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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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Case Study
The NYC Department of Health and Mental Hygiene partnered with 45 businesses or faith-based organizations in the Northeast Bronx to increase COVID-19 and flu vaccine knowledge and uptake in predominantly Black and Hispanic areas. The program disseminated health information through trusted community leaders to address vaccine hesitancy. ZIP codes with higher involvement in the program showed greater increases in vaccination rates.
Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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Peer Review Study
A retrospective registry-based chart review examined the various demographic and clinical risk factors associated with COVID-19 severity among patients aged 18-29. The study was done within a metropolitan health care system in Houston, TX. In the cohort of 1,853 young adult patients diagnosed with COVID-19 infection at a hospital encounter, including 226 pregnant women, 1,438 (78%) scored 0 on the Charlson Comorbidity Index, and 833 (45%) were obese (≥30 kg/m2). Within 30 days of their diagnostic encounter, 316 (17%) patients were diagnosed with pneumonia, 148 (8%) received other severe disease diagnoses, and 268 (14%) returned to the hospital after being discharged home. In multivariate logistic regression analyses, increasing age, male gender, Hispanic ethnicity, obesity, asthma history, congestive heart failure, cerebrovascular disease, and diabetes were predictive of severe disease diagnoses within 30 days. Non-Hispanic Black race, obesity, asthma history, myocardial infarction history, and household exposure were predictive of 30-day readmission.
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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Peer Review Study
Asabor and colleagues investigate the relationship between levels of segregation and the distribution of testing sites in four cities. Segregation refers to the extent of distance between neighborhoods of color and White neighborhoods. The highest levels of segregation are between Blacks and Whites, however, there is segregation between other communities of color and White communities. The authors compiled a list COVID-19 testing sites per Census tract through June 2020. And, in parallel, Asabor and colleagues identified the four most segregated cities in the U.S. in order to conduct a focused analysis. These cities are: New York, Los Angeles, Houston, and Chicago. In New York, Houston, and Chicago, there is an inverse relationship between percentage of Blacks in a Census tract and the number of testing sites. And, in Chicago, Houston, and Los Angeles there is a similar negative relationship for Latinx.
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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Peer Review Study
Latkin and colleagues conducted a nationally representative survey in May 2020 to examine opinions regarding vaccine hesitancy. The key outcome measure asked: if and when available, would you plan on getting the vaccine. A key set of covariate measures focused on COVID-19 prevention behaviors such as staying away from large groups, wearing a mask when leaving home, and washing hands more frequently. Additional covariates included knowing a close relative or friend who has contracted COVID-19 and how worried are you that you or someone in your family will get infected with COVID-19. Compared to White participants, Black and Hispanic respondents were significantly more likely to report that they did not intend to obtain a COVID-19 vaccine. In addition, compared to those who reported positive vaccine intentions, respondents with negative vaccine intentions were significantly less likely to report that they engaged in the COVID-19 prevention behaviors of wearing masks and social distancing.
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
Youth nationwide face new intensified stressors like illness, death, social isolation, economic stress, food insecurity, family hardship, and increase domestic violence risk. These stressors are associated with outcomes like depression, behavioral problems, anxiety disorders, and worsened existing mental health conditions. School-based health centers (SBHCs) are a cost-effective health care delivery model that increases mental and behavioral health access and use. SBHC patients live in underserved communities and are at a greater risk for mental health issues. The qualitative data from this study highlight increased demand for mental health services and a lack of resources to meet this demand, resources to ensure universal telehealth technology access are needed to improve health care access for youth, and parental buy-in and support are crucial component of sustained care.
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
This report details the immense toll the COVID-19 pandemic has taken, and continues to take, on Black communities. The report’s authors – physicians and public health and policy experts – note massive disparities experienced by Black Americans. The worse outcomes, are a predictable result of structural and social realities. The predicates that caused these disparities have long been present. These are cycles we have to break. The report highlights areas for immediate focus and attention, and presents a set of expert-generated recommendations for action.