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Centering Race Equity in Vaccine Distribution & Health Care Affordability in Illinois

*This is the second blog in a series about the Illinois Healthcare Affordability and Feasibility Study mandated by the Illinois Healthcare Affordability Act. The first blog post can be found here. 

The disproportional impact of COVID-19 on people of color, especially Black and Latinx people in Illinois, highlights the systemic racism embedded in our health care system. Protect Our Care Illinois is dedicated to ensuring quality, affordable, and equitable health care for all Illinoisans regardless of race or immigration status. To achieve this vision, Protect Our Care Illinois demands equitable distribution of and access to the COVID-19 vaccine, as this is a key step in combatting the disastrous effects of the pandemic on our communities. 

Governor Pritzker and the Illinois Department of Public Health (IDPH) have worked diligently to prepare a vaccine distribution plan that prioritizes administering the limited supply of vaccine doses to the most at-risk populations first, including senior citizens and health care workers. However, the plan falls short in addressing how the state will ensure equitable access to people of color, especially Black and Latinx communities, and this must be improved immediately.  

If the differing rates of flu vaccinations among different races are any indicator, Black and Latinx people are less likely to receive a COVID-19 vaccine if offered. Why? Many reasons exist, but an unresolved history of both structural and sometimes interpersonal harm towards Black and Latinx communities perpetrated by the government and health care institutions has resulted in widespread distrust of the health care system. For example, 70% of Black people in a survey said they think the health care system treats people unfairly based on their race or ethnic background, compared to about 40% of white and Latinx people. Additionally, Black, Indigenous and People of Color are more likely to experience access related challenges such as geographic barriers, lack of transportation, or language barriers. A recent survey shows 53% of white people are willing to take the vaccine, compared to only 24% of Black people and 34% of Latinx people. As of mid-January 2021, data regarding the demographics of those who have received at least one dose of the COVID-19 vaccine has not been released yet. 

The Governorโ€™s office and IDPH must address the above concerns. Protect Our Care Illinois recommends the following: 

  • Implementing a communication plan to address vaccine hesitancy and medical mistrust among Black, Indigenous and people of color;  
  • Distributing vaccines based on zip code, as opposed to being based solely on the county or city level, to ensure that communities that have been segregated within cities and counties are able to access vaccines equitably; 
  • Creating mobile or pop-up locations to deliver COVID-19 vaccinations in those zip codes that have insufficient access to hospitals, pharmacies, medical centers, or clinic spaces;  
  • Requiring employers to provide paid time-off to receive the vaccine and recover from side-effects if necessary; 
  • Providing widespread information about how to access the vaccine for free; and  
  • Continuing to update the IDPH COVID-19 Vaccine Administration Data website with the most current, transparent, and detailed data, including, if possible, demographic information such as zip code, race, sexual orientation, gender identity and disability status of the population vaccinated. 

Ensuring equitable access to the vaccine is the first step in the long road to affordable and accessible care for all in Illinois. The Affordability and Feasibility Study currently being conducted by the Department of Health and Family Services (HFS) and the Department of Insurance (DOI) will provide Illinois legislators and administrators with ideas about how to lower health care costs. HFS and DOI agreed to conduct the study with a racial equity lens, centering the questions asked and recommendations provided in terms of the effect on people of color, especially Black people in Illinois. A group of consumers provided recommendations to HFS that included specific ideas to address both interpersonal and systemic racism in health care, such as:  

  • Providers who look like their patients;
  • Care that is geographically close to patients; 
  • Providers listening to patients, treating patients as the experts of their bodies; 
  • Translators available for multiple languages, including American Sign Language;
  • Protecting personal information and understanding that certain groups of people (for example, undocumented immigrants) may be hesitant to provide personal data; and 
  • Better understanding of provider networks and the health services covered by plans 

Protect Our Care Illinois is pleased that HFS and DOI are considering race equity in the affordability study and we will monitor the release and implementation of the studyโ€™s recommendations to ensure racial equity is promoted. Additionally, Protect Our Care Illinois thanks the Governorโ€™s office and the IDPH for its willingness to receive recommendations on how to best distribute the COVID-19 vaccine, and centering race equity throughout the distribution process. Now is the time to act on the ideas suggested.  

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