Important update: Healthcare facilities
CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. Learn more
UPDATE
Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the guidance for fully vaccinated people. CDC recommends universal indoor masking for all teachers, staff, students, and visitors to K-12 schools, regardless of vaccination status. Children should return to full-time in-person learning in the fall with layered prevention strategies in place.
UPDATE
The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. For purposes of entry into the United States, vaccines accepted will include FDA approved or authorized and WHO Emergency Use Listing vaccines. More information is available here.
UPDATE
Travel requirements to enter the United States are changing, starting November 8, 2021. More information is available here.

Health Equity Considerations and Racial and Ethnic Minority Groups

Health Equity Considerations and Racial and Ethnic Minority Groups

Health equity is when all members of society enjoy a fair and just opportunity to be as healthy as possible. Public health policies and programs centered around the specific needs of communities can promote health equity.

The COVID-19 pandemic has brought social and racial injustice and inequity to the forefront of public health. It has highlighted that health equity is still not a reality as COVID-19 has unequally affected many racial and ethnic minority groups, putting them more at risk of getting sick and dying from COVID-19.[1], [2] The term “racial and ethnic minority groups” includes people of color with a wide variety of backgrounds and experiences. Negative experiences are common to many people within these groups, and some social determinants of health have historically prevented them from having fair opportunities for economic, physical, and emotional health.[3] Social determinants of health are the conditions in the places where people live, learn, work, play, and worship that affect a wide range of health risks and outcomes.

Factors affecting health equity

farmworkers collecting crops

To achieve health equity, CDC is committed to understanding and appropriately addressing the needs of all populations, according to specific cultural, linguistic, and environmental factors. By ensuring health equity is integrated across all public health efforts, all communities will be stronger, safer, healthier, and more resilient.

Some of the many inequities in the social determinants of health that put racial and ethnic minority groups at increased risk of getting sick and dying from COVID-19 include:

These factors and others are associated with more COVID-19 cases, hospitalizations, and deaths in areas where racial and ethnic minority groups live, learn, work, play, and worship.[6],[15],[16] They have also contributed to higher rates of some medical conditions that increase one’s risk of severe illness from COVID-19. In addition, community strategies to slow the spread of COVID-19 might cause unintentional harm, such as lost wages, reduced access to services, and increased stress, for some racial and ethnic minority groups.[17]

We all have a part in helping to prevent the spread of COVID-19 and promoting fair access to health.​ To do this, we have to work together to ensure that people have resources to maintain and manage their physical and mental health in ways that fit the communities where people live, learn, work, play, and worship. Below are additional considerations for community leaders supporting individuals who experience discrimination in healthcare systems.

Impact of Racial Inequities on Our Nation’s Health

black doctor and LTC patient wearing masks

Racism, either structural or interpersonal, negatively affects the mental and physical health of millions of people, preventing them from attaining their highest level of health, and consequently, affecting the health of our nation. A growing body of research shows that centuries of racism in this country has had a profound and negative impact on communities of color. The COVID-19 pandemic and its disproportionate impact on people from some racial and ethnic groups is a stark example of these enduring health disparities. COVID-19 data shows that Black/African American, Hispanic/Latino, American Indian and Alaska Native persons in the United States experience higher rates of COVID-19-related hospitalization and death compared with non-Hispanic White populations.[18] These disparities persist even when accounting for other demographic and socioeconomic factors.

Both historical and current experiences of racism and discrimination contribute to mistrust of the healthcare system among racial and ethnic minority groups. This mistrust may extend to vaccines, vaccination providers, and the institutions that make recommendations for the use of vaccines. To prevent widening health inequities, healthcare providers should engage with communities to tailor strategies aimed at overcoming mistrust and delivering evidence-based information to encourage uptake of COVID-19 vaccination, testing, and treatment.[19] Inequities in COVID-19 impact can worsen mistrust and lead to suboptimal healthcare behaviors.[19]

Strategies to Help Increase COVID-19 Vaccine Confidence

nurse wearing mask

Various strategies can help communities increase COVID-19 vaccine confidence and advance vaccine equity, but some may be particularly helpful when addressing individuals with mistrust.

  • Focusing on effective messaging delivered by trusted messengers (offering recommendations provided by trusted healthcare professionals).
  • Using tactics to address misinformation and hesitancy within the population of focus.
  • Tailoring strategies for the specific community.
  • Building vaccine confidence to help eliminate stigmas associated with receiving COVID-19 vaccination while also fostering relationships between community members and public health entities.

Address community concerns

Use clear, easy to read, transparent, and consistent information
that addresses specific misinformation or perceived concerns,[20] such as:

  • Vaccine side effects or risk (including boosters)
  • Newness and effectiveness of vaccine
  • Rapidly changing information (e.g., mask use, guidance for gatherings, etc.)

Partner with trusted messengers

Trusted messengers are key to the delivery of critical information for communities to continue advocating for positive change regarding COVID-19 vaccine efforts:

  • Ensure that people whose images are included in materials and leading COVID-19 outreach efforts look like, are known to, and can effectively collect input from communities where the outreach initiatives are occurring.[20]
  • Engage trusted faith leaders or vaccine workers who share the same race/ethnicity, sexual orientation, and cultural/religious beliefs as the community to share information, promote the benefits of immunization, administer vaccines, and be present at vaccination sites.[20]

Develop culturally relevant materials

  • Arts and cultural engagement can generate community demand for COVID-19 vaccines by making vaccination an accessible and socially supported choice.[21]
  • Provide messaging and tone that is culturally relevant and in predominant languages spoken in the community.[20]

Data on COVID-19 and Race and Ethnicity

CDC resources

Other resources

References