Practice Title: Using an Innovative Evidence-Based Approach to Ensure Equitable COVID-19 Vaccine Distribution in WC
Department: Wake County Health and Human Services
Size: Large (Population of 500,000+ people)
State: North Carolina
Summary of Practice:
Wake County, North Carolina is the largest county by population in North Carolina, with just over 1.1 million residents and is one of the fastest growing counties in the US (Demographics, n.d.; U.S. Census Bureau, 2021.) The recent census indicates that 67% of residents identify as White, 21% identify as Black or African American, <1% identify as American Indian and Alaska Native, 8% identify as Asian, and 10% of residents identify as Hispanic or Latino. Wake County Health and Human Services (WCHHS) serves these residents utilizing more than 1600 staff members in nine locations across the county. The Wake County Public Health Division is housed within WCHHS and plays a critical role in protecting and improving the health of communities across Wake County. As such, WCHHS has led the county in innovative COVID-19 mitigation strategies, which have kept COVID-19 rates among the lowest in the State while also ensuring health equity. Specifically, WCHHS has worked to address health disparities intensified by COVID-19 and accelerate services to communities most impacted by COVID-19 through a comprehensive COVID-19 vaccine equity strategy.
Across the US, COVID-19 has exacerbated existing health inequities rooted in structural racism, injustice, and systemic barriers. This holds true in Wake County, North Carolina where Black/African American and Hispanic/Latino communities have been disproportionally impacted by COVID-19, as seen by heightened mortality and case rates adjusted for population (NC DHHS, n.d.-a). To address these inequities, WCHHS developed a strategy to identify testing deserts, which utilized real-time data to immediately adapt testing locations to ensure that the hardest hit communities were reached through access to mobile testing. Building upon this model in early 2021, WCHHS developed a vaccine equity strategy that prioritizes census tracts in the county experiencing disparities related to COVID-19. In almost all instances, areas of the county that report the highest COVID-19 case rates also report the highest level of disparities related to healthcare access, availability to transportation services, and correlate with higher scores on the social vulnerability index.
The COVID-19 vaccine equity strategy aims to ensure that underserved communities experiencing health inequities have both access to COVID-19 vaccines and information needed to make informed decisions regarding vaccinations through trusted community partners. The strategy was developed so that it could be easily replicated for future health campaigns, with the long-term goal of ensuring more equitable access to health services in Wake County. The specific practice of implementation was multipronged and included:
· Background data analysis and mapping of all census tracts in Wake County.
· A community engagement strategy that utilized trusted partners and community health workers.
· Mobile vaccination sites at high-traffic community points in selected census tracts.
· Geo-targeted communication efforts.
· Continuous adaptation of vaccination sites based on real-time evidence.
In the census tracts that were selected for mobile vaccinations and complimentary outreach through the vaccine equity strategy, vaccination rates of Black/African America and Hispanic/Latino increased significantly as did access to vaccination/health services among these groups.
Using an Innovative Evidence-Based Approach to Ensure Equitable COVID-19 Vaccine Distribution in WC
Category
Infectious Disease Prevention and Control