Health Equity

January 15, 2021

I suspect that you have seen the drawing and blog post describing the difference between equity and equality. It’s a compelling image. Obviously, the shortest child, given equal access to view the baseball game will benefit rather little from such equality.

Yesterday, along with several dozen others, I volunteered at a local county Covid-19 vaccination site. The experience was both uplifting and concerning.

Uplifting: despite an allocation of vaccine that was (much) less than expected, the team – a hodgepodge of retired and semi-retired doctors, nurses, county employees, lawyers and other non-clinical people assembled to build our community’s immunity to SARS-CoV-2, the virus that causes Covid-19. I was impressed with the dedication, attitude, and commitment of the team from the county health department. I was touched by the gratitude expressed – as hundreds of people patiently and thoughtfully filed into the facility to get their vaccines. After giving the vaccine – I was thanked by many for “saving my life.” Alas – my part was was likely the smallest contributor to this – yet, of course, the most poignant 7 seconds – as I delivered the vaccine to its final destination. Indeed – the hope of this event was itself infectious: after giving our first injections, I reflexively attempted a high-five with the nurse (who happened to be a former colleague of mine) at the next station. She appropriately offered her elbow as a substitute to the high-five. It was a good day – filled with good moments that serve as a tangible milestone toward the end of the pandemic.

Concerning: in this county that is ~ 75% white, I saw very few people of color. 100% of the people who received their vaccine from me were white. All of them arrived by car, and all of them had signed up to be vaccinated by using the Internet. While one might argue that the underserved members of our community had an equal opportunity to sign up for the vaccine (now look back at the drawing above) – I would offer that they certainly didn’t have equity. Indeed – a sobering observation one of my volunteer colleagues shared with me was that we saw nobody from the neighborhoods adjacent to the facility we were in – everyone we were vaccinating seemed to be from the suburbs.

I offer this observation without judgment. The state and county leaders are focused on getting as many people vaccinated as possible. Vaccine supply is limited. They are doing their best – and I don’t think we can/should change the great work they are doing, or question their motives and commitment to health equity or social justice.

Yet we – as a community – can do better. We need to create an adjunct to the programs that now exist – to allocate vaccine explicitly for the underserved and implement outreach that meets them where they are: create equity.

So we will. With the counties, the federally qualified health centers, and community-based organizations – we’ll begin work yesterday to create this equity and get our underserved communities protected.

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January 15, 2021 | 2 Minutes

ABOUT THE AUTHOR

Jacob Reider MD, FAAFP
CEO Alliance for Better Health

I am here because I want the world to be more healthy. I have worked for decades to improve the health of our communities through the innovative use of technology, and the promotion of benevolence in business. I am currently CEO of Alliance for Better Health, a New York DSRIP care transformation initiative, Chief Health Officer of Health Coda, and co-founder of RS Partners, a health IT consulting and investing firm.

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Over the last few weeks, a team of amazing volunteers has created a huge open-source library of over 600 free-to-use icons for healthcare projects. Amazing effort to create a public good for the world. Please share! http://Healthicons.org

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