The American College of Surgeons acknowledges the fact that severity of the COVID-19 pandemic has been disproportionately devastating to communities of color, including minority population subsets, such as African Americans, Hispanic/Latinos, and Indigenous/Native Americans.1, 2, 3 The explanation for this disparity is multifactorial and involves socioeconomic factors related to viral exposure because minorities account disproportionately for the essential employee workforce; minorities disproportionately use public transportation; and patterns of residential segregation that result in minorities having reduced access to social distancing-compliant housing environments.4 , 5 Compounding these issues, the COVID economic recession has also affected minorities disproportionately6; these communities have experienced larger-magnitude unemployment rates and loss of employee-based health insurance compared with White Americans. The full spectrum of impaired social determinants of health resulting in an excess burden of chronic health conditions among communities of color also contribute to their COVID morbidity.
COVID vaccination programs represent an opportunity to interrupt the cascade of factors that contribute to the progressively adverse impact of the pandemic on the health of minorities. Tragically, however, a myriad of factors related to systemic racism in healthcare have created substantial barriers to implementing these vaccination programs in the very communities that have the greatest need.7 , 8 Neighborhoods in which communities of color reside are more likely to feature pharmacy deserts, which will impair access to the vaccine. Safety-net hospitals and clinics have suffered disproportionately from the economic toll of COVID care, with many of these facilities having limited resources to provide vaccinations on a large scale. Lastly, well-documented past abuses of minorities in medical research have resulted in a legacy of mistrust among our patients, resulting in widespread misinformation about potential harms from vaccination.
The American College of Surgeons recommends that surgeons play an active role in promoting COVID vaccination programs for our entire diverse patient population. We encourage our members to participate in activities that will expand awareness of vaccination safety and vaccination access among our patients belonging to minority races and ethnicities. Examples of such activities include the following:
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1.
Be a role model and communicate freely about your personal vaccination experience during in-person interactions as well as via social media.
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2.
Many patient advocacy and community outreach groups are specifically organized to serve minority population subsets, such as those that provide screening for cancer, diabetes, and hypertension. Leverage relationships with these networks to disseminate information about the safety of vaccination and the fact that its development was spearheaded by a diverse group of scientists, such as African-American virologist Dr Kizzmekia Corbett.
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Share information about vaccination safety with community-based organizations, civic associations, and churches that have robust minority memberships.
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4.
Encourage your hospital leadership to develop vaccination outreach programs that will reach minority communities.
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Encourage your hospital leadership to use culturally and linguistically appropriate messages about how to access vaccination programs
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6.
Encourage your hospital leadership to promote vaccination awareness and access among diverse personnel.
Strengthened ties between surgeons and our diverse patient population with regard to COVID vaccination represent a powerful strategy in curbing the pandemic and these improved community relations will serve as a foundation for achieving overall health equity in the future.
Author Contributions
Study conception and design: Newman, Campbell
Acquisition of data: Newman, Campbell
Analysis and interpretation of data: Newman, Campbell
Drafting of manuscript: Newman, Campbell
Critical revision: Newman, Campbell
Footnotes
Disclosure Information: Nothing to disclose.
References
- 1.Moore J.T., Ricaldi J.N., Rose C.E. Disparities in incidence of COVID-19 among underrepresented racial/ethnic groups in counties identified as hotspots during June 5-18, 2020—22 States, February-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(33):1122–1126. doi: 10.15585/mmwr.mm6933e1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Arrazola J., Masiello M.M., Joshi S. COVID-19 mortality among American Indian and Alaska Native persons—14 states, January-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(49):1853–1856. doi: 10.15585/mmwr.mm6949a3. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.APM Research Labs. https://www.apmresearchlab.org/COVID/deaths-by-race#age Available at:
- 4.Selden T.M., Berdahl T.A. COVID-19 and racial/ethnic disparities in health risk, employment, and household composition. Health Aff (Millwood) 2020;39:1624–1632. doi: 10.1377/hlthaff.2020.00897. [DOI] [PubMed] [Google Scholar]
- 5.Duque R.B. Black health matters too...especially in the era of COVID-19: how poverty and race converge to reduce access to quality housing, safe neighborhoods, and health and wellness services and increase the risk of co-morbidities associated with global pandemics. J Racial Ethn Health Disparities. 2020 Sep 18:1–14. doi: 10.1007/s40615-020-00857-w. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6.US Bureau of Labor Statistics Civilian unemployment rate. https://www.bls.gov/charts/employment-situation/civilian-unemployment-rate.htm Available at:
- 7.Gebhart F. The growing problem of pharmacy deserts. https://www.drugtopics.com/view/growing-problem-pharmacy-deserts Available at:
- 8.Callaghan T., Moghtaderi A., Lueck J. Correlates and disparities of intention to vaccinate against COVID-19. Soc Sci Med. 2021 Jan 9 doi: 10.1016/j.socscimed.2020.113638. [Epub ahead of print] [DOI] [PMC free article] [PubMed] [Google Scholar]