COVID-19 Health Equity

Photo courtesy of El Paso County Public Health: Florentino Hernandez gives the thumbs up after receiving his first dose of the COVID-19 vaccine at El Paso County Public Health South on March 26.
Photo courtesy of El Paso County Public Health: Florentino Hernandez gives the thumbs up after receiving his first dose of the COVID-19 vaccine at El Paso County Public Health South on March 26. 

How is El Paso County addressing health disparities?

El Paso County is working to reach out to impacted communities by:

  • Working with a network of grassroots community partners and trusted organizations to guide our efforts.
  • Opening free testing sites across the city, instead of in centralized locations.
  • Distributing vaccines to providers across the city, instead of in centralized locations.
  • Opening Public Health South, located in Fountain, a 30,403 square-foot facility that is intended to serve as a community health hub offering a variety of programs. The location, purchased and opened in 2020, is currently offering COVID-19 testing, and serves as a Women, Infants and Children (WIC) Office.
  • Collecting data on health disparities through COVID-19 response and recovery efforts to better tailor outreach.

What COVID-19 disparities exist?

Underlying health and social inequities put many groups, including racial and ethnic minority groups, at increased risk of getting sick, having more severe illness, and dying from COVID-19. Certain groups, including racial and ethnic minority groups, are also unequally affected by unintended economic, social and secondary health consequences of COVID-19 mitigation strategies such as social distancing.

“Health equity” means that everyone has the opportunity to be as healthy as they can be. Equitable opportunity includes equitable access to and distribution of resources. When policies, programs, and systems that support health are equitable, poor health outcomes can be reduced, health disparities can be prevented, and the whole of society benefits.

Some racial and ethnic minority groups are disproportionately affected by COVID-19. Conditions in the places where people live, learn, work, play, and worship affect a wide range of health risks and outcomes, such as COVID-19 infection, severe illness and death. These conditions are known as social determinants of health. Long-standing inequities in social determinants of health that affect these groups, such as poverty and healthcare access, are interrelated and influence a wide range of health and quality-of-life risks and outcomes.

The pandemic has been particularly difficult and deadly for people who are Black, Latinx and Native American, as well as immigrants. This is not due to any genetic or biological predisposition. These communities have experienced more negative impacts from the pandemic due to a chronic lack of access to quality, affordable health care, which leads to underlying health conditions that put individuals at higher risk for severe COVID-19. Additionally, these communities have higher percentages of individuals in jobs which do not allow them to work from home.

The Centers for Disease Control and Prevention report that nationally:

  • People who are Black are 3.7 times more likely to be hospitalized from the virus and 2.8 times more likely to die than people who are non-ethnic White.
  • People who are Native American are 4 times more likely to be hospitalized and 2.6 times more likely to die than people who are non-ethnic White.
  • People who are LatinX are 4.1 times more likely to be hospitalized and 2.8 times more likely to die than people who are non-ethnic White.
  • For more information on COVID-19 health disparities visit the CDC.

If I am (or someone I know is) uninsured, undocumented, and/or don't have a photo ID, can I still get tested for COVID-19 or get a vaccine?

Yes.

  • No ID is required to receive a COVID-19 test at a community testing site and no insurance information is collected. This is to ensure the sites are equitable. All patient information is self-reported on site or during pre-registration. To learn more about COVID-19 testing click here.
  • You do not need to be a U.S. citizen or prove lawful presence to get a COVID-19 vaccine in Colorado.
  • Public Health will never share your information for any immigration or law enforcement purposes.

Do the COVID-19 vaccines affect demographic groups differently?

Both Pfizer and Moderna required that the studies include volunteers who are high risk, have an underlying condition (like diabetes or obesity) or belong to specific racial and ethnic groups.

In Phase 3 clinical trials, large groups of trial participants tested the safety and effectiveness of the vaccines. Those groups included diverse volunteers:

  • For Pfizer, out of more than 37,700 participants, 9 percent were Black or African American, 28 percent were Latino and 21 percent had at least one underlying health condition.
  • For Moderna, out of the 30,000 participants, 20 percent were Latino, 10 percent were Black/African American and 25 percent were 65 or older.
  • For Johnson & Johnson, there were 43,783 trial participants worldwide. Of those, 44 percent of the participants were in the United States. Of U.S. participants, 15% were Latinx/Hispanic, 13% were Black/African American, 6% were Asian, and 1% were Native American. Forty-one percent of participants in the Johnson & Johnson trials had comorbidities associated with an increased risk for progression to severe COVID-19.

While COVID-19 impacts different groups disproportionately, the trials found  no difference in how effective the vaccines are across different demographics.

Are the COVID-19 vaccines being used to experiment on people of color?

No, there is no experimentation. This is a valid concern, and it is important to recognize why there is mistrust and hesitancy. Black and African American communities have suffered a long history of ethical violations and injustices. These injustices still affect health outcomes in some medical settings to this day.

The COVID-19 vaccines were studied across diverse and high-risk populations, all of whom bravely volunteered to participate, and the safety and effectiveness have been proven.

Click here to learn more about the COVID-19 vaccines.

What is health equity?


Health equity means that everyone has a fair and just opportunity to be as healthy as they can be. It means empowering community voices to guide and drive decision-making and to help us better understand and address barriers.

What is a disparity?

Health disparities are differences in health outcomes that are closely linked with social, economic and environmental disadvantage. Health disparities are often driven by the social conditions in which individuals live, learn, work and play.

Graphic Reads: What is health equity?  Health Equity means efforts to ensure that all people have full and equitable access to opportunities that enable them to lead healthy lives. To achieve health equity, we must  address health disparities. Health Disaprities are... differences in health outcomes among groups of people. Health disparities are affected by … Health Inequities are differences in health that are avoidable, unfair, and unjust. They are a result of social, economic, and environmental conditions. In El Paso County, residents of Southeast Colorado Springs have average life spans that are up to 16 years less than other parts of the city. Health inequities are influenced by health behaviors. Smoking, poor nutrition, and lack of exercises are all behaviors that may lead to poor health. Hispanic adults are less likely to receive advice from a health provider to quit smoking than non-White Hispanic adults. Can lead to … Chronic disease or injury is a result of inequities, behaviors and genetics. Smokers are 2-4 times more likely to develop heart disease than non-smokers. Health inequities and health disparities affect how long someone will live. Life expectancy for smokers is at least 10 years shorter than for nonsmokers.  Access to quality healthcare is one key in reducing inequities and disparities, but health is more than just disease or illness. Health Equity will be achieved when everyone is given the opportunity to reach their full health potential.

What are the social determinants of health?

The five key topic areas of social determinants of health listed below contribute to racial and ethnic minority groups being disproportionately affected by COVID-19. Discrimination, which includes racism and associated chronic stress, influences each of these key topic areas.

  • Neighborhood and Physical Environment
    People from racial and ethnic minority groups are disproportionately affected by difficulties finding affordable and quality housing. This may limit their housing options to neighborhoods and residences with mostly other racial and ethnic minority groups, crowded conditions, and that lack access to reliable transportation. These conditions may make illnesses, diseases, and injuries more common and more severe, when experienced. In addition, access to nutritious affordable foods may be limited, and they may experience more environmental pollution within their neighborhoods. In some cultures, it is common for family members of many generations to live in one household, which could lead to exposure for older adults who are at increased risk for severe illness from COVID-19.
  • Health and Healthcare
    People from racial and ethnic minority groups are disproportionately affected by lack of access to quality health care, health insurance, and/or linguistically and culturally responsive health care. Inequities in treatment may result in distrust of government and healthcare systems. Such barriers increase risks for poor health and health outcomes by limiting health promotion, disease and injury prevention, and condition management activities.
  • Occupation and Job Conditions
    People from racial and ethnic minority groups are disproportionately represented in essential work settings such as healthcare facilities; farms; factories; food production and processing; grocery stores; and public transportation. People who work in these settings have more chances to be exposed to COVID-19 because these types of jobs require frequent or close contact with the public or other workers, involve activities that cannot be done from home, and may lack benefits such as paid sick days.
  • Income and Wealth
    People from some racial and ethnic minority groups have lower incomes, experience barriers to wealth accumulation, and carry greater debt. Such challenges may make managing expenses, paying medical bills, and accessing affordable quality housing, nutritious food, and reliable childcare difficult.
  • Education
    People from racial and ethnic minority groups are disproportionately affected by inequities in access to high-quality education which can lead to lower literacy and numeracy levels, lower high school completion rates, and barriers to college entrance. In addition to educational barriers, limited access to quality job training or programs tailored to the language needs of some racial and ethnic minority groups may limit future job options and lead to lower paying or less stable jobs.

These factors may increase risk of COVID-19 exposure, illness, hospitalization, long-term health and social consequences, and death. To stop the spread of COVID-19, we need to ensure resources are equitably available for everyone to maintain physical and behavioral health. Resources include easy access to information, goods and services, affordable testing, and medical and behavioral health care that are all tailored to meet the needs of people from diverse communities.

What are health equity tools I can use in my work?

Community- and faith-based organizations, employers, healthcare systems and providers, public health agencies, policy makers, and others all have a part in helping to promote fair access to health. 

We need programs and practices that fit the communities where people live, learn, work, play and worship.

What is the state doing to address health disparities?

The Colorado Vaccine Equity Taskforce exists to ensure that all groups – regardless of race, ethnicity, ability and other factors – have all the facts to make informed decisions about the safety of vaccines for their families, and to hold leaders accountable for ensuring access to these vaccines for all. Taskforce members represent a diverse collection of Coloradans working to ensure all communities have all the facts to keep their families healthy.

  • Setting aside 10 percent of vaccines for distribution through CDPHE and the Governor's Office Equity Task Force.
  • Reducing health inequities in Colorado by providing vaccine to the most vulnerable communities and vaccinating 70 percent of eligible citizens in these communities.
  • Opening a community-based clinic in 50 percent of the top 50 Census tracts for high-density of low-income and minority communities. 
  • Strengthening community partnerships in the fight against COVID-19.
  • Increasing public trust in the COVID-19 vaccine and the agencies that provide it.

Is the federal government doing anything to address disparities?

President Joe Biden has ordered the federal government to pursue a comprehensive approach to advancing equity for all, including people of color and others who have been historically underserved, marginalized, and adversely affected by persistent poverty and inequality. Affirmatively advancing equity, civil rights, racial justice and equal opportunity is the responsibility of the whole of our Government. Because advancing equity requires a systematic approach to embedding fairness in decision-making processes, executive departments and agencies must recognize and work to redress inequities in their policies and programs that serve as barriers to equal opportunity.  

The Federal Government’s goal in advancing equity is to provide everyone with the opportunity to reach their full potential. Consistent with these aims, each agency must assess whether, and to what extent, its programs and policies perpetuate systemic barriers to opportunities and benefits for people of color and other underserved groups. Such assessments will better equip agencies to develop policies and programs that deliver resources and benefits equitably to all.  

Executive Order On Advancing Racial Equity and Support for Underserved Communities Through the Federal Government

U.S. Department of Health and Human Services Office of Minority Health

FOR MORE INFORMATION ON THE COVID-19 VACCINE OR COMMUNITY INFORMATION AND REFERRALS:

CALL 2-1-1
Monday through Friday, 8 a.m. to 5 p.m.
Free, confidential vaccine referrals, community information/resources. Available in multiple languages.

TEXT “vaccine” (FOR ENGLISH) OR “vacuna” (FOR SPANISH) TO 667873
to get contact information for your preferred vaccine provider

COVID-19 VACCINE HOTLINE
1-877-COVAXCO (1-877-268-2926)
Available 24 hours a day, 7 days a week.
Answers available in multiple languages.

For more information visit the Colorado Department of Public Health and Environment’s website.