New rankings identify the most and least racially inclusive U.S. hospitals.Sometimes they are just blocks apart.
BROOKLINE, Mass. — Some of the most and least racially inclusive U.S. hospitals are located in the same cities, according to anew ranking of over 3,200 hospitals from the Lown Institute, a health care think tank.
The Institute finds some hospitals in urban markets serve a whiter, wealthier patient mix, while others predominately serve patients of color and with lower incomes. In the top 50 most inclusive hospitals, people of color made up 61 percent of patients on average, compared to 17 percent at the bottom 50 hospitals.
“The difference between the most and least inclusive hospitals is stark, especially when they are blocks away from each other,” said Vikas Saini, MD, president of the Lown Institute. “As the nation reckons with racial injustice, we cannot overlook our health system. Hospital leaders have a responsibility to better serve people of color and create a more equitable future.”
Some of these disparities were magnified during the pandemic. “If you want to see structural racism, just look at big city hospitals during COVID,” Dr. Saini said. “Hospitals with a history of serving communities of color needed refrigerator trucks to hold bodies of deceased patients, while wealthier hospitals nearby had empty beds.”
Based on the analysis, the most racially inclusive U.S. hospitals are:
Metropolitan Hospital Center, New York, NY
Boston Medical Center, Boston, MA
St. Charles Madras, Madras, OR
Newark Beth Israel Medical Center, Newark, NJ
Little Colorado Medical Center, Winslow, AZ
Presbyterian Española Hospital, Española, NM
John H. Stroger, Jr. Hospital, Chicago, IL
Harlem Hospital Center, New York, NY
Sanford Chamberlain Medical Center, Chamberlain, SD
Lincoln Medical & Mental Health Center, Bronx, NY
America’s most racially inclusive hospital, Metropolitan Hospital Center, is just a short cab ride from one of America’s least racially inclusive hospitals, Lenox Hill, in New York City’s Upper East Side. Though they are close neighbors, Metropolitan serves 77 percent people of color while Lenox Hill serves 33 percent.
Only three hospitals from the U.S. News Honor Roll made the top 200: Barnes-Jewish Hospital (144), Cleveland Clinic (159), and Rush University Medical Center (178).
To create the rankings, the Lown Institute assessed how well the demographics of a hospital’s Medicare patients matched the demographics of the hospital’s surrounding communities. Hospitals underserving communities of color got lower rankings.
Additional ranking information, including an explanation of methods, is available at LownHospitalsIndex.org/inclusivity. A launch of the full 2021 Lown Institute Hospitals Index, including rankings across more than 50 metrics, will take place at the end of June.
Nurse leaders who will shape the future of nursing are in demand now more than ever. The fields of healthcare management, technology, clinical practice, and executive nurse leadership are calling nurse leaders considering a Doctor of Nursing Practice (DNP) degree.
New opportunities for career advancement, a higher earning potential, and professional leadership await you. There are several reasons why the time is now for aspiring nurse leaders.
The struggling U.S. healthcare system desperately needs innovative, highly educated nurse leaders with a DNP to help guide pandemic recovery efforts. As healthcare leaders look beyond 2021, they seek highly trained nurses with a DNP in Executive Nurse Leadership to take on more board leadership roles, navigating the uncertainty that has become the norm, according to the American Hospital Association.
A coalition of more than 20 professional organizations, including AARP and The Robert Wood Johnson Foundation, believe that nurse leaders are the key to improving the health of communities and the nation. That is why they started a successful campaign to have 10,000 nurses in leadership positions on boards by 2020.
This means that there are now more opportunities than ever for you to hold a position of power in healthcare leadership. Earning a Doctor of Nursing Practice, the most advanced nursing degree available, is the key to establishing yourself as an expert in a specialty advanced practice area, or as a nursing executive.
The anticipated physician shortage, combined with increases in available health management positions, means new opportunities for nurse leaders with a DNP in a specialty advanced practice area. The Association of American Medical Colleges (AAMC) projects that the United States will face a shortage of between 54,100 and 139,000 physicians by 2033.
The demographic reality of a lack of access to primary care in underserved communities, an aging workforce, and a growing U.S. population means that physicians, especially primary care providers, are in high demand. Widespread physician burnout, even before the pandemic, is also driving earlier retirement.
Simultaneously, the U.S. Bureau of Labor Statistics (BLS) predicts that the health care management field will grow 17 percent from 2014 to 2024. The result is more space for nurse leaders with a DNP in board rooms, federal or state health-related agencies, or clinical research institutes.
Technology is an integral part of modern healthcare. The COVID-19 pandemic only accelerated the commercialization of healthcare technology. There are now exciting and lucrative new roles at silicone-valley-style startups. These businesses capitalize on technologies such as artificial intelligence, telemedicine, virtual care, wearable medical devices, genomics, and gene editing in the healthcare sphere.
Many of these new companies are looking for executive leaders with direct healthcare experience to guide them in transferring novel technology to healthcare. DNP’s with advanced education and training in Executive Nurse Leadership are desirable candidates for growing health tech companies.
There are now more opportunities than ever for minority nurse leaders in the U.S. There continues to be a lack of representation of the nursing field’s full diversity in healthcare leadership positions. In addition to the pandemic, 2020 and 2021 also witnessed growing racial tensions, the Black Lives Matter movement, and a more significant societal commitment to Diversity, Equity, and Inclusion (DEI).
Our nation’s reckoning with its history of systemic racism is now holding our healthcare systems, government agencies, academic institutions, and healthcare companies to higher standards for DEI. Minority nurses with a DNP degree are qualified to serve in leadership positions. They will lead the charge in shaping the future of nursing practice, driving necessary policy changes, and improving patient care outcomes, cultural competence, and health equity.
Leadership roles change rapidly in the fast-paced healthcare environment. The COVID-19 pandemic accelerated that rate of change. Highly-educated, skilled nurse leaders with a Doctor of Nursing Practice degree are desperately needed to help lead our healthcare system’s successful recovery from the COVID-19 pandemic.
With a DNP, you can help to shape the future of nursing practice and strategically earn a seat at the table, representing all nurses as you help to drive the systemic changes so desperately needed. With more doctorate of nursing programs now available with flexible online course options, and employers looking to advance more nurses to leadership positions, the future looks bright for those considering a DNP.
Lost on the Frontline is the most complete accounting of U.S. health care worker deaths. The federal government has not comprehensively tracked this data. But calls are mounting for the Biden administration to undertake a count as the KHN/Guardian project comes to a close today.
The project, which tracked who died and why, provides a window into the workings — and failings — of the U.S. health system during the covid-19 pandemic. One key finding: Two-thirds of deceased health care workers for whom the project has data identified as people of color, revealing the deep inequities tied to race, ethnicity and economic status in America’s health care workforce. Lower-paid workers who handled everyday patient care, including nurses, support staff and nursing home employees, were far more likely to die in the pandemic than physicians were.
The yearlong series of investigative reports found that many of these deaths could have been prevented. Widespread shortages of masks and other personal protective gear, a lack of covid testing, weak contact tracing, inconsistent mask guidance by politicians, missteps by employers and lax enforcement of workplace safety rules by government regulators all contributed to the increased risk faced by health care workers. Studies show that health care workers were more than three times as likely to contract covid as the general public.
“We rightfully refer to these people without hyperbole — that they are true heroes and heroines,” said Dr. Anthony Fauci in an exclusive interview with The Guardian and KHN. The covid deaths of so many are “a reflection of what health care workers have done historically, by putting themselves in harm’s way, by living up to the oath they take when they become physicians and nurses,” he said.
Lost on the Frontline launched last April with the story of Frank Gabrin, the first known American emergency room doctor to die of covid-19. In the early days of the pandemic, Gabrin, 60, was on the front lines of the surge, treating covid patients in New York and New Jersey. Yet, like so many others, he was working without proper personal protective equipment, known as PPE. “Don’t have any PPE that has not been used,” he texted a friend. “No N95 masks — my own goggles — my own face shield.”
Gabrin’s untimely death was the first fatality entered into the Lost on the Frontline database. His story of working through a crisis to save lives shared similarities with the thousands that followed.
Maritza Beniquez, an emergency room nurse at Newark’s University Hospital in New Jersey, watched 11 colleagues die in the early months of the pandemic. Like the patients they had been treating, most were Black and Latino. “It literally decimated our staff,” she said.
Her hospital has placed 11 trees in the lobby, one for each employee who has died of covid; they have been adorned with remembrances and gifts from their colleagues.
More than 100 journalists contributed to the project in an effort to record every death and memorialize those who died. The project’s journalists filed public records requests, cross-connected governmental and private data sources, scoured obituaries and social media posts, and confirmed deaths through family members, workplaces and colleagues.
Among its key findings:
More than half of those who died were younger than 60. In the general population, the median age of death from covid is 78. Yet among health care workers in the database, it is only 59.
More than a third of the health care workers who died were born outside the United States. Those from the Philippines accounted for a disproportionate number of deaths.
Nurses and support staff members died in far higher numbers than physicians.
Twice as many workers died in nursing homes as in hospitals. Only 30% of deaths were among hospital workers, and relatively few were employed by well-funded academic medical centers. The rest worked in less prestigious residential facilities, outpatient clinics, hospices and prisons, among other places.
The death rate among health care workers has slowed dramatically since covid vaccines were made available to them in December. A study published in late March found that only four of 8,121 fully vaccinated employees at the University of Texas Southwestern Medical Center in Dallas became infected. But deaths lag behind infections, and KHN and The Guardian have tracked more than 400 health care worker deaths since the vaccine rollout began.
Many factors contributed to the high toll — but investigative reporting uncovered some consistent problems that heightened the risks faced by health workers.
The project found that Centers for Disease Control and Prevention guidance on masks — which encouraged hospitals to reserve high-performance N95 masks for intubation procedures and initially suggested surgical masks were adequate for everyday patient care — may have put thousands of health workers at risk.
The investigation exposed how the Labor Department, run by Donald Trump appointee Eugene Scalia in the early part of the pandemic, took a hands-off approach to workplace safety. It identified 4,100 safety complaints filed by health care workers to the Occupational Safety and Health Administration, the Labor Department’s workplace safety agency. Most were about PPE shortages, yet even after some complaints were investigated and closed by regulators, workers continued to die at the facilities in question.
The reporting also found that health care employers were failing to report worker deaths to OSHA. The data analysis found that more than a third of workplace covid deaths were not reported to regulators.
Among the most visceral findings of Lost on the Frontline was the devastating impact of PPE shortages.
Adeline Fagan, a 28-year-old OB-GYN resident in Texas, suffered from asthma and had a long history of respiratory ailments. Months into the pandemic, her family said, she was using the same N95 mask over and over, even during a high-risk rotation in the emergency room.
Her parents blame both the hospital administration and government missteps for the PPE shortages that may have contributed to Adeline’s death in September. Her mother, Mary Jane Abt-Fagan, said Adeline’s N95 had been reused so many times the fibers were beginning to disintegrate.
Not long before she fell ill — and after she’d been assigned to a high-risk ER rotation — Adeline talked to her parents about whether she should spend her own money on an expensive N95 with a filter that could be changed daily. The $79 mask was a significant expense on her $52,000 resident’s salary.
“We said, you buy this mask, you buy the filters, your father and I will pay for it. We didn’t care what it cost,” said Abt-Fagan.
She never had the opportunity to use it. By the time the mask arrived, Adeline was already on a ventilator in the hospital.
Adeline’s family feels let down by the U.S. government’s response to the pandemic.
“Nobody chooses to go to work and die,” said Abt-Fagan. “We need to be more prepared, and the government needs to be more responsible in terms of keeping health care workers safe.”
Adeline’s father, Brant Fagan, wants the government to begin tracking health care worker deaths and examining the data to understand what went wrong. “That’s how we’re going to prevent this in the future,” he said. “Know the data, follow where the science leads.”
Adeline’s parents said her death has been particularly painful because of her youth — and all the life milestones she never had the chance to experience. “Falling in love, buying a home, sharing your family and your life with your siblings,” said Mary Jane Abt-Fagan. “It’s all those things she missed that break a parent’s heart.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
For months, journalists, politicians and health officials — including New York Gov. Andrew Cuomo and Dr. Anthony Fauci — have invoked the infamous Tuskegee syphilis study to explain why Black Americans are more hesitant than white Americans to get the coronavirus vaccine.
“It’s ‘Oh, Tuskegee, Tuskegee, Tuskegee,’ and it’s mentioned every single time,” said Karen Lincoln, a professor of social work at the University of Southern California and founder of Advocates for African American Elders. “We make these assumptions that it’s Tuskegee. We don’t ask people.”
When she asks Black seniors in Los Angeles about the vaccine, Tuskegee rarely comes up. People in the community talk about contemporary racism and barriers to health care, she said, while it seems to be mainly academics and officials who are preoccupied with the history of Tuskegee.
“It’s a scapegoat,” Lincoln said. “It’s an excuse. If you continue to use it as a way of explaining why many African Americans are hesitant, it almost absolves you of having to learn more, do more, involve other people — admit that racism is actually a thing today.”
It’s the health inequities of today that Maxine Toler, 72, hears about when she asks her friends and neighbors in Los Angeles what they think about the vaccine. As president of her city’s senior advocacy council and her neighborhood block club, Toler said she and most of the other Black seniors she talks with want the vaccine but are having trouble getting it. And that alone sows mistrust, she said.
https://www.npr.org/player/embed/974059870/980308707Toler said the Black people she knows who don’t want the vaccine have very modern reasons for not wanting it. They talk about religious beliefs, safety concerns or a distrust of former U.S. President Donald Trump and his contentious relationship with science. Only a handful mention Tuskegee, she said, and when they do, they’re fuzzy on the details of what happened during the 40-year study.
“If you ask them ‘What was it about?’ and ‘Why do you feel like it would impact your receiving the vaccine?’ they can’t even tell you,” she said.
Toler knows the details, but she said that history is a distraction from today’s effort to get people vaccinated against the coronavirus.
“It’s almost the opposite of Tuskegee,” she said. “Because they were being denied treatment. And this is like, we’re pushing people forward: Go and get this vaccine. We want everybody to be protected from covid.”
Questioning the Modern Uses of the Tuskegee Legacy
The “Tuskegee Study of Untreated Syphilis in the Negro Male” was a government-sponsored, taxpayer-funded study that began in 1932. Some people believe that researchers injected the men with syphilis, but that’s not true. Rather, the scientists recruited 399 Black men from Alabama who already had the disease.
Researchers told the men they had come to Tuskegee to cure “bad blood,” but never told them they had syphilis. And, the government doctors never intended to cure the men. Even when an effective treatment for syphilis — penicillin — became widely available in the 1940s, the researchers withheld it from the infected men and continued the study for decades, determined to track the disease to its endpoint: autopsy.
By the time the study was exposed and shut down in 1972, 128 of the men involved had died from syphilis or related complications, and 40 of their wives and 19 children had become infected.Given this horrific history, many scientists assumed Black people would want nothing to do with the medical establishment again, particularly clinical research. Over the next three decades, various books, articles and films repeated this assumption until it became gospel.
“That was a false assumption,” said Dr. Rueben Warren, director of the National Center for Bioethics in Research and Health Care at Tuskegee University in Alabama, and former associate director of minority health at the Centers for Disease Control and Prevention from 1988 to 1997.
A few researchers began to question this assumption at a 1994 bioethics conference, where almost all the speakers seemed to accept it as a given. The doubters asked, what kind of scientific evidence is there to support the notion that Black people would refuse to participate in research because of Tuskegee?
When those researchers did a comprehensive search of the existing literature, they found nothing.
“It was apparently a ‘fact’ known more in the gut than in the head,” wrote lead doubter Dr. Ralph Katz, an epidemiologist at the New York University College of Dentistry.
So Katz formed a research team to look for this evidence. They completed a series of studies over the next 14 years, focused mainly on surveying thousands of people across seven cities, from Baltimore to San Antonio to Tuskegee.
The conclusions were definitive: While Black people were twice as “wary” of participating in research, compared with white people, they were equally willing to participate when asked. And there was no association between knowledge of Tuskegee and willingness to participate.
“The hesitancy is there, but the refusal is not. And that’s an important difference,” said Warren, who later joined Katz in editing a book about the research. “Hesitant, yes. But not refusal.”
Tuskegee was not the deal breaker everyone thought it was.
These results did not go over well within academic and government research circles, Warren said, as they “indicted and contradicted” the common belief that low minority enrollment in research was the result of Tuskegee.
“That was the excuse that they used,” Warren said. “If I don’t want to go to the extra energy, resources to include the population, I can simply say they were not interested. They refused.”
“If you say Tuskegee, then you don’t have to acknowledge things like pharmacy deserts, things like poverty and unemployment,” —Karen Lincoln
Now researchers had to confront the shortcomings of their own recruitment methods. Many of them never invited Black people to participate in their studies in the first place. When they did, they often did not try very hard. For example, two studies of cardiovascular disease offered enrollment to more than 2,000 white people, compared with no more than 30 people from minority groups.
“We have a tendency to use Tuskegee as a scapegoat, for us, as researchers, not doing what we need to do to ensure that people are well educated about the benefits of participating in a clinical trial,” said B. Lee Green, vice president of diversity at Moffitt Cancer Center in Florida, who worked on the early research debunking the assumptions about Tuskegee’s legacy.
“There may be individuals in the community who absolutely remember Tuskegee, and we should not discount that,” he said. But hesitancy “is more related to individuals’ lived experiences, what people live each and every day.”
“It’s What Happened to Me Yesterday“
Some of the same presumptions that were made about clinical research are resurfacing today around the coronavirus vaccine. A lot of hesitancy is being confused for refusal, Warren said. And so many of the entrenched structural barriers that limit access to the vaccine in Black communities are not sufficiently addressed.
Tuskegee is once again being used as a scapegoat, said Lincoln, the USC sociologist.
“If you say ‘Tuskegee,’ then you don’t have to acknowledge things like pharmacy deserts, things like poverty and unemployment,” she said. “You can just say, ‘That happened then … and there’s nothing we can do about it.’”
She said the contemporary failures of the health care system are more pressing and causing more mistrust than the events of the past.
“It’s what happened to me yesterday,” she said. “Not what happened in the ’50s or ’60s, when Tuskegee was actually active.”
The seniors she works with complain to her all the time about doctors dismissing their concerns or talking down to them, and nurses answering the hospital call buttons for their white roommates more often than for them.
As a prime example of the unequal treatment Black people receive, they point to the recent Facebook Live video of Dr. Susan Moore. When Moore, a geriatrician and family medicine physician from Indiana, got covid-19, she filmed herself from her hospital bed, an oxygen tube in her nose. She told the camera that she had to beg her physician to continue her course of remdesivir, the drug that speeds recovery from the disease.
“He said, ‘Ah, you don’t need it. You’re not even short of breath.’ I said ‘Yes, I am,’” Moore said into the camera. “I put forward and I maintain, if I was white, I wouldn’t have to go through that.”
Moore died two weeks later.
“She knew what kind of treatment she should be getting and she wasn’t getting it,” said Toler of L.A., contrasting Moore’s treatment with the care Trump received.
“We saw it up close and personal with the president, that he got the best of everything. They cured him in a couple of days, and our people are dying like flies.”
Toler and her neighbors said that the same inequity is playing out with the vaccine. Three months into the vaccine rollout, Black people made up about 3% of Californians who had received the vaccination, even though they account for 6.2% of the state’s covid deaths.
The first mass-vaccination sites set up in the Los Angeles area — at Dodger Stadium and at Disneyland — are difficult to get to from Black neighborhoods without a car. And you practically needed a computer science degree to get an early dose, as snagging an online appointment required navigating a confusing interface or constantly refreshing the portal.
It’s stories like these, of unequal treatment and barriers to care, that stoke mistrust, Lincoln said. “And the word travels fast when people have negative experiences. They share it.”
To address this mistrust will require a paradigm shift, said Warren of Tuskegee University. If you want Black people to trust doctors and trust the vaccine, don’t blame them for their distrust, he said. The obligation is on health institutions to first show they are trustworthy: to listen, take responsibility, show accountability and stop making excuses. That, he added, means providing information about the vaccine without being paternalistic and making the vaccine easy to access in Black communities.
“Prove yourself trustworthy and trust will follow,” he said.
Published in DailyNurse courtesy of KHN (Kaiser Health News), a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
Nurse of the Week, Carla Brown, RN, accompanied by a colleague clutching a clipboard to her chest, is standing outside a house in her North Baton Rouge, LA neighborhood. “You seem kind of impatient when you get to these doors to talk to these people…” a CBS reporter remarks. “Yes,” Brown replies, “Because I feel the urgency… Today I could see you, and tomorrow, you may not be here.”
Carla Brown does not have time for nonsense. These days, in addition to her work as an RN in a hospice, Brown has also donned the mantle of a community nurse. After experiencing her own tragic Covid loss, she’s managing her grief by doubling down on what nurses do best: helping people. Now, when not on duty at the hospice, Carla is on duty in her majority-Black North Baton Rouge area, pounding the pavement (nurses are also expert walkers!) and signing up neighbors for Covid-19 vaccination appointments. And when her elderly or disabled “patients” cannot reach a vaccination site, Brown swings by in her car and drives them there.
Her own loss was the nightmare of every frontline nurse. After Brown unknowingly contracted an asymptomatic case of Sars-CoV-2 at work, she came home and infected her family with the virus. The consequences were devastating. Carla’s husband, “the love of my life, David,” fell ill, as did her 90-year-old father, and 67-year-old brother. All three—husband, father, and brother—had to be hospitalized. Her spouse, David Brown, died in the hospital at age 67.
The grim statistics in the Baton Rouge vaccination efforts against Covid-19—that 64% of the white population has had at least one shot, while just 26% of the city’s Black community have had jabs—gave the bereaved Carla a new purpose: “All I can do now,” she says, “Is save somebody else.”
The vast discrepancy between white Baton Rouge and Black Baton Rouge has less to do with vaccine hesitancy than it does with our old familiar frenemy, structural racism. North Baton Rouge (NBR) has long been underserved by the local healthcare system, and the Covid vaccines have been strangely scarce in the area. Aside from a few ephemeral pop-up vaccination sites that have been hosted by Black churches, vaccines have been available at only four sites in the district.
To attack the vaccine scarcity problem, Carla employed some special artillery. Clad in her hospice uniform, the undaunted RN stepped into a popular neighborhood pharmacy—with a CBS reporter and camera crew in tow—and asked to speak with the owner. She told the proprietor that she could provide the completed registrations, insurance paperwork, and ID confirmations for NBR locals who have been won over by her urgent campaign. “We just need,” she said, “Somebody to supply us with the vaccine.”
The result? Well, it is hard to dismiss nurse Brown even when she is not accompanied by a news team from a major national broadcasting network. In fact, after agreeing to order vaccine ASAP, the pharmacist implied he had little choice: “She’s an angel!” he said of Carla. “An angel in disguise.”
A tough angel, though. As Brown told a local station in Baton Rouge, “You want to go to your grave early, or you want to live? That’s been my sales pitch.” And when walking the streets and knocking on doors doesn’t get results, “Some [neighbors] I just physically took in my car and brought.”
In the hospital with covid-19 in December, Lavina Wafer tired of the tubes in her nose and wondered impatiently why she couldn’t be discharged. A phone call with her pastor helped her understand that the tube was piping in lifesaving oxygen, which had to be slowly tapered to protect her.
Now that Wafer, 70, is well and back home in Richmond, California, she’s looking to her pastor for advice about the covid vaccines. Though she doubts they’re as wonderful as the government claims, she plans to get vaccinated anyway — because of his example.
“He said he’s not going to push us to take it. It’s our choice,” Wafer said, referring to a recent online sermon that praised the vaccines as God-given science with the power to save. “But he wanted us to know he’s going to take it as soon as he can.”
Helping people accept the covid vaccines is a public health goal, but it’s also a spiritual one, said Henry Washington, the 53-year-old pastor of The Garden of Peace Ministries, which Wafer attends.
Clergy must ensure that people “understand they have an active part in their own salvation, and the salvation of others,” said Washington. “I have tried to suggest that taking the vaccine, social distancing and protecting themselves in their household is something that God requires us to do as good stewards.”
Many Black Americans look to their religious leaders for guidance on a wide range of issues — not just spiritual ones. Their credibility is especially crucial on matters of health, as the medical establishment works to overcome a legacy of experimentation and bias that makes some Black people distrustful of public health messages.
Now that the vaccines are being distributed, public health advocates say churches are key to reaching Black citizens, especially older generations more vulnerable to severe covid disease. They have been hospitalized for covid and died at a disproportionate rate throughout the pandemic, and initial data on who is getting covid shots shows that Black people lag far behind other racial groups.
Black churches have also suffered during the pandemic. African American pastors were most likely to say they had had to delete positions or cut staff pay or benefits to survive, and 60% said their congregations hadn’t gathered in person the previous month, as opposed to 9% of white pastors, according to a survey published in October by Lifeway Research, which specializes in data on Christian groups.
Washington’s 75-member church is in Richmond, which has the highest number of covid deaths in Contra Costa County, outside of deaths in long-term care facilities. The very diverse city, across the bay from San Francisco, also has one of the lowest rates of vaccination.
Offerings to Washington’s church plunged 50% in 2020 due to job loss among congregants, but he’s weathered the pandemic with a small-business loan and a second job as a general contractor remodeling bathrooms and kitchens.
To combat misinformation, he’s been meeting virtually with about 30 other Black pastors once a month in calls organized by the One Accord Project, a nonprofit that organizes Black churches in the San Francisco Bay Area around nonpartisan issues like voter registration and low-income housing. Throughout the pandemic, the calls have focused on connecting pastors with public health officials and epidemiologists to make sure they have the most up-to-date information to pass on to their members, said founder Sabrina Saunders.
The African American church is an anchor for the community, Saunders said. “People get a lot of emotional support, people get resources, and their pastor isn’t just looked upon as a spiritual leader, but something more.”
And guidance is needed.
The share of Black people who say they have been vaccinated or want to be vaccinated as soon as possible is 35%, while 43% say they want to “wait and see” the shots’ effects on others, according to a KFF survey. Eight percent say they’ll get the shot only if required, while 14% say they definitely won’t be vaccinated. Among whites, the first two figures are 53% and 26%, respectively; for Hispanics, 42% and 37%. (KHN is an editorially independent program of KFF.)
Among the “wait and see” group, 35% say they would seek information about the shots from a religious leader, compared with 28% of Hispanics and 14% of white people.
Grassroots outreach to Black churches happens in every public health emergency, but the pandemic has hastened the pace of collaboration with public health officials, said Dr. Leon McDougle, assistant dean for diversity and cultural affairs at the Ohio State University College of Medicine. The last time he saw such a broad coalition across Black churches, medical associations, schools and political groups was during the HIV/AIDS epidemic in the 1980s.
“This is at an entirely different level, though, because we’ve had almost half a million die in a year,” McDougle said of the covid pandemic.
Historically, no other institution in African American communities has rivaled the church in terms of its reach and the trust it enjoys, said Dr. Paris Butler, a plastic and reconstructive surgeon at the University of Pennsylvania Health System. Last month, he and a colleague spoke to leaders from 21 churches in Philadelphia to answer basic questions about how the vaccine was produced and tested.
“Being an African American myself, and growing up in a Baptist church, I understand the value of that trusted voice,” Butler said. “If we don’t reach out to them, we’re making a mistake.”
Leaders with massive social media followings, like Bishop T.D. Jakes, are also weighing in, publishing video conversations with experts including Dr. Anthony Fauci to inform followers about the vaccines.
Church attendance is waning among young Black adults, as it is for other races. But elders can set examples for younger people undecided about the vaccine, said Dr. Judith Green McKenzie, chief of the division of occupational medicine at the University of Pennsylvania’s Perelman School of Medicine.
“When they see their grandma go, they may say, ‘I’m going,’” she said. “Grandma got this two months ago and she’s fine.”
Encouraging vaccine trust is delicate work. The Black community has reason to be skeptical of the health system, said Eddie Anderson, the 31-year-old leader of McCarty Memorial Christian Church in Los Angeles. In one-on-one conversations, congregants tell him they fear being guinea pigs. The low vaccine supply also makes Anderson hesitate to recommend, from the pulpit, that members get the shot as soon as they’re able. He fears frustration with difficult online sign-ups would further sap motivation.
“I want to do that when it’s readily available,” he said. “I want to preach it, and then within a weekend a family can actually go get the vaccine.”
Despite the doubts and fears, Anderson said the majority of his 125-member congregation, about half of whom are senior citizens, want the vaccine, in order to be with loved ones again. One older member is desperately seeking a vaccine appointment so he can help his daughter, who is going through cancer treatments. But the online sign-up process is confusing and nearly impossible for his followers, Anderson said.
For now, he’s focused on asking several vaccinated members to write down everything about their experience and share it on social media. He also plans to record them talking about their shots — and to show that many people of different races were in the same vaccine line — and will broadcast the videos during church announcements.
While he can’t tell people what to do, Anderson hopes he can remove any potential spiritual barriers to the vaccine.
“My biggest fear is for someone to say, ‘I didn’t get vaccinated’ or ‘I didn’t get a test’ because it’s against [their] faith, or because I don’t see that in the Bible,’” he said. “Any of those arguments, I want to get those off the table.”
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