Strategies That Promote Equity in COVID-19 Vaccine Uptake for Black Communities: a Review

Black communities have had a high burden of COVID-19 cases, hospitalizations, and death, yet rates of COVID-19 vaccine uptake among Blacks lag behind other demographic groups. This has been due in part to vaccine hesitancy and multi-level issues around access to COVID-19 vaccines. Effective strategies to promote vaccine uptake among Black communities are needed. To perform a rapid review covering December 2020–August 2021, our search strategy used PubMed, Google, and print media with a prescribed set of definitions and search terms for two reasons: there were limited peer-reviewed studies during the early period of vaccine roll-out and real-time perspectives were crucially needed. Analyses included expert opinion, descriptions of implemented projects, and project outcomes. The strategies described in these reports largely converged into three categories: (a) addressing mistrust, (b) combatting misinformation, and (c) improving access to COVID-19 vaccines. When working to reduce hesitancy, it is important to consider messaging content, messengers, and location. To address mistrust, reports detailed the importance of communicating through trusted channels, validating the real, history- and experience-based reasons why people may be hesitant to establish common ground, and addressing racism embedded within the healthcare system. To combat misinformation, strategies included dispelling myths and answering questions through town halls and culturally intelligent outreach. Black physicians and clinicians are considered trusted messengers and partnering with community leaders such as pastors can help to reach more people. The settings of vaccination sites should be convenient and trusted such as churches, barbershops, and community sites. While a number of individual and combination efforts have been developed and implemented, data that disentangle components that are the most effective are sparse. This rapid review provides a basis for developing strategic implementation to increase COVID-19 vaccine uptake in this ongoing pandemic and planning to promote health equity for future bio-events and health crises.

Transformation of Historically Black Universities in South Africa to Provide Access to Information

South African universities were divided along racial lines of historically Black, White, and Afrikaans universities. Pieces of legislation such as the Bantu Education Act No. 47 of 1953 and the Extension of University Education Act No. 45 of 1959 were enacted by the apartheid regime to provide inferior education to Black communities. However, after the transition from apartheid to democracy, the National Commission on Higher Education was established in 1996 to develop a framework to transform higher education. The transformation of higher education led to the integration of information management systems. The governance structures, resources allocations, training and development of staff were pillars to transform higher education. The exclusion of information management implies poor administration and little access to information. Post-apartheid South Africa recognized the significance to access information for university internationalization.

Mediators of Racial Differences in COVID-19 Vaccine Acceptance and Uptake: A Cohort Study in Detroit, MI

Despite their disparate rates of infection and mortality, many communities of color report high levels of vaccine hesitancy. This paper describes racial differences in COVID-19 vaccine uptake in Detroit, and assesses, using a mediation model, how individuals’ personal experiences with COVID-19 and trust in authorities mediate racial disparities in vaccination acceptance. The Detroit Metro Area Communities Study (DMACS) is a panel survey of a representative sample of Detroit residents. There were 1012 respondents in the October 2020 wave, of which 856 (83%) were followed up in June 2021. We model the impact of race and ethnicity on vaccination uptake using multivariable logistic regression, and report mediation through direct experiences with COVID as well as trust in government and in healthcare providers. Within Detroit, only 58% of Non-Hispanic (NH) Black residents were vaccinated, compared to 82% of Non-Hispanic white Detroiters, 50% of Hispanic Detroiters, and 52% of other racial/ethnic groups. Trust in healthcare providers and experiences with friends and family dying from COVID-19 varied significantly by race/ethnicity. The mediation analysis reveals that 23% of the differences in vaccine uptake by race could be eliminated if NH Black Detroiters were to have levels of trust in healthcare providers similar to those among NH white Detroiters. Our analyses suggest that efforts to improve relationships among healthcare providers and NH Black communities in Detroit are critical to overcoming local COVID-19 vaccine hesitancy. Increased study of and intervention in these communities is critical to building trust and managing widespread health crises.

Advancing Healthcare for COVID-19 by Strengthening Providers’ Capacity for Best Practices in African, Caribbean and Black Community Service Provision in Ontario: A Multisite Mixed-Method Study Protocol

BACKGROUND: The ongoing COVID-19 pandemic has emerged as an unprecedented challenge for public and private life, and healthcare systems worldwide. African, Caribbean, and Black communities (ACB) represent some of the most vulnerable populations in terms of their susceptibility to health hazards, difficulty receiving adequate health care and relatively lower chances of recovery. OBJECTIVES: The main aim of this study is to improve the health system’s response during and after the COVID-19 pandemic by developing evidence-based models to inform policy and collaborative best practices to mitigate its spread and ameliorate related health consequences in vulnerable communities. METHODS: This is a mixed-method, multisite study based in Ottawa and Toronto that will involve in-depth qualitative interviews and surveys using a structured questionnaire. Data will be analyzed using NVivo for qualitative interviews, Stata 16 and IBM SPSS version 26 for statistical analyses. DISCUSSION: The findings of this study gained from highly professional health practitioners will produce strong evidence on current gaps in knowledge and practice in the healthcare system’s capacity to meet the health needs of ACB population. The distinct insights and perspectives will be disseminated with policymakers and researchers at all levels which will facilitate strategic policy making with the goal of addressing the unique challenges for health

Seeing Covid-19 Through a Subprime Crisis lens: How Structural and Institutional Racism Have Shaped 21st-Century Crises in the U.K. and the U.S.

This special issue aims to use historical examples to gain insight into the socio-economic impact of, and possibilities of recovery from, the Covid-19 pandemic for Black communities. We approach this question by comparing the impact of the pandemic on Black Britons in the United Kingdom with that of the 2008 subprime crisis on Black Americans. We find that, in both cases, a pattern of racially asymmetric losses and race-neutral policy responses that have systematically ignored the disparate losses borne by Black and racial/ethnic minority communities. Both patterns are manifestations of these countries’ institutional racism. Relying on insights from stratification economics and using the concept of “racial formation” introduced by Harold Baron in 1985, we show how these nations’ historical relationships to slavery and imperialism have led to different structures of racial control. Our review of U.K. government policy includes a critique of the March 2021 report of the U.K. Commission on Race and Ethnic Disparities.

Phantom Pains: The Effect of Police Killings of Black Americans on Black British Attitudes

What effect does black politics in the United States have on the attitudes of black citizens in other national contexts? Literature on the black diaspora and transnationalism has characterized cultural and political linkages between black communities in North America, the Caribbean, and Europe, especially during the mid-20th century. In this article, I exploit random timing in the administration of a public attitudes survey to demonstrate that such linkages persist and that the police killing of Eric Garner in 2014 negatively affected black Londoners’ attitudes toward the Metropolitan Police. Notably, I find the effect was largely concentrated among black Londoners: estimates of an effect on white and South Asian Londoners were small and largely insignificant. The evidence presented here demonstrates that racial violence in the United States can affect racial politics in other national contexts and helps frame the emergence of Black Lives Matter chapters and protests beyond the United States.

COVID-19 Disparities and Vaccine Hesitancy in Black Americans: What Ethical Lessons Can Be Learned?

Objective This state of the art review focuses on bioethical questions and considerations from research findings and methodological issues, including design and recruitment of participants, in studies related to COVID-19 vaccine hesitation in Black individuals. Ethical concerns identified were applied to otolaryngology with recommendations for improving health inequities within subspecialties. Data Sources An internet search through PubMed, CINAHL, and socINDEX was conducted to identify articles on COVID-19 vaccine hesitation among the Black population between 2020 and 2021. Review Methods A systematic review approach was taken to search and analyze the research on this topic, which was coupled with expert analysis in identifying and classifying vital ethical considerations. Conclusions The most common COVID-19 vaccine hesitation factors were related to the development of the vaccine, mistrust toward government agencies, and misconceptions about safety and side effects. These findings raised bioethical concerns around mistrust of information, low health literacy, insufficient numbers of Black participants in medical research, and the unique positions of health professionals as trusted sources. These bioethical considerations can be applied in otolaryngology and other health-related areas to aid the public in making informed medical decisions regarding treatments, which may reduce health inequalities among Black Americans and other racial and ethnic minority groups. Implications for Practice Addressing ethical questions by decreasing mistrust, tailoring information for specific populations, increasing minority representation in research, and using health professionals as primary sources for communicating health information and recommendations may improve relationships with Black communities and increase acceptance of new knowledge and therapies such as COVID-19 vaccination.

Contextualizing the Experiences of Black Women Arrested for Intimate Partner Violence in Canada

This qualitative study was informed by critical race feminism and explored Black women’s experiences with the police with a particular focus on how issues of race, racism, oppression, and subordination inform their experiences. It sought to answer three research questions: (1) What is known about Black women’s experiences with the police in the context of intimate partner violence? (2) Given their experiences with the police, what is their perception of the police? and (3) To what extent do women construct counter-narratives of their experiences with the police and what does that involve? The sample was comprised of 25 participants, 15 of whom were arrested. The women were over the age of 18 and lived in the Greater Toronto Area and surrounding areas. Most women expressed that they had negative encounters with the police, which was influenced by the police’s negative perceptions of them. Black women who called the police to intervene in an intimate partner violence incident were subjected to great scrutiny and vulnerable to racialized and gendered police violence. Consequently, women were fearful and distrustful of the police and were less likely to seek help from them in the future. The study answers the call for research that examines Black women’s experiences with the police from their perspective. It has implications for social service providers and provides strategies to improve future police interactions with Black communities.

Access and use of health services by quilombolas (inhabitants of black communities) with arterial hypertension

The present study aimed to describe the access and use of health services by hypertensive individuals living in quilombola communities in Bahia. This is a population-based descriptive investigation, with data obtained through the application of a validated questionnaire for the quilombola population,> 18 years old, of both sexes. Hypertension was determined by self-referral medical diagnosis. And, questions regarding access and use of the system and health were obtained. Blood pressure was measured by 72.7% of participants in the last six months. Hypertension was prevalent in 28.0% of the population, higher in the elderly and in women. The diagnoses occurred at 55.3+14.7 years on average. Among the sick, 55.5% cited consultations to monitor their clinical status, while 49.7% purchased all medicines from public health services. There is a discontinuity of assistance or use of health services, so it seems a misconception the indication of underutilization of services by quilombolas, the problem is the absence and / or barriers to access and accessibility for appropriate use to demand.

Affirmation of Unhu as Reflected in Selected Manyika Proverbs

Unhu/ubuntu is one of the important mainstays of black communities in Southern Africa. It emphasizes the connectedness of people and the need for them to work together and sustains families thus ensuring their continued existence. This paper thus argues that the vanhu/abantu (people) of the sub-region have employed proverbs among other ways to ensure that unhu keeps people going even when faced with daunting challenges. It asserts that through the use of some of these aspects of living heritage in the form of expressions like proverbs, unhu has been, and continues to be affirmed. Through an analysis of some proverbs of the Manyika, especially those of the Tangwena people on the border with Mozambique, by employing the speech act theory, this paper discusses how through proverbial lore the Manyika have buttressed and affirmed unhu in their communities, primarily among their children. The paper concludes by emphasizing that such gems of intangible cultural heritage need to be vigorously preserved, promoted and safeguarded through various means that include radio and online interactive platforms.