Want to reduce health care inequities? Lessons from our COVID vaccine campaign: AHIP execs
We need to focus on and overcome social barriers to health care. Improving equity can be as simple as offering telemedicine or a ride to the doctor.
Millions of Americans are getting back to normal this summer, visiting relatives, shopping at small businesses and traveling to their favorite beaches or parks – all thanks to the COVID-19 vaccine. Yet, racial gaps in our nation’s health care recovery persist. For many Black, Hispanic, Latino and Indigenous people, who were two to three times more likely to get sick and die of COVID-19 and whose vaccination rates trail those of white people, this summer looks a lot different: an empty seat at the dining table, continued fear of COVID-19 or uncertainty about how to get the vaccine.
Social barriers to good health, likefood insecurity, poor transportation options and unstable housing conditions, are major obstacles to quality care and life-saving vaccines. More than 2 million seniors are homebound and do not have access to transportation. And 5 million more seniors and people with disabilities have health conditions that make it difficult to go outside. Yet without health care data that reflects these realities, it is impossible to reach the full range of Americans who need a COVID-19 vaccine or treatment for other serious chronic diseases.
100 days, 2 million seniors vaccinated
During our recent nationwide vaccine campaign, called Vaccine Community Connectors, health insurance providers worked with the White House and state leaders to tackle this challenge. Our goal was to deliver COVID-19 vaccines to the most vulnerable Americans in the most at-risk communities as quickly as possible. We conservatively estimate thatwe successfully vaccinated more than 2 million seniors in less than 100 days, and we continue working to reach community immunity in the places we serve,recently expanding our outreach to younger people on Medicaid.
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Most important, this effort helped the industry home in on one specific strategy to accelerate health equity: better access to health care data that incorporates the social determinants of health.
To get started, we paired customer information with neighborhood-level Social Vulnerability Index data. The index includes 15 social factors that affect health, among them household composition, disability status, primary language, and access to housing and transportation. This unique data combination helped us identify and communicate with the people we serve in the 25% most at-risk communities in America.
Health insurance providers then helped break down barriers in these communities. The effort allowed us to focus our outreach and education efforts, underscoring that COVID-19 shots were cost free.We knew where people were most likely to need rides to get vaccinated and we provided them. We vaccinated people unable to travel and their caregivers at home. We personalized solutions on a massive scale to reach everyone we serve.
Black medical leaders: Coronavirus magnifies racial inequities, with deadly consequences
This approach can be a model for addressing other chronic diseases like diabetes and heart disease, as well as colon cancer and other serious conditions. These diseases have a bigger impact on Black and brown communities and require urgent action: for example, Black people are 60 percent more likely and Latinx people are 17 percent more likely to be diagnosed with diabetes than white people.
Records should include social data
However, too few Americans’ health records include information on their social determinants of health, including race, ethnicity, and social context -- and most insurers cannot even access COVID-19 vaccination records at all. Health plans must have access to immunization records in order to streamline outreach and engagement with people who have not been vaccinated and help improve care for other chronic diseases.
By including this type of data and creating data systems that facilitate information sharing, we can tackle COVID-19, improve uptake of other important vaccinations, and provide tailored strategies for other conditions that disproportionately impact Black and brown communities, like high-blood pressure, diabetes and strokes.
With the right information, health insurance providers and other stakeholders could better provide solutions to more communities. This could include services as simple as a ride to the doctor’s office, information on vaccine safety, or access to telemedicine.
Leaders in the health care community, as well as policymakers in Congress and the Biden administration, should support this change. Progress toward addressing systemic inequities will only happen through a concerted, coordinated effort at the national level.
We can’t fix health inequities overnight. The pandemic demonstrated the clear need for focused, impactful policies at the national level that improve health equity. But for many, dismantling systems that deny access to health care can be as simple as ensuring that the person who wants a COVID-19 vaccine has a ride to the doctor.