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Monday, September 27, 2021

UC Davis Health Novavax vaccine trials prioritize high-risk populations including minority groups

UC Davis Health Novavax vaccine trials prioritize high-risk populations including minority groups 

As UC Davis Health begins phase three of testing the Novavax vaccine, researchers are prioritizing participants from communities that have been severely affected by COVID-19 for their clinical trial, including Latino, African American and Native American populations, according to a recent press release. Loralyn Taylor, a lecturer in the public health science department at UC Davis, expressed how the pandemic has not only brought to light already existing health disparities faced by minority groups, but has also increased their severity.

Taylor explained how social determinants of health—such as education, economic stability, access to healthcare, culture and where one lives—are the driving forces of health disparities. For example, from an economic stability standpoint, Taylor stated certain populations are at higher risk for contracting COVID-19 based on where they work. Service industry workers, who tend to be minorities, are often forced to work and unable to social distance. She added that in her hometown of Napa, CA, many outbreaks of COVID-19 occur among farm workers because they must work in the vineyards and often live in close quarters with others in farmworker housing. 

“We already have these inequities and disparities in our country, and COVID-19 has really amplified that and is showing us how much those determinants matter, and how much historically they’ve already affected health and are continuing to affect health,” Taylor said.

In addition to one’s workplace, other factors that put minority groups at risk are a lack of access to healthcare, tendency to live in multi-generational homes and chronic health conditions. Taylor expressed how it is important to consider how intersectionality plays a role in the health outcomes of these groups. For example, a person of color who is young and healthy likely experiences the pandemic differently from a person of color who is older and has a chronic health condition.

“People aren’t just their race,” Taylor said. “They’re also their age and their socioeconomic status and their health status. So, I think thinking about that too and the intersectionality of how those compete together in the COVID-19 pandemic is important.”

Prachi Verma, a fifth-year global disease biology major and co-director of social services at Bayanihan Clinic, added that these social determinants of health can be thought of as symptoms of the systemic inequities and structural racism that currently exist in society. Although she believes it is hard to see the direct impact this inequity has on patients, studying health disparities can help one realize the larger umbrella under which these issues exist. 

“When things like systemic oppression, racism, the diversity of patients and inequity aren’t addressed, it promotes the idea that structural inequities have no impact on health and a patient’s access to health,” Verma said.

Through her social service work in Bayanihan Clinic, Verma has learned the value of listening to patients’ stories of how different factors, such as lack of transportation or stable housing, impact patients’ health and access to healthcare. She explained that by recognizing the history of the Filipino community and understanding the role this history plays in a patient’s living situation or income, the clinic strives to provide treatments catered to specific patients. For example, if it is known that a patient has financial challenges, the clinic’s staff make an effort to find cheaper prescriptions that the patient may be able to afford. 

Verma believes that understanding structural inequities, diversity and cultural humility are all important in order to ensure patients receive culturally sensitive and relevant care. 

“Without understanding the diversity in communities’ cultures and history and experiences and circumstances, patients don’t receive the care that’s relevant to their specific situation, and then overall care and overall outcomes are ineffective and unsuccessful,” Verma said. “Then lower quality of care can reinforce mistrust in healthcare and medicine, and then that in turn can lead to patients avoiding seeking healthcare and then that leads to further inequities and it just becomes a cycle.”

Statistics increasingly show minority groups disproportionately being affected by COVID-19 compared to white people. According to a recent article by National Public Radio (NPR), the Centers for Disease Control and Prevention (CDC) recently released data that Latino, African American and Native American populations are being hospitalized at rates 4.5 to 5.5 times higher than non-Hispanic white people. 

Taylor expressed that when looking at these statistics, it is important to consider the proportion of the population that has COVID-19 in comparison to the number of people of that race that live in the country. In the same article by NPR, data shows non-Hispanic white people contribute to 61.1% of the population and 51.1% of COVID-19 deaths while African American and Hispanic populations, which contribute to 12.3% and 17.8% of the U.S. respectively, each account for 21.1% of COVID-19 deaths. 

“I have to believe that [these statistics are] both a result of things that have come about like being forced to work or needing to work and not being able to work from home, and preexisting conditions or those social determinants of health that put them at greater risk,” Taylor said.

Despite the health disparities these minority populations are facing, Taylor described how these groups have historically been left out of many treatments. She commended UC Davis for acknowledging that such disparities exist and that these populations should receive front-of-the-line prevention. 

“Minorities and people who experience health disparities are less likely to get access to healthcare—less likely to get access to new treatment,” Taylor said. “So putting them at the front of the line is great in the sense that you’re trying to bypass that historic disparity of them not having access.” 

In order to address these health disparities, Taylor expressed the importance of educating oneself using reputable sources and speaking up when it is apparent that something is inequitable. Verma added that a large part of action and advocacy is awareness. She encourages students to uplift the voices of marginalized community members and listen to their stories to better understand the systemic and structural inequities they face. Taylor also advocates for change at the state and federal level to make sure healthcare can be accessible to all. 

“We need to make sure people have access [to healthcare],” Taylor said. “The big problem we’re seeing in the U.S. is especially in these rural communities, they may not have access to a health provider. Just because we give them health insurance doesn’t mean they can then access it. So I think affordable and accessible healthcare will really help with health inequities.”

Written by: Michelle Wong — science@theaggie.org


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