Black Health in America: Exploring Racial Disparities in COVID-19 Vaccination Data
COVID-19 highlights the already existing racial disparities in our healthcare system. With the distribution of COVID-19 vaccines now underway, it’s imperative to turn our focus to the delivery of care. Additionally, we must identify how Black people are still negatively impacted by poor U.S. health infrastructure and racist narratives. We know that public health data must continually be interpreted in the proper historical context, considering the various elements of structural racism that shape the American public health ecosystem.
The availability of vaccines has introduced discussions of pandemic recovery and a return to “normalcy”, however, we must ask: Are Black people, who remain overrepresented among COVID-19 deaths, receiving sufficient access to the vaccines?
Below is a chart containing data from a number of states and Washington, D.C. to help visualize the gap between how many Black people are dying from COVID-19 and how many are receiving the vaccine. U.S. states and the percentages of Black people are respectively on the y- and x-axes. For each location, there are 3 data points:
- Percent of State’s Black Population (Pct Population Black/AA): How many residents of the state identify as Black/African-American. Displayed as the blue dot.
- Percent of State’s Vaccinated Population that are Black (Pct Vaccinations Black/AA): How many residents of the state have received at least one vaccine dose and identify as Black/African-American. Displayed as the gray dot.
- Percent of State’s COVID-19 Deaths that are Black (Pct COVID Deaths Black/AA): How many residents of the state who died from COVID-19 identified as Black/African-American. Displayed as the orange dot.
Hover over points for each state to explore the data or go to the legend at the bottom of the chart titled “Measure Names” and click the orange, blue, or gray squares to explore each series individually. As an example, notice that for Georgia the distance between the gray and orange dots is large. This means a lot of Black people in the state are dying from the virus but proportionally, not nearly as many people are getting the vaccine.
States have expressed the importance of racial equity in their COVID-19 vaccine distribution plans, but many are failing to reach their Black residents who are still disproportionately affected by the virus. In Maryland, for example, Black residents comprise roughly 30% of Marylands’s population while accounting for 35% of Maryland’s COVID-19 related deaths and only 15% of Maryland’s COVID-19 vaccinated population. This large disparity illustrates how Maryland’s Black residents are overrepresented in COVID-19 related deaths and yet severely underrepresented in vaccinations. A common occurrence across numerous Black communities in the U.S., these states must immediately acknowledge this gap in care and remediate the problem.
When encountering a state that does not yet breakdown their vaccination data by race and/or ethnicity, we explored vaccination rates across the state’s predominantly Black counties and cities. Although these locations are largely Black, the number of vaccinations administered in those locations does not tell us how much of the respective Black population have received a vaccine.
Michigan, for example, as of February 22 has reported nearly 2 million COVID-19 vaccine doses administered. Michigan does not provide COVID-19 vaccine distribution data by race or ethnicity. They do, however, provide a vaccine distribution map by county. Black residents account for 14% of Michigan’s population and approximately 11% of Michigan’s COVID-19 cases and 21% of Michigan’s COVID-19 related deaths. Exploring Michigan’s vaccination data, they define vaccination coverage as “the percentage of people receiving one or more doses” and they rank the coverage of the state’s counties on a scale from Low-Moderate-High.
When exploring areas in Michigan with the largest Black populations, Detroit was assigned a vaccination coverage level of “Low” while the wider Wayne County along with Genesee and Saginaw County were assigned levels of “Low to Moderate.” Further investigation is required to understand why the vaccination rate is so low given the relatively high density of Black people and the state’s overall overrepresentation of Black fatalities as a result of COVID-19. We need more data into who exactly is receiving the vaccine in these counties and if any measures are being taken by Michigan to prioritize the distribution of vaccines to Black people and reduce COVID-19 disparities.
Our research compliments existing work that highlights consistent health disparities and systemic racism within our healthcare system related to COVID-19. Black people are underrepresented in vaccinations, and with Black, Native American, Asian, and Hispanic COVID-19 patients still dying at disproportionately alarming rates, this is unacceptable. While some states have highlighted the need for equity in vaccine distribution, not all states are releasing vaccine distribution data disaggregated by race/ethnicity.
There are a variety of reasons why: 1) Black people are not properly prioritized in state vaccine distribution plans and 2) Black people are hesitant to receive the vaccine. It is important to acknowledge the historical context of anti-Black racism within the U.S. public health system in this discussion. The truth is, Black people have every right to legitimately fear and be skeptical of the U.S. healthcare system as it has continually failed to provide Black patients with the assurance that their health and safety is a concern, much less a priority. Additionally, the narrative circulating online that Black people are dubious of vaccines due to conspiracy theories is misleading and oversimplifies valid distrust. Historically, medical research and vaccine trials are quite familiar with racism (see the story of Henrietta Lacks and the unethical Tuskegee Syphilis Study) and it does not help that distrust in the healthcare system is accompanied by barriers to access to health information and the fact that Black patients may be less likely to have access to health insurance and health care services. These barriers are felt at an institutional level as much as they are at an individual one. As we also may unfortunately recall our own personal experiences with condescending and racist health professionals who jeopardize the lives of our loved ones due to substandard care.
We have observed that more work and infrastructure is required to keep Black people safe through the remainder of the pandemic and beyond. We’ll keep our network updated as more data is made available. Remember to contact your state health department for information on its COVID-19 vaccination plan.