Health experts push to combat respiratory illnesses disproportionately impacting Black communities

(The Dallas Examiner) – “COVID-19 affected the Black community at an alarming rate,” said Debra Fraser-Howze, founder and board chair of Choose Healthy Life, during a recent webinar, “Somebody asked me when we were going to go back to normal, and my response was, ‘We’re not going back to normal. We died in normal. We’ll never go back to normal again.’”

Black people are infected, hospitalized and die from COVID-19 at a higher rate than any other race. Because of a combination of past and current injustices and lack of access to care, the Black community has more vaccine hesitancy than any other race. Communities of color often lack access to testing and contact tracing.

During the webinar, Advancing Better Health Through Better Understanding: Community Narratives, Visions and Actions, the discussion focused on community-based interventions that support vaccine confidence for respiratory illnesses that are disproportionately impacting Black and African American populations. Those illnesses include COVID-19, flu, RSV and pneumococcal disease.

“Health care outcomes in the Black community lag far behind health care outcomes in comparison to the White population,” Fraser-Howze stated.

Black adults are 30% more likely to be obese and 60% more likely to be diagnosed with diabetes. Black men – at 30% – and women – at 60% – are more likely to have high blood pressure. Black women being twice as likely to have a stroke.

Black women are 40% more likely to die of breast cancer. Black women also have the second highest incidence and the highest mortality rates of cervical cancer.

“We can’t just keep fighting and doing these episodic things when there’s a crisis. There’s a reason why people couldn’t breathe when they got COVID. You know, the obesity, the hypertension. They have all kinds of underlying respiratory illnesses, asthma, and that’s why we died more than anybody else,” Fraser-Howze commented.

“And we can’t seem to get past these words like ‘health disparities’ or ‘health inequities.’ We keep calling them something else, but the point is that we haven’t yet solved the problem.”

Black communities experience lower vaccination rates when compared to the total population. According to the Centers for Disease Control, in 2023, Blacks had the lowest percentage of those who had received at least one dose of the COVID-19 vaccine among all ethnic groups.

In January 2024, RSV vaccination coverage was highest among non-Hispanic Asian (22.8%) pregnant persons and lowest among non-Hispanic Black (9.5%) pregnant persons.

The same holds with flu vaccinations.

“Looking at influenza vaccination coverage during the 2021 and 2022 flu season, Blacks, as well as other racial, ethnic minority populations, had a lower [rate] by over ten percentage points compared to vaccination coverage amongst Whites,” stated event facilitator Captain David Wong, MD, chief medical officer of the Health and Human Services Office of Minority Health.

Wong explained that there are associations between the decreased vaccination coverage and health outcomes of Black individuals.

In 2023, Black Americans were hospitalized for RSV at a younger age (70 years) than Whites (77 years), Hispanic/Latinos (74 years), and American Indian/Alaska Natives (72 years), in a study conducted by the CDC.

“The COVID-19 mortality rates were 2.7 times higher in Black Americans compared to White Americans … For influenza hospitalizations, they’re 80% higher for Black and African Americans compared to others,” Wong said.

It was noted that Black communities face several barriers to accessing vaccines – distance to vaccine sites, literacy to schedule appointments, insufficient vaccination sites, inflexible work hours, lack of transportation and lack of internet access.

Other speakers shared how their organizations worked to break down barriers and intervened to assist Black communities in supporting vaccine confidence.

Regional Medical Director Dr. Bukola Olusanya talked about St. John’s Community Health efforts to overcome vaccine hesitancy. They have a network of primary care clinics in South and East Los Angeles and Compton, California. Their efforts included early vaccination campaigns, community vaccination sites, mobile clinics, grassroots outreach programs such as door-to-door visits, and social media, TV and radio. Through their efforts, St. John’s vaccinated over 575,000 people, of which 94% were people of color from low-income households.

“We need to continuously educate our, in honesty, our patients and our community about the importance of getting the vaccination, and also to let them know that even though you’re getting the vaccine, it does not prevent you from getting sick. It only prevents you from getting the complication that may be very devastating from not getting the vaccines,” Olusanya stated.

Project director Felicia Kent spoke about the efforts made by the CHAMPIONS – COVID-19, health literacy, accessibility, management, prevention, intervention, outcomes and new skills – for equitable communities Advancing Health Literacy Program in Vicksburg, Mississippi. The program sat out to develop and implement a health literacy plan to improve the accessibility of public health messages and promote change in the Health Care Delivery System at Jackson-Hinds Comprehensive Health Center.

“When we started the project, we had about 17% that were fully vaccinated, and today, it’s over 55% of our residents that are fully vaccinated,” Kent said.

The project faced several challenges, including misinformation leading to fear and panic, the use of Health People 2023 objectives, high vaccination hesitancy levels, the adoption of National Culturally and Linguistically Appropriate Services standards, and the implementation of teach-back/show-back provider training. To overcome those challenges, the project offered mobile health clinics.

“Our belief is that you must meet people where they are, and so meeting them at the church, at the barbershop, at the grocery store,” Kent explained.

To address barriers and overcome vaccine hesitancy, it was suggested:

1. Incorporate cultural competence in health outreach programs.
2. Collaborate with trusted sources to increase awareness about the benefits and safety of vaccines.
3. Empower local health care providers and provide training and resources to communicate with Black patients effectively.
4. Address historical mistrust, inequalities and systemic barriers contributing to vaccine hesitancy.
5. Collaborate with community organizations and churches to administer vaccines at trusted locations.
6. Continual monitor and feedback assess vaccine confidence levels within the community through surveys and focus groups.
7. Address financial barriers by providing free services, facilitating transportation and offering culturally sensitive educational materials.
8. Develop long-term strategies that extend beyond the initial program implementation.

“People keep talking about vaccine hesitancy, but we have a larger problem now…It’s not just vaccine hesitancy anymore; it’s also vaccine fatigue,” Fraser-Howze expressed.

Fraser-Howze spoke about her organization’s – Choose Healthy Life – efforts. The organization combines faith and medical science to connect hard-to-reach and underserved communities to health services. They do this by creating a network of Black churches, establishing and sustaining a faith-based health workforce to address COVID-19 through testing/vaccination, promoting wellness, addressing health equity and ensuring pandemic preparedness in the community.

“We have to really do a better job of empowering patients and minority communities with information – not just information but being able to organize groups where people can have a dialogue,” Kent concluded.

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