As efforts accelerate nationally to provide the coronavirus vaccine to communities of color, skepticism about the inoculations is often highlighted as a major impediment. But a lack of pharmacies, hospitals, providers and transportation has emerged as an equally significant concern in those communities, where covid-19 has wrought its worst damage.
Public health experts, physicians and civil rights advocates say attention must be paid to the practical barriers that fuel the disparities that have become a hallmark of the American health-care system. If not accounted for, they say, those same obstacles stand to stymie efforts to bridge a growing divide in coronavirus vaccinations.
“Covid is exploiting not just human virus response, but our structured health-care response as well,” said Janice C. Probst, director emerita of the University of South Carolina’s Rural and Minority Health Research Center. “It finds the gaps.”
Covid-19, the illness caused by the novel virus, has killed 1 out of every 645 Black Americans in the past year. But of the 13 million people who received the coronavirus vaccine during the first month shots were available, just 5 percent were Black, limited data from the Centers for Disease Control and Prevention shows. Those figures also show that Latinos, another community disproportionately affected by covid-19, are underrepresented in getting shots. Race and ethnicity data was missing for nearly half of all coronavirus recipients during that time.
Researchers know that inadequate health-care infrastructure, including a lack of pharmacies, is one of the barriers.
One out of eight pharmacies shut their doors between 2009 and 2015, according to a brief 2019 study published in the medical journal JAMA Internal Medicine. Independent, urban drugstores whose clients are mainly uninsured or publicly-insured patients — two groups who are disproportionately Black and Latino — were most at risk of shuttering, the report said. A separate study shows rural residents are contending with hospital closures and provider shortages that have left 4.4 million residents living in a county without a hospital.