What data tells us about health disparities and COVID-19 vaccines | Opinion – Tennessean

Sherri Zink and Bryan Heckman, Guest columnists Published 4:01 a.m. CT Nov. 25, 2020

Nashville's 3 COVID testing sites staffed by Meharry Nashville Tennessean

BlueCross and Meharrys shared concern is that vaccine hesitancy could increase in underserved minority populations if left unaddressed, especially since COVID-19 severity varies by race.

Nine months into the pandemic, a great deal of uncertainty remains. COVID-19 continues to spread, our schools assess whether to stay open, and our economy struggles.

Sherri Zink(Photo: Submitted)

Pfizer and Modernas recent announcements on their coronavirus vaccines have offered a beacon of hope. But theres still much we dont know as to when the vaccine will be approved and widely available or if the public will embrace it.

Thats why thorough research, reliable dataand unbiased conclusions are more essential to our communities health than ever before.

Earlier this year, BlueCross BlueShield of Tennessee and Meharry Medical College embarked on a partnership to collaborate on making Tennesseans healthier. The teams primary goal is to improve COVID-19 response by examining health disparities and addressing social determinants of health in minority and underserved populations.

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These determinants are comprised ofthe health-shaping conditions in which people are born, grow, live, work and age.BlueCross uses its data to gain insight around these factors.To apply the data and remove barriers to care, BlueCross developed the Social Vulnerabilities Index, an aggregate score that ranges from 0 to 19. The SVI quantifies the number of social determinants (19 total) for which a member may be at risk and is used to help identify and engage with vulnerable populations.

Bryan Heckman(Photo: Submitted)

Nashvilles Meharry Medical College is the largest private historically Black college in theUnited States and is committed to educating tomorrows health care professionals and scientists. Since the beginning of the pandemic, Meharrys been battling the virus on numerous fronts. Meharry is operating COVID-19 testing sites, exploring treatments and vaccines, conducting clinical trialsand researching vaccine hesitancy.

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Minority vaccine hesitancy, or the reluctance to be vaccinated, is rooted in longstanding systemic health and social inequities and distrust in the health care system. BlueCross and Meharrys shared concern is that vaccine hesitancy could increase in underserved minority populations if left unaddressed. But we see a clear path forward for data-driven decision making and quality improvement.

Our goals are to:

Jacqueline Ike, a registered nurse and first-year medical student, administers a COVID-19 test at Mount Gilead Missionary Baptist Church on Saturday, June 6, 2020.(Photo: Alan Poizner / For The Tennessean)

The data showsthat COVID-19 severity varies by race. Hispanic people have the highest average number of social vulnerabilities, and Black people have higher social vulnerability rates across many different factors. When BlueCross looked at high-severity cases of COVID-19 among its commercial plan members, the percentage for Asian Americans is twice as high as others in the commercial population.

BlueCross notes similar results for Black people in our Medicaid population. Approximately 9% of our Medicaid members tested positive for COVID-19, and 50% of those testing positive for COVID were Black. These individuals accounted for 72% of the high-severity cases.

Williamson Medical Center doctors and nurses celebrate the release patient Isaiah Whalum on Tuesday, May 12, 2020, at the Franklin hospital. Whalum recovered COVID-19 and was a patient for 53 days.(Photo: Shelley Mays/The Tennessean )

The reason for these differences? Following significant medical events like heart attack, strokeand hospitalization, members experience the health care system differently. Were seeing a direct correlation between cost and severity of each COVID-19 patient journey. For the more severe COVID-19 journeys, in many cases, we see a larger minority population group.

Data has already shown that COVID-19 vaccine acceptance levels will vary by location anddemographic and socio-economic conditions. Were using flu vaccine acceptance to help us understand the negative perception brought on by decades of distrust in the health care system.

Williamson Medical Center doctors and nurses celebrate the release of recovered COVID-19 patient Isaiah Whalum on Tuesday, May 12, 2020, at the Franklin hospital. Whalum had been a patient for 53 days.(Photo: Shelley Mays/The Tennessean )

Phase 1 of our collaboration, already underway, involves mapping communities at high risk for COVID-19 vaccine hesitancy and using predictive modeling to identify individual- and community-level risk factors. The results will help inform public health messaging.

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One size of care doesnt fit all. Ultimately, were working to uncover the best approach to optimizing health equity for all Tennesseans.

Sherri Zink is chief data officer for BlueCross BlueShield of Tennessee. Bryan Heckman, Ph.D., is director of theCenter for the Study of Social Determinants of Health and associate professor of psychiatry and behavioral sciences at Meharry Medical College.

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What data tells us about health disparities and COVID-19 vaccines | Opinion - Tennessean