. To learn more about our network and community partnerships, read about our solutions here.

Topics: healthcare delivery health disparities public health managed care community-based organizations care coordination sdoh health equity

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