Recommendations to Address COVID-19 in Low Income and Minority Communities Actionable Opportunities to Address COVID-19 in Minority Communities

Policymakers can take a variety of actions to help support low-income and minority communities that continue to be disproportionately affected by COVID-19. These recommendations are based on feedback from civil society, government, private sector, and academic stakeholders. 

Fund state and local governments for data-driven vaccine planning

The lack of trust between minority communities and the U.S. healthcare system is a persistent barrier to the delivery of adequate healthcare to these populations. Collecting data on healthcare utilization and the languages spoken in different communities could help improve outreach and the work of community-based organizations (CBOs) among target demographic groups. In addition to a general distrust of healthcare institutions, minority communities may be skeptical about the development and use of vaccines due to negative experiences with medical research in the past, including unlawful experimentation and mistreatment (e.g. the Tuskegee Syphilis Study).  The federal government should allocate funds to states and localities to support community resources and community-based organizations for vaccine planning to help overcome this trust barrier. This will be critical when vaccines for COVID-19 are ready for public use, and will be essential for widespread uptake. States and localities should work with individuals who already are trusted and respected within their communities to help increase medical trust. 

Establish data-driven policies to relieve financial burdens for low-income and minority communities

COVID-19 has created severe financial stress across the U.S., and even more so in low-income and minority communities. Policies should be put in place to ease these financial burdens, and the outcomes of those policies should be measured. For example, collecting data on COVID-19 rates in workplaces with paid sick leave may highlight how this benefit could be expanded to other workplaces. Roundtable participants suggested mandating paid sick leave for workers and implementing other policies to reduce current and emerging poverty and economic hardship. Policies that connect unemployed or underemployed groups to social services are also essential for these communities.

Use data on housing to reduce crowding and homelessness

Low-income and minority communities are more likely than the rest of the U.S. population to live in multigenerational or multi-family households. This reality, in addition to high rates of homelessness, contributes to the greater difficulty of following COVID-19 mitigation measures including social distancing and quarantining in these communities. To address this issue, Roundtable participants suggested making empty hotel and dorm rooms available for the homeless and others in extenuating circumstances. HUD and Census data should be utilized to identify areas with high rates of homelessness and poverty to develop these interventions.

Use Case: In the early days of the pandemic it was reported that multiple jurisdictions were renting hotel rooms – and even entire hotels – to house COVID-19 patients and first responders in need of housing close to hospitals. Others rented empty hotel rooms to help residents experiencing homelessness self-isolation after a COVID-19 diagnosis or while awaiting test results. These programs could be continued in the wake of the COVID-19 pandemic to help those experiencing homelessness secure temporary housing while they deal with economic and other reverberations from the crisis. 

Fund state and local governments for data-driven vaccine planning

The lack of trust between minority communities and the U.S. healthcare system is a persistent barrier to the delivery of adequate healthcare to these populations. Collecting data on healthcare utilization patterns and the languages spoken in different communities could help improve outreach and the work of community-based organizations (CBOs) in targeting demographic groups for vaccine uptake. In addition to a general distrust of healthcare institutions, minority communities may be skeptical about the development and use of vaccines due to historical negative experiences with medical research, including unlawful experimentation and mistreatment (e.g. the Tuskegee Syphilis Study).  The federal government should allocate funds to states and localities to support community resources and community-based organizations for vaccine planning to help overcome this trust barrier. This will be critical when vaccines for COVID-19 are ready for public use, and will be essential for widespread uptake. States and localities should leverage community members who already hold the trust of their communities  to help increase others’ trust in the healthcare system and, ultimately, vaccine uptake. 

Improve collection of workforce data

A key factor in one’s likelihood of contracting COVID-19 is employment status and employee benefits, or lack thereof. Certain jobs – many of which are deemed “essential” during the pandemic – and workplace policies place workers at an increased risk of contracting COVID-19.  Such data on individuals in low-income communities can help identify who has a job-related risk of COVID-19 positivity and severe infection.6 Important factors to consider are employment status, essential worker status, employer health insurance, availability of sick leave, and more. These factors can each have an impact on individuals’ risk of COVID-19 infection.

Increase publication frequency and expand access to Medicaid claims data

Roundtable participants identified a need to increase the frequency with which Medicaid claims data is published and expand access to that data. Medicaid claims data can be used to identify at-risk populations and understand the prevalence of comorbidities. For example, a county health official can use claims data to see Medicaid recipients in their county and what kinds of procedures have been carried out among that population, allowing them to better understand their potential for increased COVID-19 risk. Policymakers should consider ways to provide more access to Medicaid claims data to researchers and others.