Why improving vaccine access is key to addressing public health disparities

Experts discuss vaccines and health equity in UChicago Urban Network panel

The COVID-19 pandemic and subsequent vaccine rollout have both highlighted and increased the disparities facing Black and Hispanic Americans in nearly every aspect of public health, according to health leaders from the University of Chicago and the city of Chicago health leaders.

Though vaccine hesitancy is often cited in mainstream media coverage as the prevailing challenge in vaccinating Black and Hispanic Americans, access to the vaccine in underserved communities is actually the more significant obstacle.

In a UChicago Urban Network event on March 25, experts, including Candice Robinson, medical director of the Chicago Department of Public Health, grappled with how systemic racism has created inequitable health outcomes in cities across the country, and how America’s public health infrastructure needs to realign to ensure vaccines are accessible in vulnerable communities already disproportionately impacted by the pandemic and where shots in arms are needed most.

“Equity is important to ensure that everybody has the fair and most optimal ability to get vaccinated based upon what their needs are,” said Brenda Battle, senior vice president of community health transformation at UChicago Medicine. “Otherwise, folks who have massive resources, which we see now, go into vulnerable neighborhoods to get appointments because they can get to those neighborhoods, where many vulnerable populations can’t get to other neighborhoods … and aren’t always welcome.”

While Battle’s work is centered on improving health outcomes in Black communities on Chicago’s South Side, Assoc. Prof. Arshiya Baig works with Mexican American communities on the city’s West Side and has seen significant demand for vaccine that is not matched by supply. Her on-the-ground observations reinforce what has been revealed in nationwide polling that debunks the notion that these communities are not getting vaccinated because they do not want to be.

“More than 70% of Hispanics in the U.S. want the vaccine,” said Baig, a UChicago Medicine physician and an expert in community medicine. “If more than 70% of a community wants something, I don’t think that’s ‘hesitancy.’ I think that means they want it.”

The experts said they hoped that the pandemic could be a turning point in the longstanding health crisis facing underserved communities, where systemic racism has created inequities in health access, affordability and outcomes.

To improve health outcomes in underserved communities in cities across the United States, public health infrastructures need to transform to meet the needs of all urban residents. With vaccine production and distribution increasing, this critical moment in time could serve as a turning point in years-long efforts to recenter the health care system on equity.

“We can’t stop after the pandemic,” Robinson said. “We can’t say job well done and a move onto the next thing and get back to a normal that doesn’t address the underlying issues that led us to the COVID inequities we saw.”