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Disparities in Covid-19 vaccination rates among U.S. counties fall across economic and digital divide

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Counties that lag behind the global Covid-19 vaccination rate in the US they tend to be poorer and less educated, with less access to computers and the Internet, according to a CNN federal data analysis.

This digital and economic divide contributes to disparities in access to health care in general, experts say, and access to Covid-19 vaccines is no exception.

“With too many things in health, we focus on individual behavior without looking at the systems that facilitate or not make it possible for someone to practice this healthy behavior,” Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation, told CNN.

In counties that fall behind the U.S. average vaccination coverage, 35% more households do not have Internet access and 39% more households do not have a computer.

“Health behaviors (like getting a vaccine against Covid-19) are, in part, a personal choice,” Besser said. “But one of the things that is often said is that the decisions we make depend on the decisions we make. For someone who doesn’t have access to the Internet, there’s not much choice to be able to connect to the Internet and schedule their appointment. “.

And economic disparities are the root cause of these and many others, according to experts.

According to CNN analysis, in counties that have completely vaccinated a smaller portion of their population than the average, the average income of families is about 20% lower than in counties that have vaccinated a larger portion.

In fact, a county’s vaccination coverage jumps an average of 3 percentage points for every $ 10,000 more in median household income.

The average poverty rate is also higher in counties that have vaccinated a smaller portion of their population (about 16%, compared to 12% in counties with higher vaccination rates) and a lower proportion of adults. aged 25 or over have received a Bachelor’s degree or higher: approximately 19%, compared to approximately 30%.

CNN’s analysis used CDC vaccination data at the county level as of May 26, 2021, as well as data from five-year estimates from the 2019 Census Bureau’s American Community Survey. The analysis excluded data from seven states where county information was not included in more than 15% of vaccination records.

A recent CDC study found that rural counties have vaccinated a lower average of residents than U.S. urban counties. And experts say vaccination rates have been slower in rural counties for many of the same reasons that the incidence of Covid-19 and mortality rates were higher in rural counties.

“The rural population is older, sicker and poorer in most places. That’s who they are,” Alan Morgan, CEO of the National Rural Health Association, told CNN. But it’s also a much more diverse group than conservative white men they tend to focus on, he said.

The oldest population is well covered in the United States (nearly three-quarters of people age 65 and older are completely vaccinated, according to CDC data), putting at risk the “sickest” and “poorest” parts of the United States. rural communities.

“Poverty in a rural context has always been a major driver of public health problems and concerns,” Morgan said.

According to him, there are now problems with access to health and messaging, and poverty is crossed with both, creating barriers not only to transportation and Internet access, but also to health literacy.

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Many rural communities still don’t understand that it’s free to get a vaccine against Covid-19 and can’t afford (or don’t know how to) take time off work to get one, Morgan said.

While the daily rate of vaccinations has slowed in recent weeks, the proportion of Americans who say they are hesitant has also declined.

The next phase of the Covid-19 vaccination campaign will be slower and more deliberate, Besser said, but just as important.

“Now what we’re seeing is a more consistent and continuous effort. It’s harder work to reach people who have more barriers to getting vaccinated,” he said. “But I’m excited and optimistic that interest will continue to exist.”

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