The COVID-19 pandemic has exacerbated the health inequities faced by Black communities in America in undeniable ways. These inequities are not new. They have existed for centuries and are steeped in the institution of slavery and systemic racism.

This reality holds true in Minnesota as Black Minnesotans continue to be disproportionately impacted by the COVID-19 pandemic. According to recent data from the Minnesota Department of Health (MDH), Black Minnesotans are testing positive, being hospitalized and being put in the ICU at higher rates than the overall population. These disproportional rates of infection are the result of existing health inequities, segregation, racism and lack access to quality health care― all making Black communities more vulnerable to COVID-19.

Tragically, despite these higher rates of infection and severity of illness, Black Americans are one of the least vaccinated racial groups in the nation. In fact, as vaccines are becoming more available, there are troubling racial inequities in vaccine distribution, particularly for Black and Latino communities.

As of February 23, 2021, national data showed that only 5.7 percent of Black people had received at least one dose of a COVID-19 vaccine. This is compared to 11.3 percent of white people. In Minnesota, MDH data shows that approximately 38 percent of Black people 65 and older have been received at least dose of the vaccine, while 45 percent of white people in the same age group have had at least one shot.

It is also important to note that data provided by MDH is limited and only accounts for the 83 percent of vaccinated Minnesotans. This means that inequities in vaccination rates are more than likely greater than the current data suggests.

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Equitable access to the vaccine

Access to the COVID-19 vaccine is one of the greatest barriers standing in the way of equitable rates of vaccination for Black communities. Research shows that when Black people are given the opportunity to get vaccinated, they do. In fact, 61 percent of Black Americans polled by the Pew Research Center said they plan to get vaccinated or already have received a dose of the vaccine. This number is up from only 42 percent of Black Americans who said in they planned to get vaccinated in November 2020.

This lack of access is driven by institutional and systemic racism, which impacts our health care systems in countless ways. This includes where clinics are located, accessibility and implicit bias in care and treatment. Blue Cross believes that health care providers must recognize these barriers and work to create greater access to care for those most impacted by health inequities and COVID-19.

Representation Matters

Rebuilding trust and prioritizing the needs of those most impacted by health inequities starts with listening to Black, Indigenous and people of color (BIPOC) communities and being accountable for creating change. It also requires us to acknowledge our own role in maintaining the status quo and committing to do better. Blue Cross is firmly committed to racial equity and we are focusing on uplifting the voices of BIPOC leaders and community members when it comes to addressing the impacts of pandemic.

Amplifying the voices of Black doctors for racial equity in vaccinations

A critical component of moving towards racial equity in vaccination rates is amplifying the voices of Black doctors. Dr. Nneka Sederstrom, Ph.D., MPH, MA, FCCP, FCCM, is the chief health equity officer at Hennepin Healthcare and a nationally recognized author and speaker on topics related to racism, racial disparities, bias, crisis, standards of care and treatment. She feels that it is not only important, but essential to have Black doctors as spokespeople when communicating information about COVID-19 in Black communities.

 Dr. Nneka Sederstrom, Ph.D., MPH, MA, FCCP, FCCM
Dr. Nneka Sederstrom, Ph.D., MPH, MA, FCCP, FCCM

“Black people have had a long history of white physicians dictating important information and having that encounter subjected to implicit bias and racism,” Dr. Sederstrom says.

This challenging history is why she points to the need for Black physicians to be heard.

“Without the support and trust of Black physician voices in this work, we would not be able to engage the Black communities at the level we are,” she says. “The desperate need to build trusting relationships to stop the continuous disenfranchisement requires us to not only seek out the voices of Black doctors, but we must also allow them to be the loudest and clearest heard.”

"Without the support and trust of Black physician voices in this work, we would not be able to engage the Black communities at the level we are…we must also allow them to be the loudest and clearest heard."

Hesitancy does not mean refusal

Mistrust of the medical establishment can also be a factor impacting vaccination rates for BIPOC communities. Medical experimentation, abuse and malpractice in BIPOC communities at the hands of doctors, scientists and health officials are well documented. This painful history can fuel skepticism of the medical establishment.

Because of this, it is imperative to recognize that racism and abuse in healthcare are not isolated historical instances. In fact, ongoing discrimination, racism and bias play a major role in health outcomes and levels of trust in health care for BIPOC communities to this day.

However, it is also important to recognize that distrust and hesitancy does not mean that Black communities do not want to be vaccinated, nor does it singularly explain lower rates of vaccination.

“I think the biggest barrier to vaccination and COVID-19 prevention in Black communities is lack of respect for the people,” Dr. Sederstrom says. “With respect comes deliberate focus, targeted information gathering and sharing and ensuring the best outcome is achieved. None of these things have happened. Instead, there is this need to blame the victim for the lack of knowledge and trust.”

She adds, “There is continued belief that past wrongs, like Tuskegee, are the reasons for the distrust today. This is despite clear evidence of continued racism impacting care delivery and outcomes happening today. If the medical community respected the Black community, we would not have any barriers to vaccination. Hesitancy does not mean refusal.”

An opportunity to do better

It is imperative that Blue Cross prioritize racial health equity in our efforts to promote the COVID-19 vaccine. Blue Cross recognizes that we have more to do as an organization― today and in the days to come. We are willing to do the work.

Black physicians, health care workers, nurses and community organizers are leading the way and finding ways to ensure that their communities have credible information about vaccination and greater access to vaccines. It is time for health care institutions to listen, learn and act. We must actively work to address racism and center equity, respect and justice in our efforts to create a healthier future.

“In order to address the inequities highlighted from this pandemic towards Black, Indigenous and other communities of color, we must engage in targeted and deliberate initiatives to vaccinate, prevent, and care for them,” Dr. Sederstrom says. “It isn’t enough to just acknowledge the data. We have to act on it and focus our efforts on addressing the immediate concerns.”