Community health centers: one year of vaccination of the most vulnerable in the country

The coronavirus pandemic has led public health and economic crises on a scale most Americans have never experienced in their lifetime, while laying bare critical vulnerabilities in the country’s public health system. As we continue to examine how we can improve the current coronavirus response and better prepare for any future public health crises, it is essential that we understand the failures that have occurred and recognize our triumphs. One of our triumphs is the administration of more than 19 million vaccinations of America’s most vulnerable by Community Health Centers, also known as Federally Qualified Health Centers – an effort that celebrates this month- it’s his first birthday.

As coronavirus vaccines rolled out in late 2020 and early 2021, many had difficulty accessing it due to various social and structural barriers, such as inability to take time off work, lack of experience navigating the healthcare system or concerns about payment, transportation issues, lack of fluency language and fear of immigration enforcement.

Community health centers—often the only way to get quality, affordable primary care for uninsured or publicly insured patients largely excluded from access elsewhere—were enlisted to help overcome these obstacles. An influx of federal dollars has allowed health centers to hire additional staff and expand their awareness campaigns, not only to their own patients, but also to the wider community – sometimes going door-to-door. . These centers are trusted and often long-standing entities in the communities they serve. They are particularly well suited to this task.

Patients treated at these centers are among those hardest hit by COVID – frontline, agricultural and migrant workers; residents of social housing; older people living on fixed incomes; homeless people; low-income families; and immigrants with limited English skills. More than 90% of health center patients are low-income and nearly 60% are people of color.

Health centers’ efforts to provide language-friendly services through staff whose cultural and racial identities reflect the patients they serve are integral to their success, says Gloria Warner, director of operations for Beaufort-Jasper-Hampton Comprehensive Health Services (BJHCHS). These services help make health centers “trusted messengers”. “We look like them and we are part of who they are,” says Warner.

BJHCHS, a network of health centers spread across the largely rural southern tip of South Carolina, dispatched a mobile unit to vaccinate workers at the Hilton Head resort, a group of mostly Hispanic and Jamaican immigrants who had struggled to miss work and may have lacked awareness of how to go about getting vaccinated. The health centers have been a key strength to narrow the vaccination gap between white Americans and those of color, with 68% of vaccines given to people of color versus 40% given to racial and ethnic minorities in the general population.

A year after these efforts began, we are seeing evidence of their impact. a joint analysis from Morehouse School of Medicine and the National Association of Community Health Centers shows that areas with health centers had fewer coronavirus infections and deaths, compared to areas without them – an average of 200 fewer cases and nine fewer deaths per 100,000 people.

Despite these triumphs, challenges remain. The labor shortages that have plagued the healthcare industry during the pandemic have not spared healthcare centers. In January 2022, 44% said they did not have adequate staff to administer vaccines. Chronic illnesses, such as long-distance COVID, mental illness and substance use disorders, are on the rise, and health centers are expected to add 8.5 million new patients over the next four years.

Fortunately, the Biden administration did historical investments to support major health care construction and renovation projects in health centers across the country, with congressional funding provided as part of the U.S. bailout. These investments will help advance health equity and health outcomes in medically underserved communities, including through projects that support COVID-19 testing, treatment and vaccination.

As we continue our efforts to make America’s Greatness accessible and affordable to all Americans, we must provide health centers with a steady level of funding to strengthen the primary care workforce and infrastructure to to meet the demand for affordable and accessible health services now and beyond the pandemic. .

James E. Clyburn is House Majority Whip and Chairman of the Select Subcommittee on the Coronavirus Crisis.