The Association of Reported Experiences of Racial and Ethnic Discrimination in Health Care with COVID-19 Vaccination Status and Intent - United States, April 22, 2021-November 26, 2022.

In 2021, the CDC Director declared that racism is a serious threat to public health,* reflecting a growing awareness of racism as a cause of health inequities, health disparities, and disease. Racial and ethnic disparities in COVID-19-related hospitalization and death (1,2) illustrate the need to examine root causes, including experiences of discrimination. This report describes the association between reported experiences of discrimination in U.S. health care settings and COVID-19 vaccination status and intent to be vaccinated by race and ethnicity during April 22, 2021-November 26, 2022, based on the analysis of interview data collected from 1,154,347 respondents to the National Immunization Survey-Adult COVID Module (NIS-ACM). Overall, 3.5% of adults aged ≥18 years reported having worse health care experiences compared with persons of other races and ethnicities (i.e., they experienced discrimination), with significantly higher percentages reported by persons who identified as non-Hispanic Black or African American (Black) (10.7%), non-Hispanic American Indian or Alaska Native (AI/AN) (7.2%), non-Hispanic multiple or other race (multiple or other race) (6.7%), Hispanic or Latino (Hispanic) (4.5%), non-Hispanic Native Hawaiian or other Pacific Islander (NHOPI) (3.9%), and non-Hispanic Asian (Asian) (2.8%) than by non-Hispanic White (White) persons (1.6%). Unadjusted differences in prevalence of being unvaccinated against COVID-19 among respondents reporting worse health care experiences than persons of other races and ethnicities compared with those who reported that their health care experiences were the same as those of persons of other races and ethnicities were statistically significant overall (5.3) and for NHOPI (19.2), White (10.5), multiple or other race (5.7), Black (4.6), Asian (4.3), and Hispanic (2.6) adults. Findings were similar for vaccination intent. Eliminating inequitable experiences in health care settings might help reduce some disparities in receipt of a COVID-19 vaccine.

Declaring Racism a Public Health Crisis in the United States: Cure, Poison, or Both?

Declaring racism a public health crisis has the potential to shepherd meaningful anti-racism policy forward and bridge long standing divisions between policy-makers, community organizers, healers, and public health practitioners. At their best, the declarations are a first step to address long standing inaction in the face of need. At their worst, the declarations poison or sedate grassroots momentum toward anti-racism structural change by delivering politicians unearned publicity and slowing progress on health equity. Declaring racism as a public health crisis is a tool that must be used with clarity and caution in order to maximize impact. Key to holding public institutions accountable for creating declarations is the direct involvement of Black and Indigenous People of Color (BIPOC) led groups and organizers. Sharing power, centering their voices and working in tandem, these collaborations ensure that declarations push for change from the lens of those most impacted and authentically engage with the demands of communities and their legacies. Superficial diversity and inclusion efforts that bring BIPOC people and organizers into the conversation and then fail to implement their ideas repeat historical patterns of harm, stall momentum for structural change at best, and poison the strategy at worst. In this paper we will examine three declarations in the United States and analyze them utilizing evaluative criteria aligned with health equity and anti-racism practices. Finally, we offer recommendations to inform anti-racist public health work for meaningful systematic change toward decentralization and empowerment of communities in their health futures.

The COVID-19 Vaccine and the Black Community: Addressing the Justified Questions.

Established in 2019, the Roundtable on Black Men and Black Women in STEM convenes a broad array of stakeholders that focus on the barriers and opportunities encountered by Black men and Black women as they navigate the pathways from K-12 and postsecondary education to careers in science, engineering, and medicine. Through meetings, public workshops, and publications, the Roundtable advances discussions that raise awareness and/or highlight promising practices for increasing the representation, retention, and inclusiveness of Black men and Black women in STEM. In keeping with the charge of the Roundtable, Roundtable leadership and leaders of the COVID-19 action group conducted an informational video in January 2021 to provide an in-depth discussion around common, justified questions in the Black community pertaining to the COVID-19 vaccine. The manuscript addresses selected questions and answers relating to the different types of COVID-19 vaccines and their development, administration, and effectiveness. Discussion focuses on addressing vaccine misconceptions, misinformation, mistrust, and hesitancy; challenges in prioritizing vaccinations in diverse populations and communities; dealing with racism in medicine and public health; optimizing communication and health education; and offering practical strategies and recommendations for improving vaccine acceptance by clinicians, health care workers, and the Black community. This manuscript summarizes the content in the YouTube video ( https://www.youtube.com/watch?v=wdEC9c48A_k ).