Think back to the early days of the Covid-19 vaccine rollout. Many Black people in the United States were initially hesitant to get the shot and faced greater barriers to accessing it than the general population. Data from February 2021 showed less than 6 percent of Black people had received the vaccine compared with more than 60 percent of their white counterparts.
Now consider the picture today. In just one year, starting in the summer of 2021, Black adults went from among the least vaccinated groups to among the most vaccinated. Coronavirus death rates are now lower for Black people than they are for white people.
How did public-health leaders disrupt decades-old racial health disparities to produce this successful outcome for Black adults? And what can philanthropy learn from the experience?
The short answer is that a typically slow-moving process was accelerated as the health community scrambled to prevent the devastating consequences of very low vaccination rates. Nonprofit and philanthropic groups, government agencies, and businesses bypassed longstanding, time-consuming planning methods and deployed resources at record speed. Matching speed to need required grant makers to increase support of local, community-based groups whose vaccination efforts proved remarkably effective.
Did philanthropy leaders like the two of us (David is CEO and Jeniffer is head of health equity at the Siemens Foundation) suddenly attain the wisdom to trust these local leaders to get the job done? Or were we forced to turn to them because we feared what would happen if we moved too slowly and had to explain our actions later? Our guess is a combination of both.
Whatever the reason, working together in a crisis revealed that the public-health community could act quickly to achieve results and change the trajectory for millions of Black people. With the recent end of the Covid-19 national emergency, philanthropy should build on those lessons by adhering to the following three strategies.
Empower trusted community leaders. The reliance on credible messengers with deep community ties helped overcome a major barrier to vaccination: longstanding distrust of health care institutions among Black people. Unlike in the past, grant makers put these organizations in charge, supporting them and following their lead, rather than merely gathering information from such groups and then making their own decisions about what was needed.
For example, the nonprofit Choose Healthy Life, a coalition of Black clergy in New York, Chicago, Atlanta, and several other cities, played an instrumental role in addressing vaccine hesitancy in communities where churches are highly trusted institutions. Clergy started by simply asking their congregants directly about their concerns with the vaccine and then providing regular up-to-date information they could trust — an approach gleaned from their experience working with Black communities during the HIV/AIDS epidemic.
With philanthropic support, including from the Siemens Foundation, Choose Healthy Life partnered with more than 150 local leaders to devise ways to improve vaccination rates in their communities, including directing people to Federally Qualified Health Centers, which offer care to anyone regardless of health insurance status or ability to pay. Working with United Way of New York City, Choose Healthy Life was even able to advance workforce development during the pandemic by training community members to serve as health navigators, who connect people with wellness and diagnostic services.
Focus on face-to-face outreach. Public-health campaigns traditionally devote considerable attention to developing the right messaging and slogans. Even before the pandemic sparked an increase in virtual gatherings, social media and other digital platforms were increasingly used to spread public-health messages. But tackling the challenges of quickly vaccinating millions of people revealed why face-to-face outreach is so important.
Somewhat ironically, the clergy of Choose Healthy Life modeled how to stop preaching and start listening. They showed that being physically present for people and offering empathy is far more powerful than telling them what they need to do.
Clergy members tailored their approaches to their individual congregations. In some cases, that meant acknowledging from the pulpit congregants’ reservations about the vaccine. In other instances, it required being seen wearing a mask, getting tested, and receiving a vaccine. Preachers went the extra mile and did what it took, whether that was going door to door, arranging transportation to a vaccination site, or even setting up vaccination fairs in their churches.
Strong health care messages are important, and social media can be a highly effective outreach tool. But giving people the chance to be heard and understood seemed to matter a lot more when it came to convincing people to get the Covid-19 vaccine.
Don’t wait for crisis moments to develop partnerships. The Siemens Foundation, which supports workforce training and education, had not focused on health equity before the pandemic. Fortunately, when the crisis hit, we were able to draw on the relationships and expertise of staff who previously worked on health-equity issues at other foundations.
Without those relationships, finding our way in this new territory would have been difficult. To successfully address health disparities, foundations must forge trusted partnerships. Crisis moments are not the right time to do this. Why? Because as became evident during the pandemic, such moments require the health community to move fast and, if necessary, cut through red tape.
Grant makers who sustain trusted partnerships with community groups as a core, long-term priority will be ready to act quickly when the next health crisis arrives and as efforts to address health disparities continue. These strong partnerships are most often the product of diverse staffs and boards composed of people who are experienced and credible with the communities the foundation aims to serve.
Philanthropy needs to fully adopt what worked during the pandemic and avoid reverting to the old ways. The role of foundations is to make the right connections with trusted leaders, learn from them, and then give them adequate resources to deliver the desired results.
While racial health disparities have narrowed for Covid-19, they remain stubbornly wide in far too many other areas. Black adults are nearly twice as likely as white adults to develop Type 2 diabetes. They are 30 percent more likely to die from heart disease or to have asthma, and 50 percent more likely to have a stroke.
The coronavirus success story in Black communities shows that addressing racial health disparities is possible. Now, as the challenges of the pandemic recede, let’s apply what we’ve learned and commit to shaping a healthier future for all Americans.
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