Editor’s note: Second in a series on the impact of COVID-19 on communities of color, and responses aimed at improving health equity. Click here to read part one.
In early March 2020, as COVID-19 was declared a public health emergency in Boston, Mass General Brigham began to care for a growing number of patients with COVID-19. Even at this early stage in the pandemic, a few things were clear: our data showed that Black, Hispanic, and non-English speaking patients were testing positive and being hospitalized at the highest rates. There were large differences in COVID-19 infection rates among communities. Across the river from Boston, the city of Chelsea began reporting the highest infection rate in Massachusetts. Within Boston, several neighborhoods, including Hyde Park, Roxbury, and Dorchester, exhibited infection rates double or triple the rest of the city. COVID-19 was disproportionately harming minority and vulnerable communities.
From the start, our work was driven by examining COVID data by race, ethnicity, language, disability, gender, age, and community. As the COVID crisis intensified in Massachusetts, we sought ways to improve health equity and extend support within the communities we serve. We designed and deployed initiatives aimed at our patients, community members, and employees. Below are examples of tools to enhance equity that we found useful.
As new COVID care models were established, we worked on access to clinical communication for all patients and their families. There was a particular focus on language, since COVID greatly impacted non-English speaking communities, and on communication for people with disabilities.
Guidance on how to protect yourself from COVID-19 evolved rapidly. Limited English proficiency, limited access to the Internet or to smartphones and computers, and limited tech savvy are barriers to receiving information for many of our patients and employees. We needed to identify ways to ensure that rapidly changing health information was available to everyone.
Through the COVID pandemic, we were building on our existing presence in, and partnerships with, the communities we serve in eastern Massachusetts in several ways.
We made it through the peak of the pandemic in Massachusetts, launching a suite of initiatives to address inequity within Mass General Brigham’s COVID response. However, the battle is by no means over. Now is the time for action. Even in states like Massachusetts, where infections, hospitalizations, and deaths have substantially declined in recent months, we need to ready ourselves for a resurgence — one that is already occurring in parts of the US and Europe. Surveillance and early preparation are key. Increased prevention and mitigation efforts, widespread testing, and identification of emerging hot spots can help curb the impact of a fall and winter resurgence of the virus. Unless we act now, and unless we ramp up efforts aimed at improving health equity, this will once again hit minority communities hardest.
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