
COVID-19 and Health Disparities: Could Eroded Public Trust Impede a Rebound?
What people believe about health and public health, although challenged before the coronavirus disease 2019 (COVID-19) pandemic, is even more crucial now as vaccine distribution efforts could soon begin.
Perhaps one of the biggest revelations brought by the coronavirus disease (COVID-19) pandemic is the faltering information ecosystem, guilty of perpetuating falsehoods and assumptions disguised as hard facts, and potentially inhibiting progress on closing disparity gaps.
Americans faced the challenge of
A Cornell University study analyzing 38 million English-language articles on the pandemic concluded President Donald Trump was the largest driver of the current "infodemic," The New York Times
According to The American Journal of Tropical Medicine and Hygiene, an
Althoug misinformation comprised only 2.9% of the whole COVID-19 conversation in the Cornell
According to a
When it comes to state and local government, 35% of Black respondents of the Commonwealth Fund International Health Policy COVID-19 Supplement Survey offered a “good” or “very good” assessment compared with 54% of White respondents (P ≤ .05).
“Past research has shown that Black Americans’ public trust in institutions—more so than any other racial or ethnic group—is shaped by their awareness, and experience, of inequities faced as a group,” the report reads. The disproportionate impacts of the pandemic on Black Americans may have contributed to low government approval ratings.
However, when asked the same question with regard to hospitals, doctors, and nurses’ handling of the pandemic, 86%, 80%, and 79% of White, Latino, and Black respondents answered with a positive assessment, respectively.
“During a pandemic, the ability to communicate effectively and manage uncertainty is key to maintaining people’s trust and confidence,” the authors wrote.
For Latino Americans in particular, the role of the trusted messenger is imperative, said
Further
“As public health professionals, it's important that we consider targeting information sources that are used and trusted by certain population groups in order to make sure that COVID-19 information is reaching a diverse audience,”
Vaccine Distribution and Federal Action
Once an immunization becomes available, mixed views on health officials’ and governments’ handling of the pandemic among vulnerable populations can lead to roadblocks in effective and efficient vaccine distribution.
Data show Black Americans are the most hesitant to receive a COVID-19 vaccine, and their skepticism is only growing,
One focus group found skepticism and distrust of the government due to historic medical mistreatment of Black Americans (including, but not limited to, the Tuskegee
However, “We can’t make assumptions about why people might be concerned about a vaccine,” said Jewel Mullen, MD, MPH, the associate dean for health equity and associate professor of population health and internal medicine at the University of Texas at Austin, Dell Medical School, in an
“We can’t make assumptions at the individual or community level about what concerns are operative. That requires giving up a little bit of our tendency to craft a public health message that’s just loaded with recommendations to get a shot, to helping people understand their personal risk,” Mullen explained.
Lack of participation in vaccine clinical trials may also lead to adverse outcomes in minority populations, as it
Pharmaceutical companies developing new vaccines have attempted to combat the trend of low minority participation in
As part of a nationally coordinated strategy to address disparities, the National Institutes of Health and the CDC instructed The National Academies of Sciences, Engineering and Medicine (NASEM) to construct a
“Part of making sure that equity is upheld is doing all we can to support distribution and administration to those most at risk first,” Mullen said.
To set general priorities among population groups, the framework took into account the following criteria: risk of acquiring infection, risk of severe morbidity and mortality, risk of negative societal impact, and risk of transmitting infection to others.
“Rather than applying discrete racial and ethnic categories to allocation phases, the allocation framework focuses on the underlying causes of health inequities that are linked to systemic racism and the social determinants of health,” the framework’s
Although coordination will need to be carried out at all levels of government to ensure an equitable distribution of a vaccine, on the federal level, President-elect Joe Biden has indicated a robust effort will be made to address the disparities laid bare by the pandemic.
In November, Biden announced members of his administration’s
“We’re going to protect vulnerable populations who are at risk, most at risk from this virus, older Americans, and those with preexisting conditions," Biden
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