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Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Other
This episode from the podcast 99 Percent Invisible reflects on how the COVID-19 pandemic exposed the American public to a long-standing problem: the disjointed nature of the U.S. health system. Because state and local health departments largely operate independently and use their own data collection and analysis tools, health systems across the country lack standardized data definitions and systems. These inconsistencies made it nearly impossible to collect and analyze comprehensive, standardized data on COVID-19 cases, deaths, and vaccines administered amid the pandemic. Health experts featured on this episode believe that the pandemic made the need for an overhaul of America’s informatics system very apparent. When rebuilding this system, it’s important to focus on remedying existing inequalities in data collection and classification that in some cases render the health status of certain populations – think Native American communities and other communities of color – completely invisible in the data. By virtue of being small populations, it can be difficult for health departments to collect sufficient and/or statistically significant data on minority communities. Another issue discussed in this episode is the use of broad racial categories like “other,” “multiple races,” or even “Asian American,” which, if not disaggregated, obscures the health status of diverse populations who are grouped under the same category. Without comprehensive and inclusive health data, it’s difficult to identify disparities and implement policies and programming that promote social mobility and health equity.
Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Systematic Review/Meta-Analysis
This review of state data collection and reporting practices during the COVID-19 pandemic found inconsistencies and gaps in data collected by race and ethnicity. Improved standardization across the U.S.–which may come in the form of a federally-operated centralized database–would address some of the concerns in data representation of all Americans.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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White Paper/Brief
This brief lists interventions to support state public health efforts to address rural disparities and racial discrimination. It emphasizes the importance of localized data on social determinants of health and improving systemic and structural underpinnings of racial disparities. Suggested interventions address data collection and workforce issues, including representativeness and paid family leave.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Case Study
The Massachusetts Executive Office of Elder Affairs (EOEA) oversees programs and services for older adults through the aging service network, and worked closely with the COVID-19 command center during the COVID-19 pandemic. EOEA worked with senior affordable housing providers and advocated for vaccines for older adult populations. They also used their network to disseminate COVID-19 information to older adults, caregivers, and those working directly with older adults.
Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Case Study, Peer Review Study
Practice involves using “get out the vote” (GOTV) outreach strategies, conventionally used in political campaigns, along with mobile pop-up vaccine clinics, to encourage vaccination among marginalized communities.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This study sought to assess the correlation between population and spatial characteristics of COVID-19 by examining positive COVID-19 data from New York City with ZIP Code Tabulation Areas to determine what social determinants of health increase an individual’s risk of contracting COVID-19. Results showed that neighborhoods with larger proportions of Black people, people older than 65, people with heart disease, and people living in densely populated housing are at higher risk of contracting COVID-19.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This study assessed vaccine hesitancy in the United States by looking at Census Bureau’s Household Pulse Survey data. The study looked at race and ethnicity for individuals who have received at least one COVID-19 vaccine dose by June 2021, but also looked at other socioeconomic factors such as access to healthy food, insurance status, and state-level political differences. The results found that while initial race/ethnicity analyses shows Black adults are more likely to not get vaccinated for COVID-19 than White adults, once other social factors were included, these differences were no longer significant. Additionally, insurance status and food insufficiency were not seen as significantly associated with vaccination hesitancy, but political differences does create an impact in overall state vaccination rates.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This article examines a cohort study of children in England to determine a possible association between COVID-19 testing rates, COVID-19 mortality rates, and race. Results found that Asian and Black children experienced race-specific disparities when compared to white children, with white children receiving more COVID-19 testing, but Black and Asian children experiencing worse outcomes, including hospitalization, ICU admission, and death.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Peer Review Study
This study looks at the perceptions, challenges, barriers, and experiences of undocumented immigrants in the U.S. The study used a snowball sampling of 20 undocumented Asian and Latinx men and women and asked them a series of questions about access to health care and their experience during the COVID-19 pandemic. The results found significant barriers in language comprehension, mistrust of public systems, and socioeconomic factors such as employers with little to no sick leave for those affected by COVID-19.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Summary Report/Recommendations
In this project, RAND Corporation researchers identified existing health equity measurement approaches that might fit with Medicare’s VBP programs, quality reporting efforts, and confidential reports. The project had two objectives: identify health equity measurement approaches, and decide which of these approaches merit consideration for inclusion in Medicare’s VBP programs, quality reporting efforts, and confidential reports. This report describes the methods and findings of the project and delineates potential first steps for the U.S. Department of Health and Human Services to consider as it continues to evaluate the prospect of incorporating health equity measures and domains in Medicare’s VBP and reporting programs.