As the pandemic gripped Kentucky last spring, Gov. Andy Beshear announced Black Kentuckians were dying of COVID-19 at disproportionately high rates. Now, nearly two months into the vaccine rollout, history has repeated itself.
Black Kentuckians have received a disproportionately low number of vaccines compared to the state’s demographics: Though they make up around 8.1% of the state’s population, Black residents have received only about 4.3% of the vaccines administered.
Beshear has pledged to increase transparency and improve disparities in vaccine access for Black Kentuckians.
“It shows our need to be intentional, that we need to do better to ensure there is an equitable distribution of this vaccine,” Beshear said during a coronavirus press briefing Monday.
He announced a new federal vaccination program that will directly supply local community health centers in order to vaccinate underserved communities. The state also began working in recent weeks with local health departments and hospitals to add pop-up community vaccination sites in Louisville, where a majority of the state’s Black population resides.
One of those sites could be at the Kingdom Fellowship Christian Life Center where Timothy Findley, Jr., is the pastor. Louisville’s chief health strategist Dr. Sarah Moyer organized a meeting last week to address the issue, two days after Beshear disclosed the racial disparities in vaccine access.
It was the first time anyone had reached out to Findley, or anyone in the local Black community, as far as he knew. He said he was more than happy to help. But he also wants to know why Kentucky is just now talking about access for Black residents.
“I can’t say that I think the plan has been good at all,” Findley said. “We’ve got to do more than just include [Black leaders] when the fire has already started to rage.”
Limited Supply In Low-Income Communities
Every week, the Park DuValle Community Health Center requests access to vaccines from the state, CEO Ann Hagan-Grigsby said.
The community health center serves above 20,000 patients, including in west Louisville — home to the largest population of Black Kentuckians in the state. The majority of her clients are Black and about 95% are low-income.
The center had received just 200 doses as of last week, and Hagan-Grigsby said the health center was lucky to get those. She wasn’t aware of any other similar community health centers in Louisville that received any vaccines at all.
Hagan-Grigsby said the limited supply of COVID-19 vaccines is the main issue her community health center faces in vaccinating Black residents.
“There is not enough vaccine,” Hagan-Grigsby said. “If it was flowing like water in all our communities, we could be injecting patients daily.”
Barriers To Access
As of Monday, fewer than 19,000 Black Kentuckians had received a dose from the limited supply, compared to nearly 380,000 white Kentuckians.
The bottleneck in supply left the federal government to prioritize certain groups with the goal of minimizing deaths and protecting those deemed most vulnerable, including health care workers, K-12 educators, first responders and people over the age of 70.
State and city officials, health care experts and residents say inequity is built into the priorities for distribution.
“The very construct of the federal program skewed the way the distribution would occur,” said Kentucky Public Health Commissioner Dr. Steven Stack.
White people are overrepresented and Black people are underrepresented in many healthcare fields, said T Gonzales, director of Louisville’s Center for Health Equity. Similarly, most K-12 teachers across the country are white.
The history of why those institutions are whiter than the general population stems from a legacy of racist policies including segregation and access to education to gain entry into those careers, Gonzales said.
Age is another barrier for Black Kentuckians in the quest for equitable vaccine access. In some west Louisville neighborhoods, the average life expectancy is less than 70 years old — the age prioritized for vaccine access, Gonzales said.
Across Jefferson County, residents live an average of 12 years longer on the east side of the city than on the west side. That’s resulted in a disproportionate number of residents in other parts of the county receiving vaccinations, compared to those living in west Louisville neighborhoods.
Vaccination rates for Black residents in Louisville are comparable to the state as a whole, with about 11% of Louisville’s supply of first doses going to Black residents, who make up about 22% of the city population.
Aside from the vaccine rollout itself, Black Kentuckians are also more likely to have limited access to internet and transportation, making it more difficult to learn about the vaccine, sign up and get to an appointment, Gonzales said.
Often, experts and media cite hesitation to take vaccines as yet another barrier. That hesitation is rooted in a history of discrimination against Black people in health care, and in abuses like the Tuskegee syphilis experiment.
“I think that’s maybe part of it,” Gonzales said. “But I think more of it is those historical, structural issues.”
Pledging To Improve Equity
Last spring, Beshear acknowledged the racial disparity in COVID-19 deaths.
“We have a lot more work to do, and we should have done it by now,” he said.
Now two months into the vaccine rollout, Beshear is again pledging to improve healthcare outcomes for Black Kentuckians — this time through vaccines.
Beshear spoke Monday about a new federal program to supply vaccine doses to nine federally qualified community health centers around the state with the goal of vaccinating “hard to reach” populations and improving equity in access, though he provided few details.
In the last few weeks, state and local health departments began connecting with hospitals and churches for pop-up community events to improve vaccine access for underserved populations.
Norton Healthcare has a vaccine administration site at the YMCA on 18th Street and Broadway, as well as temporary sites at two churches, said Dr. Steven T. Hester, the company’s chief medical officer.
“These are temporary sites and we plan to move to various locations over time. The goal of these sites is to ensure anyone who wants to receive the vaccines is able to do so,” Hester said in an email.
Meanwhile, Carolyn Callahan, a spokesperson with University of Louisville Health, said the hospital is working with dozens of churches. Both said the appointments at the churches are for members who are 70 and older.
“Our goal is to meet people where they are, and make sure we’re making it as easy as possible for them to get their vaccines,” Callahan said.
On The Wrong End Of Priorities
Pastor Findley of the Kingdom Fellowship Christian Life Center is working with U of L Health to put on a pop-up clinic this week.
Findley said the fact that the state is only now thinking about vaccine access for Black Kentuckians two months into the rollout points to another systemic problem: Black residents have been an afterthought in decision-making.
Black people are always on the wrong end of these structures, he said.
“A lot of that racism has to do with the kind of care that we get and the kind of access that we have. A lot of that racism has to do with the conditions in the environment of the neighborhoods,” Findley said.
Within hours of posting on social media about the upcoming pop-up vaccine event at his church, nearly 500 people registered, he said. Many were Black. Many others were white people scrambling to get a vaccine anywhere, since supplies are still short.
U of L Health assured Findley that if he could find 1,000 participants, they would supply the vaccine for the event, he said. As of Tuesday, he’d done just that.
Findley said he is more than happy to oblige them, but he’s also got some advice for state leaders.
“You’ve got to get to the people who are influential and leaders in our community,” Findley said. “And you’ve got to get to them quickly and early and strategize with them.”