State Health and Value Strategies (SHVS), in partnership with Manatt Health, Georgetown’s Center on Health Insurance Reforms (CHIR), State Health Access Data Assistance Center (SHADAC), Bailit Health, and GMMB developed this resource page to serve as an accessible “one-stop” source of COVID-19 information for states. This resource is designed to support states seeking to make coverage and essential services available to all of their residents, especially high-risk and vulnerable people, during the COVID-19 pandemic. SHVS will update this page frequently with new resources as they become available.
| If you have materials you are willing to share with other states through this page, or if there are topics of particular concern that you would like addressed, please contact SHVS. |
Oregon’s Race, Ethnicity, Language and Disability Summary Novel Coronavirus (COVID-19)
The plan provides officials with the tools to create, implement, and support a vaccination campaign that works with BIPOC communities to remedy COVID-19 impacts
The rollout of vaccines designed to end the coronavirus (COVID-19) crisis has begun in earnest across the United States. Currently, each state is responsible for determining how to allocate, distribute, track, and report its vaccine allotment from the federal government, although the federal government is expected to take on a larger role under a new Biden administration. Since the beginning of the pandemic, Black, Indigenous, and other people of color have been disproportionately impacted by both higher risks of infection and poorer health outcomes, and many are concerned that an inequitable or inefficient distribution of the COVID-19 vaccine may further widen health inequities among these populations. One way to help ensure the equitable administration of COVID-19 vaccine is to track vaccine administration disaggregated for key subpopulations, such as gender, race and ethnicity, and geography (e.g., urban vs. rural). This expert perspective reviews the data states are currently publicly reporting related to vaccine administration and provides an interactive map that explores the extent to which all 50 states are reporting vaccine administration data breakdowns by age, gender, race, ethnicity, provider type, and level of geography. The expert perspective also discusses what current data sources states are using to provide this information and provides an overview of options states can consider to collect information about the administration of COVID-19 vaccine in populations via survey data.
The presidential transition and the incoming Biden-Harris administration’s commitment to addressing the equity issues associated withtheCOVID-19pandemicprovide an opportunity to identify programmatic and policy approaches that can ensure the kind of participation in containment and prevention strategies that will address the disproportionate disparities we see every day.
This paper identifies the services that are essential to an equity-centric approach totheCOVID-19pandemic, as well as the infrastructure and workforce needed to ensure these services are available and have an equity focus.It reviews a set of administrative and legislative steps that the new presidential administration can take to strengthen the immediate response to the pandemic and address the long-term health and social needs the pandemic has exacerbated. Finally, it offers a strategy for “building back better” in the long term.
Demographic Characteristics of Persons Vaccinated During the First Month of the COVID-19 Vaccination Program
A national, ongoing survey explores deep-rooted views of those with low and middle incomes, with a focus on people of color, on health, equity and race.
Nationwide, the U.S. vaccination rollout has been plagued by data gaps, which threaten to make it harder to hold leaders accountable for their goals, obfuscate if and when we reach the long-sought goal of herd immunity, and erode public confidence in the entire vaccination process.
On January 12, House Ways and Means Chairman Richard E. Neal (D-MA) released a staff report, titled “Left Out: Barriers to Health Equity for Rural and Underserved Communities” that analyzes the barriers to health care in underserved communities and discusses the challenges associated with scalable and sustainable solutions. From massive geographic coverage deficiencies to structural environmental factors, the report examines the realities millions of Americans face that adversely affect their health.
The rollout of vaccines designed to end the coronavirus (COVID-19) crisis has begun in earnest across the United States. Currently, each state is responsible for determining how to allocate, distribute, track, and report its vaccine allotment from the federal government, although the federal government is expected to take on a larger role under a new Biden administration. Since the beginning of the pandemic, Black, Indigenous, and other people of color have been disproportionately impacted by both higher risks of infection and poorer health outcomes, and many are concerned that an inequitable or inefficient distribution of the COVID-19 vaccine may further widen health inequities among these populations. One way to help ensure the equitable administration of COVID-19 vaccine is to track vaccine administration disaggregated for key subpopulations, such as gender, race and ethnicity, and geography (e.g., urban vs. rural). This expert perspective reviews the data states are currently publically reporting related to vaccine administration and provides an interactive map that explores the extent to which all 50 states are reporting vaccine administration data breakdowns by age, gender, race, ethnicity, provider type, and level of geography. The expert perspective also discusses what current data sources states are using to provide this information and provides an overview of options states can consider to collect information about the administration of COVID-19 vaccine in populations via survey data.
As health inequities continue to be exacerbated by the COVID-19 pandemic, there is concerted energy to address this topic across states. Oregon has had a longstanding focus on health equity and employed two foundational strategies that can serve as examples for other states seeking to further their health equity efforts. Oregon first developed a common language and defined what “health equity” meant in the state. The state also engaged community partners to ensure that the community voice was apparent in policy decisions on the state level. When combined, these strategies have helped Oregon develop a foundation to build and implement subsequent health equity efforts in the state.
This paper identifies the services that are essential to an equity-centric approach to the COVID-19 pandemic, as well as the infrastructure and workforce needed to ensure these services are available and have an equity focus. It reviews a set of administrative and legislative steps that the new presidential administration can take to strengthen the immediate response to the pandemic and address the long-term health and social needs the pandemic has exacerbated. Finally, it offers a strategy for “building back better” in the long term.
As the nation awaits the arrival of a COVID-19 vaccine, local and state health officials are making plans to distribute the vaccine. This webinar will examine: 1) legal issues arising from devising equitable and efficient vaccine allocation plans, including the relevance of ongoing emergency declarations, potential legal challenges to allocation plans, and available liability protections for manufacturers and health care practitioners; and 2) the process used by governmental agencies when considering recommending a novel vaccine.
The COVID-19 pandemic has highlighted longstanding health inequities which have resulted in an increased risk of sickness and death for people of color. The crisis has also propelled a nationwide focus on understanding and addressing health inequities. While COVID-19 and the reckoning on racial justice have mobilized some state officials working in Medicaid, public health, insurance departments, and Marketplaces, alike, states are at different places on their journeys to confront systemic racism and inequities in health care, and each faces unique and challenging barriers. This issue brief explores impediments and accelerants to advancing health equity as states are increasingly being called upon to drive change.
California has developed a health equity metric to ensure California reopens its economy safely by reducing disease transmission in all communities.
HHS announced that 389,040 Abbott COVID-19 rapid tests have been distributed at no cost to 83 Historically Black Colleges and Universities (HCBUs) in 24 states. The Abbott test is the only rapid point of care test that does not require instrumentation, produces COVID-19 test results within fifteen minutes, and costs five dollars.
On October 25, HHS announced that, of the 150 million test kits acquired by HHS, 50 million test kits are reserved for direct shipments to congregate care settings such as nursing homes, assisted living facilities, home health, hospice, the Indian Health Service, and historically black colleges and universities (HBCUs).
This expert perspective provides an update on states’ reporting of health equity data related to cases, mortality, hospitalizations, and testing and new state activity related to data collection, including examples of collecting additional data measures and creating taskforces to advance health equity. The post also provides a summary of CARES Act reporting requirements related to testing.
During this COCA Call,Presenters of this webinar discussed the intersection of telehealth and health equity and implications for health services during the COVID-19 pandemic. Presenters identified long-standing systemic health and social inequities that contribute to COVID-19 health disparities, while highlighting opportunities and limitations of telehealth implementation as an actionable solution.
Blog post that explores health inequities tied to lack of access to energy, water and broadband
A report designed to increase consensus around meaning of health equity
A report which gives some practical suggestions for public health departments wanting to become equity focused
An executive plan of action in response to Ohio’s Minority Health Strike Force’s report, “COVID-19 Ohio Minority Strike Force Blueprint,” which addresses racism and promotes long-term health equity through 34 recommendations.
Governor Mike DeWine formed the COVID-19 Minority Health Strike Force on April 20, 2020, in response to the disproportionate impact of COVID-19 on minorities in Ohio. The strike force contracted with the Health Policy Institute of Ohio (HPIO) to develop this “COVID-19 Ohio Minority Health Strike Force Blueprint.”
The Governor of New Jersey signed legislation, S2357, requiring hospitals to report demographic data to the Department of Health, including age, ethnicity, gender, and race of individuals who have tested positive for COVID-19, who have died from COVID-19, and who have tried to get testing but have been turned away.
The state of Michigan established the Michigan Coronavirus Task Force on Racial Disparities, which is charged with identifying the drivers of existing racial disparities in COVID-19 outcomes and recommending policies addressing such disparities. The Michigan Safe Start Plan utilizes public health metrics such as impacts on at-risk populations as criteria to trigger movement into consequent phases of reopening.
As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access the healthcare services they need in as safe a manner as possible. In order to provide our clients with quick and actionable guidance on the evolving telehealth landscape, Manatt Health has developed a federal and comprehensive 50-state tracker for policy, regulatory and legal changes related to telehealth during the COVID-19 pandemic.
In April 2020, Louisiana announced the formation of a COVID-19 Health Equity Task Force. In June 2020, the task force provided recommendations relative to health inequities which are affecting communities that are most impacted by the coronavirus.
Telehealth increases convenience for both the doctor and patient and decreases everyone’s risk of exposure to COVID-19. But telehealth also has limitations, the most obvious of which are that it does not allow for physical exams or lab tests. Less obvious though, is the potential of telehealth to exacerbate health disparities.
Public conversations surrounding COVID-19 health outcomes in Black and Latino communities must address the role of structural racism, including how community trauma, neighborhood disinvestment, and environmental toxins can cause or further exacerbate those conditions, and how these, in turn, are driven by inequities in political power and economic opportunities. This webinar, co-hosted by Families USA and the National Urban League, highlights findings from “The Fierce Urgency of Now: Federal and State Policy Recommendations to Address Health Inequities in the Era of COVID-19”, and discusses how COVID-19 reveals legacies of disinvestment and inequities in communities of color, and how you can take action to organize for justice at the state and federal level.
The second edition of the Health Equity Guide for Public Health Practitioners and Partners is intended to support practitioners and partners engagement in multifaceted approaches to addressing health equity.
COVID-19 has urgently demonstrated that everyone needs to live in safe and healthy communities. The people most affected by COVID-19 are communities of color, people with low income, immigrants, and other underserved groups. These groups are most vulnerable in part because of existing laws and policies that affect the fundamental drivers of health inequities. Communities and local governments that take steps to ensure health, safety, housing, food, and economic stability for all of their residents will be helping to prevent the spread of COVID-19 and laying the groundwork for health equity and prosperity for future generations. To help communities and local governments strengthen their response to COVID-19 and advance health equity, ChangeLab Solutions is publishing a blog series about policies that governments can enact right away.
CDC’s COVID-19 Response Health Equity Strategy broadly seeks to improve the health outcomes of populations disproportionately affected by focusing on four priority areas.
During this COCA Call, Presenters of this webinar discussed the intersection of telehealth and health equity and implications for health services during the COVID-19 pandemic. Presenters identified long-standing systemic health and social inequities that contribute to COVID-19 health disparities, while highlighting opportunities and limitations of telehealth implementation as an actionable solution.
The National Academies National Academies of the Sciences, Engineering, and Medicine (NASEM) published “A Framework for Equitable Allocation of COVID-19 Vaccine”. The 236-page report, which was commissioned by the National Institutes of Health (NIH) and Centers for Disease Control and Prevention (CDC), builds on the shorter “discussion draft” that NASEM released in early September . Four risk-based criteria informed NASEM’s recommendations for how to prioritize vaccine allocation across populations: (1) risk of acquiring infection, (2) risk of severe morbidity and mortality, (3) risk of negative societal impact, and (4) risk of transmitting infection to others. Based on these criteria, NASEM recommends the followed phased approach for vaccine allocation (which closely resembles the phases outlined in the discussion draft):
– Phase 1a (representing an estimated 5% of total U.S. population): First responders, as well as high-risk health workers involved in direct patient care and facility services (e.g., transportation or environmental services).
– Phase 1b (est. 10% of U.S. population): People with two or more health conditions that put them at significant risk of severe illness or death from COVID-19 (per CDC guidelines), as well as older adults living in nursing homes and other congregate settings.
– Phase 2 (est. 30–35% of U.S. population): K–12 teachers, school staff, and child care workers; critical workers in high-risk settings who cannot avoid a high risk of exposure to COVID-19 (e.g., workers in the food supply system or public transit); all older adults not included in Phase 1; people health conditions that put them at moderately higher risk of severe COVID 19 consequences (per CDC guidelines); and people in homeless shelters, group homes for individuals with physical or mental disabilities, incarcerated individuals and detention staff (if not already included in Phase 1).
– Phase 3 (est. 40–45% of U.S. population): Children and young adults under age 30, as well as any essential workers at increased risk of exposure who are not covered in Phases 1 and 2.
– Phase 4: Everyone living in the United States. Individuals who do not fall into the preceding phases include adults between the ages of 30 and 65 who do not work in essential occupations or industries.
While efforts to reduce the spread of COVID-19 have been difficult in all environments, the conditions for those working in agricultural production raise additional challenges. Migrant and seasonal farmworkers, many of whom travel as crops ripen throughout the spring and summer, live and work under conditions that even before COVID-19 posed risks to their safety and wellbeing. This expert perspective examines approaches to addressing the particular risks of COVID-19 faced by farmworkers, provides a survey of state and local policies and outlines some key themes and recommendations for policymakers as they work to support agricultural workers and stem the spread of COVID-19.
This expert perspective provides a survey of actions that state and local governments have taken to intentionally incorporate equity into their recovery and reopening policies.
This expert perspective provides a survey of actions that state and local governments have taken to intentionally incorporate equity into their recovery and reopening policies.
CDC released a new study examining the disproportionate impacts of COVID-19 on American Indians and Alaska Natives (AI/AN) in 23 states between January 31 and July 3. The report found: • The cumulative incidence of laboratory-confirmed COVID-19 cases among AI/AN was 3.5 times that of non-Hispanic whites• Compared to whites, a higher percentage of cases among AI/AN individuals were in people under 18 years of age (12.9 percent AI/AN; 4.3 percent white) • A smaller percentage of cases were among AI/AN individuals who are 65 years or older (12.6 percent AI/AN; 28.6 percent white)
This paper from Families USA and Futures Without Violence urges policymakers to recognize the long term health, social, and economic benefits of upstream investments for children, including those who have experienced trauma, violence or severe adversity, and to fully include children in health care payment and delivery system reform.
This analysis includes several key considerations intended to help state policymakers identify and overcome common barriers associated with integrating and operationalizing CHWs in Medicaid and other state health programs
Considering both the public health crisis and future patient needs, Families USA has assembled state policy recommendations around three themes: 1) improving telehealth financing and implementation models to increase reach; 2) removing provider barriers to increase access to telehealth; and, 3) bridging the digital divide to improve patient access to telehealth services.
This post will present a framework for understanding health disparities during the COVID-19 pandemic, as well as provide short-term and long-term solutions to reduce these disparities.
This expert perspective highlights examples employed by DC Health Link, the Oregon Health Authority, and beWellnm and the community-centered outreach they are using to actively enroll and connect consumers to care. The expert perspective also includes best practices surfaced for marketplaces and agencies to adapt their COVID-19 communications and outreach—and beyond—to ensure those with inequitable access to health coverage are prioritized and supported.
The Committee on Ways and Means Majority at the US House of Representatives authored a report on the stark barriers that communities of color and rural communities face to accessing equitable health care.
HHS’ Office for Civil Rights (OCR) issued guidance to recipients of federal financial assistance on applicable federal civil rights laws and regulations that prohibit discrimination on the basis of race, color, and national origin in HHS-funded programs during COVID-19. In its guidance, OCR identified a range of activities and policies that recipients of federal financial assistance, including state and local agencies, hospitals, and other health care providers, should implement to ensure compliance with Title VI during the public health emergency.
Policy makers can help ameliorate disparities by mandating standardized case and fatality reporting requirements and directing public health agencies to investigate why particular populations, including Asian Americans, face a seemingly heightened risk of death from COVID-19.
Health system leaders and policy makers should take the lead in addressing alarming disparities in COVID-19 deaths.
This memo provides a summary of policy approaches to address the disproportionate impact of COVID-19 on communities of color.
HHS’s Office of Minority Health (OMH) announced the selection of the Morehouse School of Medicine as the awardee for a new $40 million initiative to mitigate COVID-19 in racial and ethnic minority, rural and socially vulnerable communities. The Morehouse School of Medicine will lead the National Infrastructure for Mitigating the Impact of COVID-19 (NIMIC) within Racial and Ethnic Minority Communities initiative– a three-year project designed to engage with national, state, territorial, tribal, and community-based organizations to deliver education and information on resources including COVID-19 testing as well as healthcare and social services. The NIMIC initiative is expected to begin in July and the first award is for $14.6 million.
The Health Opportunity and Equity (HOPE) Initiative, funded by the Robert Wood Johnson Foundation, provides an interactive data tool to help the nation and states to move beyond measuring disparities to spur action toward health equity.
Louisiana Gov. John Bel Edwards announced two co-chairs and appointed members to the Louisiana COVID-19 Health Equity Task Force and several subcommittees.
The COVID-19 pandemic has introduced new challenges for Navigators. To learn more about their experience, and how they are helping consumers manage often unexpected transitions in coverage, this blog post highlights conversations with six navigators across five states using the FFM to hear how they were faring.
The state’s Task Force on Business and Jobs Recovery issued an open letter urging business and civic leaders in California to explicitly address racial disparities and focus their recovery policies on equitable and sustainable solutions.
Targeted testing and contact tracing represent a more ethical approach to lifting pandemic restrictions and opening up the economy given limited test supplies.
The New Jersey COVID-19 Information Hub addresses privacy concerns around contact tracing, including around public charge, in their FAQ page.
New COVID-19 data have revealed that Black families face a much higher risk of contracting and dying from the virus. Residents of majority-Black counties have three times the rate of infection and almost six times the rate of deaths as residents of majority-white counties.This paper examines policy pptions for eliminating structural racism in key aspects of Black families’ lives.
Early evidence suggests there are health disparities based on race, gender, and geography in both the contraction of COVID-19 and deaths related to the virus. People of color and those who live in urban centers are faring worse from this pandemic. These higher rates of illness and death are rooted in longstanding, structural inequities in our country. While these inequities cannot be fixed overnight, states can begin to foster a more equitable and just COVID-19 response, relief, and recovery effort by employing a few key guidelines. This expert perspective poses a series of questions states can use to inform immediate actions to strengthen their initial responses and lay the foundation for broader reforms to advance health equity.
On Thursday, May 7, State Health and Value Strategies hosted a webinar that reported on how states are tracking the disproportionate impact of COVID-19 on vulnerable populations and provided a framework for states to examine their COVID-19 response efforts to yield better outcomes for such populations. As the COVID-19 crisis evolves, it has become increasingly clear that vulnerable populations are disproportionately impacted. Unsurprisingly, these disparately affected groups are the same ones that have long experienced stark health disparities, such as communities of color, low income populations, and those that reside in congregate living facilities (nursing homes, jails, shelters, etc.). During the webinar, technical experts from Health Equity Solutions and SHADAC shared findings from recent SHVS publications.
In an effort to address health disparities, the Governor of North Carolina signed an executive order directing resources to historically underutilized businesses, ensuring equitable distribution of pandemic relief funds, and supporting mass testing of migrant farm workers and food processing plant workers.
The Governor of New Jersey signed legislation requiring hospitals to report demographic data to the Department of Health, including age, ethnicity, gender, and race of individuals who have tested positive for COVID-19, who have died from COVID-19, and who have tried to get testing but have been turned away.
In his vision to restart the state economy, Governor Murphy outlined six key principles to guide the process for restoring New Jersey’s economic health by ensuring public health, which included creating the Governor’s Restart and Recovery Commission to advise on the process and recommend responsible and equitable decisions.
Based on recommendations of the Health Disparity Task Force, Governor Tom Wolf announced the state is now collecting sexual orientation and gender identity data as part of the state’s COVID-19 data collection effort.
The Ohio Department of Health created a new position that will build on existing efforts to respond to health inequity by working directly with local communities on their specific long-term health needs and Ohio’s response to COVID-19.
The Wisconsin Department of Health Services (DHS) announced $10 million in funding for health care providers serving the state’s most underserved populations, including rural health clinics, tribal health clinics, community health centers, and free and low cost clinics.
The city of Los Angeles’ reopening plan incorporates testing rates by poverty levels and race/ethnicity into its Effectiveness Indicators, which guide future decisions about loosening or tightening social distancing restrictions.
The city of Chicago’s reopening plan monitors cases over time by zip code, age, sex, race, and ethnicity to determine movement into different phases.
The city of New York hired over 1,700 contact tracers to join their Test & Trace Corp, with 700 of the new hires being from the neighborhoods that have been the hardest hit by COVID-19.
In a letter to the state’s Patient Protection Commission, the Governor of Nevada requested that the Commission develop long-term policy recommendations that address COVID-19 and broader health equity concerns.
In addition to helping New Yorkers safely separate, the city will also support those who are separating at home by designating Resource Navigators, who work with community-based organizations across the city, to help New Yorkers overcome logistical issues such as accessing medicine or clean laundry.
The state of Rhode Island submitted a waiver to CMS to use Medicaid funds to provide food, housing, and mobile phone minutes for people who are housing insecure.
West Virginia is increasing COVID-19 testing access for marginalized populations and those in medically underserved counties, making testing free and available to all residents in the targeted localities.
The state of Virginia is partnering with the City of Richmond to expand access to personal protective equipment in underserved communities.
The Virginia Department of Health and the Health Equity Task Force partnered with a local media outlet to provide information about the next phases of the recovery process and its implications for health equity.
Ohio’s Minority Health Strike Force recommended the hiring of public health workers who reflect the makeup of their own community to expand exposure notification capacity.
The state of New York is expanding access to testing for communities of color and low-income neighborhoods by establishing an initial 24 testing sites at churches in predominantly minority communities in downstate New York.
Recommendations developed by the Connecticut Health Foundation aimed at ensuring the state’s COVID-19 response reaches those who are most at risk.
This report outlines three guiding principles for state policymakers in their equity efforts.
Medicaid agencies can leverage existing and new authorities, enabled through recent COVID-19 federal regulatory flexibilities, to develop a broad plan for addressing disparities in the near-and long-term.
The task force will act in an advisory capacity to the Governor and study the causes of racial disparities in the impact of COVID-19 and recommend actions to immediately address such disparities and the historical and systemic inequities that underlie them.
This brief describes health equity principles for states as they design and implement their responses.
This resource highlights solutions to ensure more equitable enforcement of public health laws.
Webinar on racial inequities of COVID-19 and impact on communities of color
The state of Virginia has formed a Health Equity Work Group that is intentionally embedded into the state’s Uniform Command center addressing COVID-19. Both the Work Group and the Taskforce meet on a regular basis and work to apply a health equity lens to each phase of the state’s response, ranging from preparedness to mitigation to recovery.
In April, the state of Ohio formed the Minority Health Strike Force, which is tasked with responding to the disproportionate impact of the Coronavirus on African Americans. The state is now focused on implementing recommendations from the Strike Force.
This comprehensive report begins by describing the link between social injustice and COVID-19 outcomes at the local level, including original analysis of economic and disease data for 11 counties with high Black and Latino populations that are among the hardest-hit counties in the United States. The second section of this report provides an action guide for health equity advocates, identifying short-term policy options that respond to the current pandemic and longer-term policy.
Opinion piece written by Dr. Richard Besser, President and CEO of the Robert Wood Johnson Foundation and former acting director of the Centers for Disease Control and Prevention.
The Social Interventions Research and Evaluation Network (SIREN) at the University of California San Francisco, is a research organization focused on the intersection of medical and social services. In response to the COVID-19 crisis, SIREN has developed a resource center of sites aggregating data about health equity, policy, and social risk related to the coronavirus and related financial crisis.
This expert perspective looks in more depth at which states are regularly reporting data that helps shed light on the health equity issues of this crisis. Specifically, the post includes interactive maps that explore the extent to which all 50 states and the District of Columbia are reporting (as of April 14) data breakdowns by age, gender, race, ethnicity, and health care workers for both cases of and deaths from COVID-19.