RAND Corporation Study demonstrates how community-based organizations are central to efforts to promote Covid-19 vaccination equity and strengthen public health systems
NEW YORK | August 25, 2022 ― Hyper-local engagement involving community-based organizations (CBOs) can help create a more-resilient public health infrastructure that is better prepared for future challenges that disproportionally affect Black, indigenous, and People of Color (BIPOC), according to a new report from the Rand Corporation. The report, “Putting Equity First in Covid-19 Vaccination,” analyzed results from the Equity-First Vaccine Initiative (EVI), a five-city project funded by The Rockefeller Foundation designed to increase vaccine uptake among these populations.
The EVI initiative, which ran from April 2021 to April 2022, addressed multiple barriers to increasing Covid-19 vaccination rates among BIPOC populations in Baltimore, Chicago, Houston, Newark, New Jersey, and Oakland, CA, by using a hyper-local approach, including involvement from CBOs not typically considered part of public health outreach. CBOs focused on voter registration, food insecurity, and youth development, among others, were integral parts of the work. Barriers included a lack of access to accurate information, shortage of trusted leaders, and difficulty accessing vaccine services due to travel constraints and work conflicts.
The primary goal of the work was to help the CBOs build broad capacity to respond to community needs. EVI helped these organizations work together to build health communication infrastructure and skills, establish stronger relationships, networks, and communities of practice in their cities; and advocate for equitable policies.
During the study period, which was funded by The Rockefeller Foundation, vaccinations provided through the initiative’s participants continued to trend upward, while at the national level the number of first and second doses of Covid-19 vaccines given per month steadily declined.
“Working with this wide range of CBOs created a holistic approach to vaccination that addressed the real barriers and hidden costs people faced. To build an equitable and community-centered public health system of the future, we must engage those that are outside the fields of health care and public health,” said pediatrician Laura Faherty, the report’s lead author and a physician policy researcher at RAND, a nonprofit research organization.
“Our report shows the urgency of making this part of the definition of an effective public health workforce and ensuring that there is adequate, consistent, and flexible funding to meet the needs of communities as the Covid-19 pandemic evolves and other crises emerge,” continued Faherty. “The strategies used to increase access to Covid-19 vaccines, and to good information about them, provide insights for the types of outreach that will be needed as the pandemic continues. They can be applied now to increase Covid-19 vaccine uptake among children and encourage the general public to receive new booster shots expected to be available in the fall.”
“To sustain this work, not only for Covid-19 but for other emerging or longstanding issues affecting their communities, CBOs should not be seen as stopgaps used to plug holes in an emergency,” said Jeanne Ringel, the project’s co-leader and a senior economist at RAND. “These groups need to be empowered to take action to respond to needs on the ground and supported to build the capacity they need to be part of effective response,” said Ringel.
“We want everyone to be confident in the safety and efficacy of the vaccines—but that will only happen if everyone has access to them,” said Greg Johnson, Managing Director for the Equity and Economic Opportunity Initiative at The Rockefeller Foundation. “People need to see the benefits to their friends, families, and loved ones, and be able to get the vaccine from a provider and a place they trust.”
Other authors of the report are Jeanne S. Ringel, Ashley M. Kranz, Lawrence Baker, Brian Phillips, Malcolm V. Williams, Lilian Perez, Lucy Schulson, George Timmins, Allyson D. Gittens, Priya Gandhi, Khadesia Howell, and Tiwaladeoluwa Adekunle.
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