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The Racial Disparities, Systemic Racism Behind Who Has Received Vaccines

A MARTINEZ, HOST:

We've been reporting for a while, actually, on vaccine hesitancy among Black Americans. Thing is, a recent NPR/Marist poll found that they are not especially hesitant. About equal proportions of Black and white respondents said they don't plan to get a COVID-19 vaccine. Yet in many states, there are racial disparities in who has received the shot. Dr. Rhea Boyd is a pediatrician and public health advocate in the Bay Area of California. Doctor, you wrote in The New York Times that the primary barrier to COVID-19 vaccination is access, not hesitancy. But, Doctor, why do you think all we seem to hear about is all about how Black Americans are vaccine hesitant?

RHEA BOYD: You know, it's a great question. It's a question that I ask myself. You know, I wonder if it is a part of the same ways that we sometimes blame individual patients or patients of color, like Black folks in particular, for many of their health ailments. We say, the reason that you have higher rates of diabetes or higher rates of heart disease is your own individual choices. You know, your cultural choices to choose what to eat shapes your disparity rather than the structural environment around you that might place you in a food desert. I think, in health care, we have had an analysis of what drives racial health inequities that centers on individuals rather than on our systems. And that has led us not to really confront racism as a cause of racial health inequities, including right now during the vaccine distribution.

MARTINEZ: You wrote that access matters and that when Black people are given the opportunity, they do get vaccinated. So when it comes to vaccine access or a lack of it, describe exactly what you mean by that.

BOYD: Yeah. As a pediatrician, I know that Black parents vaccinate their kids. So back in the 1990s, our federal government said, let's eliminate cost as a barrier to vaccination for children. And they created the Vaccines for Children program. That program then saw narrowing racial health inequities throughout the '90s. And by 2005, there were no gaps between Black children and other racial and ethnic groups for receipt of regularly recommended vaccines like MMR and polio. When Black parents had the opportunity to vaccinate their children, they do vaccinate them.

MARTINEZ: So maybe the bigger problem is an access to information, a lack of access to information. But you know this as well as I do, misinformation about vaccines in general predates all of this. So how do you overcome that?

BOYD: Exactly. This is why Black health care workers across the country and I started working to create an information campaign just for Black folks about the COVID vaccines before a single vaccine had emergency use authorization. We knew that there were already baseline information gaps about how vaccines work and particular concerns that folks in the Black community had about this vaccine's development and their safety. Their concern is shared across all racial and ethnic groups. And so we put together a campaign to actually tackle that misinformation so that when folks make the choice about vaccination, they can make an informed one.

MARTINEZ: And that campaign is called The Conversation: Between Us, About Us. And then, Doctor, thinking about things long-term, thinking after this pandemic and, maybe, before the next one, how do we ensure efforts to improve access to health care for Black Americans remain ongoing?

BOYD: Yes. This is a critical question. So we know that in this country, one out of five Black adults are unlikely to have a regular provider. They don't have somebody that they go to who they trust for their clinical care. We also know Black folks have some of the highest rates of un-insurance and underinsurance. And so those are easy solutions that we can target right now to ensure that we expand the network of our health care services. Place primary care clinical sites right in Black communities. Make going to the doctor in the United States free. Cover it for people, particularly people who we know have suffered from the chronic effects of racial segregation and chronic discrimination, which shapes health outcomes. I think that would go a long way in ensuring that our health system no longer undertreats the needs of communities of color and Black folks in particular.

MARTINEZ: That's Dr. Rhea Boyd, pediatrician in the Bay Area of California. Doctor, thanks a lot.

BOYD: Thank you so much for having me. Transcript provided by NPR, Copyright NPR.