President Joe Biden has emphasized getting the Covid-19 vaccine to those most affected by the pandemic, with a focus on racial and ethnic minority groups, such as Blacks and Latinos, who have been dying at higher rates than whites and have thus far been less likely to receive the vaccination. However, in that push, it has become evident that many of the steps the White House has taken so far disproportionally benefit urban areas and do not take into consideration the unique challenges rural areas have been struggling with.
On a related note, NPR has a great 3-minute listen on how more Black And Latinx Americans are embracing the COVID-19 vaccination.
Rural communities have been some of the hardest-hit by the pandemic. The death rate for rural areas was 48 percent higher in December than that of urban areas. In North Dakota, about 1 in 500 residents has died from the virus. Rural areas have borne a greater brunt from the virus in part because they tend to have older populations and a high prevalence of underlying medical conditions. People in rural areas may also be more vulnerable because of a lack of nearby medical care or health insurance.
The struggle to secure adequate vaccines is evidenced at the Heart of Texas Healthcare System, located in the rural town of Brady, Texas. Each Friday afternoon, the staff at the Healthcare System have rehearsed what they will do when their shipment of Covid-19 vaccines arrive: they have a plan in place for how they will let the public know when they can sign up for an appointment, they have the space at the town civic center to administer the vaccines, and they have staff trained to dole out the shots. However, each week that they put in their request for the Covid-19 vaccine from the state, the doses never arrive.
Tim Jones, CEO of Heart of Texas Healthcare System — the only hospital serving a four-county region two hours west of Austin — said last week:
We have been ready for two months. The only missing piece in the equation is the vaccine. This story is ubiquitous with every little town of 2,500 to 5,000 people. From Amarillo to Brownsville, it is a carbon copy.
Bill Finerfrock, the executive director of the National Association of Rural Health Clinics also noted:
There needs to be some initiative to get vaccines out to those communities and an acknowledgement that we need to not forget about those rural underserved areas. Our concern is that it doesn’t seem to be part of the conversation.
To make the determination about where to set up mass vaccination centers and which retail pharmacies should get the vaccine, the White House has been using the Centers for Disease Control and Prevention’s social vulnerability index, which measures how susceptible a community is by looking at metrics like poverty, lack of vehicle access and crowded housing. However, those metrics often overlook the unique needs of rural areas.
Moreover, the Biden administration has, in addition to emphasizing the use of mass vaccination centers and retail pharmacies to administer the vaccine, been shipping doses directly to federally funded community clinics, which serve 1 in 5 rural residents. However, the focus of the community clinics has primarily been to serve the homeless population, public housing residents, migrant agricultural workers, and people with limited English language skills. About a third of vaccine doses that have been sent through that federal program have gone to rural clinics.
While the Biden administration has talked about deploying mobile vaccination units to rural areas, the effort hasn’t been fully rolled out so far. Rural providers said they were hoping they would get a large share of the single-dose Johnson & Johnson vaccine, which doesn’t require the special refrigeration capacity many rural clinics lack. But White House officials said last week it will be distributing that vaccine evenly across the country and not targeting it at any specific areas.
Alan Morgan, CEO for the National Rural Health Association said:
This vaccine distribution isn’t equitable when it comes to urban and rural, that is the perception. These communities are also most at risk. There are hundreds of these small towns with a greater percentage of elderly, people with multiple chronic health issues and chronic workforce shortages. Some of these communities aren’t adhering to public health measures like wearing masks, and now you have an unequal distribution of vaccines. What more could possibly go wrong here? It is the worst possible public health setup.
In the coming months, it is very likely that the federal government will need to take action to increase the number of doses sent to rural areas, as well as address both the shortage of health care workers to administer the vaccination and the needs of older populations who lack the ability to travel far distances and have limited access to the internet.
NPR has a wonderful 3-minute listen on the vaccine rollout in rural areas.
More posts of the COVID-19 vaccine in rural America can be found here, here, and here.
3 comments:
Considering rural areas don't want to use the vaccine they have why should we send more out there? People from cities have been claiming to be a caretaker and driving out to trump country just to get a shot
Thank you for writing about this Jaspreet! It's disheartening to read that out of all areas, rural areas are being left behind. As you mention in your post, these areas have high rates of elderly people and people with underlying conditions. They should have been prioritized given their susceptibility to getting COVID-19. The numbers from North Dakota are atrocious. As vaccine manufacturing picks up, I wonder whether some of the disparities between urban and rural areas will begin to minimize? I'm surprised the Johnson and Johnson vaccine isn't being targeted to rural areas considering that it seems to be the best bet for some of the rural clinics that don't have the refrigeration capacity. I understand the need for the vaccine distribution to be equal but rural areas are being hard hit by COVID-19 so it wouldn't be the worst approach to provide some targeted relief, right?
Really interesting, Jaspreet! I recently saw that Mitch McConell called on conservative white men who are reluctant to get vaccinated to change their minds and get the "jab." I cannot help but think that President Trump would have won the election had he championed efforts to combat the coronavirus. He always seemed ambivalent on the issue by saying he saved lives by closing the borders but also attacked Governors enforcing a mask mandate. The situation in North Dakota and Texas is tragic. I hope that the rural vaccination units mobilize soon. I read that the J&J recently lost 15 million doses in a manufacturing error. Hopefully their single dose vaccine will be ready to ship.
Post a Comment