by Holly Fletcher
Using insights from the COVID-19 response, Consuelo Wilkins, MD, MSCI, outlined to the U.S. Senate a three-pronged plan to increase health equity by prioritizing trust in communities.
The unequal impact of COVID-19 on minority populations highlights the need for better data collection and analysis; community-driven solutions that promote collaboration and outreach; and preparation to offer care and research on COVID-19 for the long-haul, said Wilkins, Vice President for Health Equity at Vanderbilt University Medical Center, to the U.S. Senate’s Health, Education, Labor and Pensions (HELP) Committee.
“To be successful we must prioritize trust. We must prepare for the long haul of COVID-19. They need care, we need research and, of course, long-term we need solutions that will address the underlying structural racism that impedes equitable access to care,” said Wilkins.
Wilkins testified in a hearing, “Examining Our COVID-19 Response: Improving Health Equity and Outcomes by Addressing Health Disparities,” along with Gene Woods, MBA, MHA, president and chief executive officer at Atrium Health, Abigail Echo-Hawk, executive vice president of Seattle Indian Health Board, and Taryn Mackenzie Williams, managing director of Poverty to Prosperity at the Center for American Progress.
Referencing analysis of the early COVID-19 test results processed by VUMC that spotlighted the disproportion burden on people who speak languages other than English, Wilkins explained the importance of collecting relevant cultural and demographic data such as dialect and neighborhood.
Efforts to share urgent and high priority public health messages depend on being able to connect with people individually on terms and in language they understand. Wilkins, along with the other experts, explained how one-size-fits-all data collection and communication strategies often overlook what engenders trust in different communities.
“We need better data if we’re truly going to develop strategies specific to the communities we want to improve the lives of. We are not collecting the types of data that we need. COVID has brought to light an opportunity for public health, social services and health systems to come together to capture information in the ways people identify themselves and information about their lives, such as whether they live in food deserts or food swamps and where clinics are,” Wilkins said, reiterating that collaborations between agencies, institutions and community organizations are central to promoting health equity.
Language and terminology, such as “vaccine hesitancy,” Wilkins testified, perpetuates stereotypes and puts the onus on the patient to seek out information and assimilate into the health care system. Wilkins prefers to describe “vaccine readiness”: whether or not people have received enough relevant, easy-to-understand information from trusted sources to make informed decisions.
She told the Senate that the pandemic thrust to the fore the complexity of “access to care.” There’s more to access to vaccines than availability or supply, Wilkins, said. People often need help with transportation, child care and technology before they ever get to the vaccination site.
“Vaccination sites need to be where people live, work, pray and play. Taking vaccines out to communities is really important,” she said.
