Since the pandemic began, we’ve studied 9 communities as they overcome the challenges posed by the crisis while working to improve health and well-being. The latest set of reports in the Sentinel Community series: COVID-19 Community Response, examines the community’s response to the pandemic over the past year. We hope this research will contribute to a broader understanding of strategies that can create lasting and equitable change.
Both Harris County, Texas and Tampa, Fla., have strategies and structures in place to comprehensively address public health and prioritize health equity before the pandemic. These communities have faced disasters such as extreme weather events and disease outbreaks in recent years. They can leverage tools and infrastructure from past emergencies to rapidly respond to the pandemic and its spillover effects — from food shortages to crises. housing crisis.
Using policy to address local inequality
Before the pandemic hit, efforts to build a more equal, resilient community were well underway in Tampa. In recent years, the city has welcomed a large influx of newcomers, pushing low-income residents far from the city center to neighborhoods where housing costs are lower but public transport lacking again. Tampa has directed resources to address these challenges, which Mayor Jane Castor has identified as a priority for her administration. In 2019, Mayor Castor convened advisory groups of experts to develop priorities and strategies to expand access to affordable housing and improve Tampa’s transportation infrastructure.
Work on improving economic opportunity in Tampa has continued throughout the pandemic. Mayor of Castor established the Economic Advisory Committee in August 2020. This diverse working group of 23 community stakeholders is tasked with developing recommendations to reduce poverty, reduce gender disparities and income race, and economic diversification. Their recommendations, released in April 2021, focus on four key areas: promoting inclusive economic growth, reducing poverty, committing to racial equality and emphasizing educational opportunity. These recommendations have fueled initiatives to close the digital divide and address the racial unemployment gap.
The purpose of these actions is important, but the community also needs to measure their impact. Last year, our colleagues launched the COVID-19 U.S. State Policy (CUSP) database to gauge the equity impact of state-level policies similar to those announced by the U.S. Marketplace. Chief Castor issued.
Have a partnership that promotes equity
Equity is at the heart of Harris County’s pandemic response, informing decisions around COVID-19 testing strategies and communicating with residents of color. HCPH has established an Incident Command System and in it, the Resilience and Equity Branch uses the Social Vulnerability Index from the Centers for Disease Control and Prevention (CDC) to prioritize testing sites to promote equity. Outreach groups are deployed daily to community events in areas with a high percentage of residents of color.
Harris County’s focus on combating health disparities is rooted in the health equity framework the county established in 2014. Since then, this unequivocal commitment to equity has taken shape. day-to-day public health operations, including efforts to use data to target policies to the areas of the community most in need.
Where do we go from here?
Leaders in Harris and Tampa Counties have made health equity a priority in routine policymaking and in response to the pandemic, but they have limited authority. While state leaders in Texas and Florida pursue aggressive reopening policies, local public health officials have developed more cautious approaches to reopening, according to guidelines of CDC recommendations.
Tensions between state and local leaders play out in northern Harris County, in Dallas. After the city prioritized racial equity in their vaccine strategy, the state threatened to send fewer vaccine shipments.
Local efforts to promote health equity are also limited by the state’s inaction on expanding Medicaid. Texas and Florida are among 12 states that have refused to expand Medicaid, exacerbating health disparities for people of color and low-income adults. As Dr. Richard Besser writes, “…populations disproportionately affected by COVID-19 are those that are most likely to be uninsured. These are not coincidences, but patterns that reflect the past and present of our people.”
Our research has made it clear that the time to prioritize equity is now, before the next disaster hits, whether it’s a health crisis, natural disaster, the effects of climate change or any other disaster. social work. For the health and well-being of our communities, we must integrate equity planning into our routines so that we are better prepared to weather the next crisis — and address those inequalities that communities face every day.
We cannot ignore the hard lessons of COVID-19.
