When the former first lady of D.C., Cora Masters Barry, invited our institute to help organize a mass vaccination event at the Southeast Tennis and Learning Center she founded in Ward 8, we immediately reached out to community-based organizations such as the Family Success Centers, established by D.C. Mayor Muriel E. Bowser (D), and the Far Southeast Family Strengthening Collaborative. Rather than taking a top-down approach to administering vaccines, our years of experience have taught us that success hinges on collaborating directly with the community.
Community-based organizations know their neighborhoods intimately. They know who has an Internet connection, who is food insecure, who has lost someone to the coronavirus. They know the obstacles that impede the path to good health.
Despite suffering the highest per capita rate of coronavirus-related deaths in D.C., Ward 8 residents repeatedly told us during a listening tour that mental health and food security were their greatest health concerns. According to the Robert Wood Johnson Foundation, only 20 percent of Americans’ health outcomes are related to the health care they receive. Structural and social determinants of health, such as poverty, racism, access to clean water and air, healthy food, education and housing, play a bigger role.
In under-resourced communities such as Ward 8, people must decide which competing priority gets their immediate attention. Paying the rent or putting food on the table can make preventive care or registering for a vaccine — even a lifesaving one — fall to the bottom of the to-do list. This is why we invited community-based partners such as DC Greens, the Capital Area Food Bank, Food and Friends and Whitman-Walker Health to provide food and mental health consultations at the vaccination event. It’s why we offered free Uber rides to and from the vaccination site, on-site child care and blood pressure readings. (Ward 8’s Temple of Praise Baptist Church has been a model of success in comprehensive community care. Since the start of the pandemic, it has delivered 1.2 million meals to residents and vaccinated 4,600 people.)
Our community-based collaborators also reflect their community and may have the same fears and hesitations about the coronavirus and vaccines. We held several town halls to answer their questions, allay fears and equip them with the information they needed to be effective vaccine ambassadors. We also gained valuable insights through the work of groups such as the Black Coalition Against Covid, of which our institute is a member. For example, we learned that Black seniors are getting vaccinated at the same rate as their White counterparts. The challenge has been reaching the younger demographic, reminding us that neighborhoods like Ward 8 are not monoliths.
Yet, all of our efforts to prepare for a vaccination event would be completely futile if people didn’t show up. One of the biggest barriers to vaccination has been getting people to register for appointments. For that, we needed people, not portals.
Barry devised a registration approach similar to a get-out-the-vote campaign. Instead of pre-registering via online portals, community-based organizations went door-to-door in the neighborhood signing up would-be patients, even those who remained deeply hesitant.
By working closely and thoughtfully with a consortium of partners (including three of our peer institutions, Children’s National Hospital, Howard University and Georgetown), we successfully vaccinated nearly 900 Ward 8 residents. We also followed up to see how people were feeling after their vaccination, making sure we addressed any new questions or concerns.
If we can thank this pandemic for anything, it is for showing us how much we need to shift the locus of power in health care. A health-care model that centers the community rather than the medical establishment is one that can inoculate a population against a virus and, what’s more, solve the health disparities that will still be here long after the coronavirus has departed.
The Rodham Institute and others have long advocated for this community-based approach. The pandemic helped us show how effective this model can be in delivering a vaccine to our most vulnerable communities, a possible road map for others trying to serve their hard-to-reach populations. My hope is that through this tragedy we heed this lesson and begin delivering the kind of equitable, quality and compassionate care that all Americans deserve.