Nassau County is launching a $450,000 study to examine the impact the coronavirus pandemic has had on minority communities, taking aim at what residents experienced while trying to access COVID-19 testing and vaccination appointments.
The COVID-19 Disparity Study, financed through the U.S. Department of Housing and Urban Development's Community Development Block Grant program, also will delve into broader health care issues, the county said.
The signs of COVID-19's disparate impact on Blacks, Latinos and other communities — with statistics showing higher death rates and lower vaccination rates — have reverberated across the country. Nassau officials thought more could be learned about what local barriers emerged, with an eye toward new approaches, according to Andrea Ault-Brutus, health equity director for the county's health department.
"First of all, we understood that COVID-19 was disproportionately impacting communities of color, not only in Nassau County but across the country," Ault-Brutus said. "And while there’s so much literature on the reasons why we have these health inequities, we wanted to get more context as to what are the issues in Nassau County."
What to know
Nassau County is launching a $450,000 study to examine the impact the COVID-19 pandemic has had on minority communities.
Two surveys will be undertaken, with one getting input from residents generally, and the other with particular focus on nine communities with large minority populations.
Regarding COVID-19 disparities, the vaccination rate among Blacks on Long Island was far below their share of the population — 6.7% had received at least one dose, even though Blacks represent nearly 11% of the Island's population over the age of 15.
Nassau officials have opened COVID-19 testing and vaccination sites in minority communities to try to address the disparities. County Executive Laura Curran said "this study will help us continue to serve our most vulnerable residents in the best way possible."
Nine communities in focus
Two surveys will be undertaken, with one getting input from residents generally, and the other with particular focus on nine communities with large minority populations, areas Ault-Brutus said "were particularly vulnerable to health inequities." They are Hempstead, Elmont, Freeport, Uniondale, Glen Cove, Long Beach, Westbury, Roosevelt and Valley Stream.
The study also will present an opportunity "to dig deeper, to not only focus on COVID-19, but to look at those historical [health] inequities in the county," Ault-Brutus said, highlighting one problem in the county as an example.
"Infant mortality is an issue in Nassau County, where Black babies have a higher likelihood of dying compared to babies of other races and ethnicities. We have data that show other disparities when it comes to chronic conditions across the county impacting both Black communities and Latinx communities. But we wanted to get more contextual information, as to what’s driving these disparities," Ault-Brutus said.
"For example, we’ve heard stories from our community partners about Black families utilizing health resources at a lesser rate than other communities. But we don’t have recent hard data on this."
The county awarded the 15-month Disparity Study contract — which started March 1 and runs through May 15, 2022 — to John Snow Inc., a public health research and consulting firm based in Boston, in partnership with Choice for All, a Roosevelt-based nonprofit focused on helping families with education, health and income issues.
Community participation from "beginning to end" was critical for the study, said Jacob Dixon, founder and chief executive of Choice for All.
Dixon said a community advisory board would be jointly created with Nassau's health equity office, and that it will assist in designing the surveys and evaluating the results. He said they want to "make sure we're asking the right questions."
Dixon said his group is focused on community engagement in myriad ways, such as calling on community leaders to help promote the survey, and helping people with a "technology gap" or a language barrier to navigate the survey online.
Ault-Brutus said white residents would be sampled as well.
"So hopefully, when we conduct the survey, we will not only be able to see what health issues have been occurring in these nine communities, but also comparing it to white residents in the county to see if there are any health inequities," she said.
Martine Hackett, a public health professor at Hofstra University, said targeting the nine communities "should tell you something about, objectively, why they have worse outcomes, and have the highest [number of] minority residents."
"There's a body of literature that talks about racial segregation as a fundamental reason you have health disparity in the first place," Hackett said. "I hope they can properly identify the root causes of these disparities. I would be very disappointed if it just came down to individual behaviors. That plays a role. But how people conduct their individual behavior is affected by their environment."
She said some communities offer their residents protections, such as providing parks, safe streets and access to healthy food, whereas other places don't.
"I think it’s important in public health to get a sense of the history of how we got to our current situation. Without understanding the context, it would be challenging to address current problems," Hackett said.
Data reveals disparities
Regarding COVID-19 disparities, the vaccination rate among Blacks on Long Island was far below their share of the population — 6.7% had received at least one dose, even though Blacks represent nearly 11% of the Island's population over the age of 15, according to the state's vaccine demographic data on Tuesday. By contrast, 82% of Long Island whites had received at least one vaccine dose, and they represent nearly 80% of the Island's population over age 15.
The age-adjusted COVID-19 fatality rate also was highest for Blacks. In Nassau, the fatality rate for Blacks was 248 per 100,000 population; 172 for Latinos; 138 for Asians, and 109 for whites.
The COVID-19 statistics, in the view of one national expert, do not even give the full scope of the disparate impact on minorities in the United States.
"The demographic data is incomplete, it’s absolutely incomplete and the CDC should be reporting this and going after providers" who don't provide demographic data, said Debra Furr-Holden, an epidemiologist and public health professor at Michigan State University who is a member of the Michigan Coronavirus Racial Disparities Task Force. "Ultimately, we don’t have a clear picture of the disparity."
As for Nassau's study, Furr-Holden said, "If they’re willing to do that and identify their problems and address them, I think that’s a good thing. … They need to make sure, if you just start collecting better data now on COVID tests and vaccines, then add depth by interviewing people, good. But the first thing you have to do is get the data."