Data-Informed Health Equity in COVID-19 Response and Recovery

West Virginia University School of Public Health, Department of Social and Behavioral Sciences Office of Health Services Research
2022 APHA Annual Meeting and Expo

Abstract 519325 - Data-Informed Health Equity in COVID-19 Response and Recovery

Session 5140.1 - Equity and Social Determinants of Health Roundtable

Wednesday, November 9, 2022, 12:30 p.m. EST: 205A

Authors: Adam Baus, PhD, MA, MPH (1), Samantha Shawley-Brzoska, PhD, MPH (1), Andrya Durr, PhD (1), Andrea Calkins, MPH (1), Sheryn Carey, BA (2), Cecil Pollard, MA (1), Aaron Hunt (1)

(1) West Virginia University School of Public Health, Department of Social and Behavioral Sciences

(2) Division of Health Promotion and Chronic Disease, West Virginia Bureau for Public Health

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Special thanks to the WV Bureau for Public Health for their leadership and support for this initiative.

Learning Objectives

  1. Describe the Health Equity in COVID-19 Response and Recovery initiative. 

  2. List essential data elements and data sources leveraged in evaluating the initiative’s reach and impact. 

  3. Identify ways in which essential components of this initiative can be implemented across other health systems. 

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About the West Virginia University Office of Health Services Research

40+ years supporting groups working to improve the health and social well-being of their communities. Long-term partnership with the WV Bureau for Public Health.

Mission: We support quality improvement efforts that empower those who serve the underserved

Vision: Improved health for all through applied efforts designed to move discoveries into practice and policy change

Values: Respect for our culture; Inclusion of equity always in our work

Data-focused work with primary care and community-based organizations

  • Quality improvement

  • Care coordination / Patient navigation

  • Population health measurement

  • Program evaluation

  • Health analytics

  • Practice-based research

  • Disseminating findings to stakeholders and the public (data briefs, policy recommendations, peer reviewed publications)

COVID-19 Timeline

  • Declared a pandemic by the World Health Organization in March 2020

  • By mid-2020, significant health and economic consequences

  • COVID-19 vaccine rollout in 2021. Difficulties in reaching individuals, especially those with challenging social determinants of health

  • Source: Kathy Katella, March 9, 2021

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COVID-19 Globally, in the United States, and in West Virginia

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COVID-19 Among Minority Populations

  • COVID-19 death rates by American Community Survey Race and Ethnicity and US Department of Health and Human Services (HHS) Region and by Age for Hispanic or Latinx, Black or African American, and non-Hispanic White Populations

  • Estimates for Black or African American communities were potentially conservative because the Census data on age by race and ethnicity are not disaggregated by Hispanic or non-Hispanic origin.

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COVID-19 + SDOH

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“The COVID-19 pandemic is having a huge impact on community life and health, especially in poorer neighbourhoods. Many social problems have been made worse; e.g. poverty, difficulties getting food and social isolation.”

Source: Community Engagement in Deprived Neighbourhoods During the COVID-19 Crisis: Perspectives for More Resilient and Healthier Communities Health Promot Int. 2022 Apr 29;37(2):daab098. doi: 10.1093/heapro/daab098

“It’s pretty clear that COVID-19 disproportionally impacts persons with underlying chronic diseases such as congestive heart failure or coronary artery disease, COPD, diabetes and obesity, in addition to advanced age. But what we have also witnessed early in the pandemic within the U.S. is that Black Americans are at a much higher risk of severe infection and death compared to whites. And this appears to be because they are at increased risk for these underlying chronic conditions. We see risk tracking along poor health overall for people in poverty, and that is a reflection of SDOH.”

Jenifer Leaf Jaeger, MD, MPH; Source: COVID-19 magnifies impact of SDOH on U.S. healthcare system (hfma.org)

Overview: Health Equity in COVID-19 Response and Recovery

Leveraging two funding opportunities: 1) ELC Enhancing Detection through Coronavirus Response and Relief; 2) Supporting Health Equity in COVID-19 Outreach and Measurement (2103)

Goals

  • To support patient navigation for individuals with high risk factors for COVID-19, those with challenging social determinants of health factors, and those not generally engaged in health care for COVID-19 screening and vaccination services and other preventive or health maintenance services. 

  • To improve COVID-19 data collection and reporting for testing underserved patient populations* at higher risk of COVID-19.

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*Individuals who are racial and ethnic minorities, have underlying medical conditions, are 65+, are low-income, and/or who have limited access to healthcare

Health System Partners

Request for Applications (RFA) released to health systems. Application scoring based on:

  • County-level Social Vulnerability Index data from the CDC, encompassing socioeconomic, household, disability, minority status, language, housing, and transportation metrics

  • Sections of the application:

    • Background

    • Connecting with community-based organizations

    • Purpose / Objectives

    • Approach

    • Feasibility

    • Stainability

    • Timeliness of the application

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Implementation Planning

A living document with each health system which provides a framework for project implementation and success centered on reaching the target patient populations and ensuring their connectivity to COVID-19 services + routine health care.

  • Technical assistance available from OHSR in project planning and sustainability

  • Implementation plan sections:

    • Background

    • Partners

    • Activities (patient navigation / care coordination / mobile units)

    • Data management

    • Timeline

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Data Collection and Baseline Analysis

Goals:

  • Create summary level baseline data to share with individual healthcare systems, the WV Bureau for Public Health, and other key stakeholders 

  • Re-evaluate healthcare systems following the implementation of their plan to target COVID-19 disparities in vulnerable populations --> Identification of successes, challenges, and lessons learned over the course of the initiative 

Data Sources

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Next Steps

  • Continue baseline data reviews and prepare for post data reviews

  • Booster reach

  • Closing gaps with screenings/vaccinations

  • Operationalizing patient navigation

  • Continued collaboration between health systems

  • Dissemination

    • WV Rural Health Association 

    • WV Health Connection

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Contact Information