Concerns and Hesitations
The barriers and gaps to vaccine equity involve more than just physical and digital distance. Last week, Sendero Health Plans – the nonprofit health insurer created by Central Health, the taxing district that also provides funding to CommUnityCare and UT Health Austin – released a study exploring concerns and hesitations among its members about getting a COVID-19 vaccine. In a survey of 1,648 Sendero members, Black respondents were 47% less likely than non-Black respondents to say they plan to get their shots; those who identified as Mexican, Mexican American, or Chicano were 15% less likely than others. “There’s a lot of people that are scared,” said Latino HealthCare Forum Chief Operating Officer Isabel Lopez. “There is a lot of hesitation, and we want to find out why.”
As with larger health disparities, the reasons for this vaccine hesitancy are varied. Some people are simply misinformed, said Lopez, believing they need to pay for the vaccine or have health insurance to receive it. Some people living with chronic conditions (such as diabetes, hypertension, and kidney disease) are afraid the vaccine will make them sicker. But mistrust of the health care system, with a legacy of medical racism and mistreatment that hasn’t entirely been left in its past, is a baseline reality among communities of color.
Latino HealthCare Forum is also collecting data at community events like those put on by Austin Latino Coalition and, through working with Central Health and CommUnityCare, is helping residents register for vaccination. Its community health workers – in Spanish, promotores – gain feedback that helps LHCF shape its own outreach strategies. (The DVCC is also collecting data on community attitudes toward the COVID-19 vaccine; although similar to LHCF’s objectives, it’s a separate effort, part of a $25,000 outreach grant awarded to the coalition by APH.) LHCF leaders see these workers, typically women who receive training and support to educate members of their own communities, as a powerful front-line force to bridge COVID-19 equity gaps.
“They are the ones that can take the message back to the community – people know who they are, they are trusted,” explained LHCF CEO Jill Ramirez, herself a state-certified promotora. “They also understand the barriers the community has, and so they will not [put on] activities or say things that make no sense to the community.” CommUnityCare and other safety-net clinics (such as People’s Community Clinic and El Buen Samaritano) and APH also employ community health workers, who Hayden-Howard says are already registering residents; LHCF not only employs but, through its PromoSalud program, also trains many of Austin’s promotores, which it describes as a “core competency” of the nonprofit. “The thing is, one organization cannot address everything,” said Ramirez. “We need to look at each organization: What is their strength, and what do they bring to the table? So that you have a well-rounded plan with lots of different organizations doing what they do best.”
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