T.The affluent town of Woodbridge, Connecticut, has less than half the population of neighboring Ansonia, yet it has more people who received a Covid-19 vaccine. The inequality is grave: In Woodbridge, where residents have an average household income of $ 138,320 a year, 19.3% of the population had been vaccinated on February 4, according to the Connecticut Department of Health. In Ansonia, where the median income is $ 45,563 per year, only 7.1% received their first shot.
According to a STAT analysis of vaccine data at the local level in 10 states, Connecticut has the biggest differences in vaccination rates between the richest and poorest communities – a 65% difference the largest wealth gaps. Four other states – California, Florida, New Jersey, and Mississippi – also have significantly higher proportions of people vaccinated in the richest 10% of counties.
The discrepancies vary: in California, residents in the richest areas received 156 shots for every 100 vaccines in the poorest counties, while in Mississippi, residents in the richest counties received 111 vaccinations for every 100 doses in the poorest areas.
In Washington, DC, the two richest communities have vaccination rates more than double that of the two least affluent ones.
Findings back up hard data on individual reports from across the country that wealthy people were given access to vaccines before those on low incomes. “We are seeing individuals with privileges and access who displace the people who don’t,” said Tekisha Dwan Everette, executive director of Health Equity Solutions in Connecticut and a member of the state governor’s Covid-19 advisory group.
However, the analysis also shows that some states seem to distribute vaccines more fairly than others. Among the states with the greatest wealth gaps, Texas, Tennessee, New Mexico, Pennsylvania, and Illinois showed no significant income differences in county-level vaccination rates. The analysis excluded states, including Georgia, Louisiana, and Massachusetts, that do not publicly share data on county-level vaccine recipients.
However, because counties can contain different population groups, the analysis is not a definitive indicator of equity. Several experts said they expected more accurate data to reveal inequalities in wealth even in states with fair data at the county level. Racial differences were still evident in some of these states.
Olivia Goldhill / STAT
Sources: State and Washington, DC, Health Departments
Any loophole in vaccinating the rich against the poor inevitably exacerbates racial segregation. Blacks and Latinos are much more likely to live in poverty than white people, and although they died more frequently during the pandemic, they get fewer vaccines than white people.
The data suggests that in some states, the first wave of vaccinations benefited the rich. “There are really two Connecticuts. We as a state need to focus more on that, ”said Tiffany Donelson, executive director of the Connecticut Health Foundation.
Inequality was a feature of the pandemic from the start, Everette said, citing Covid-19 testing sites that were more accessible to wealthier populations. “Instead of learning from this lesson, let’s recreate the privilege,” she said.
It is not enough just to find vaccination sites in different areas with lower incomes: “People travel outside their own geographic area to get vaccinated elsewhere,” she said.
Similar problems have been observed in California. “We’ve heard these stories from people in LA going to Compton or any other part where there are other locations,” said Anthony Wright, executive director of Health Access California.
Government action can help eliminate inequalities. According to Imelda Garcia, chair of the Texas Expert Vaccine Allocation Panel, vaccination centers in Texas need to put aside some of the vaccines for vulnerable communities, work with local leaders, and distribute the vaccine in racially diverse areas. In contrast, California counts are expected to focus on justice, but there are no special requirements, said Darrel Ng, spokesman for California’s Covid-19 Vaccine Task Force.
But the introduction of vaccines in Texas, while not reflecting income inequality, has disproportionately helped the white population State data Show. Racial data has not been recorded for all vaccinations, Garcia said, and more data collection could reveal a fairer distribution: “The data does not reflect what is happening. I can say that the data is missing. “
Similar concerns about lack of data apply to the county-level analysis, as several states with the greatest differences have not published this information. Tracking and sharing this data is one way to improve gender equality, said Julie Swann, director of industrial and systems engineering at North Carolina State University. “When we start measuring who they are reaching in terms of race, ethnicity, or income, they will do the extra things it takes to reach everyone.”
The rush to vaccinate people as quickly as possible may have curtailed equity in the first phase of the rollout. “[States] feared they would lose their allocation if they didn’t move quickly, ”said Swann. “Everyone freaked out.”
Up until now, vaccine distribution has mainly focused on healthcare workers and those over 75. “Justice is our north star for vaccine distribution. When the state launches its new vaccine distribution network, we can target our disproportionate vaccination efforts more precisely to affected communities, “said California’s Ng.
However, the lack of equality for health workers in the first phase also indicates disadvantages that poor communities face. In areas with a shortage of hospitals, which are often poorer rural areas, fewer people are vaccinated. California’s Central Valley, for example, has a far less robust healthcare system than Silicon Valley.
“Those areas that have more health infrastructure and workers, by definition, have received more vaccine,” said Wright of Health Access California.
Health Department spokeswoman Maura Fitzgerald said Connecticut is taking several steps to address vaccine inequality. This includes providing vaccines to people in vulnerable communities and setting up a vaccine phone line for residents without internet.
In New Jersey – where STAT found vaccination rates 28% higher in the richest counties – the health department is working with partners such as places of worship and senior centers to provide education and access to vaccines through mobile clinics and possibly door-to-door vaccinations in areas severely affected by Covid-19, said Ministry of Health spokeswoman Donna Leusner. Washington, DC, has partnered with hospitals, community health centers, and other organizations to achieve justice, a health department spokesman wrote, and approximately 20% to 30% of vaccine supplies are aimed at diverse populations, including homeless shelters and faith-based initiatives.
Meanwhile, Mississippi Department of Health spokeswoman Liz Sharlot said the state is working with black pastors, historically black colleges and universities, and prominent African American doctors to eradicate inequality. And Florida – where the vaccination rate is 23.6% higher in the richest counties – is partnering with places of worship and other locations in underserved communities where the vaccine can be given, a health agency spokesman said. Florida vaccine allocation per county is based on population age 65 and over.
While the elderly are more prone to Covid-19, the distribution of vaccines by age can lead to inequalities. In Connecticut, northeast Hartford has a life expectancy of 68.9 years compared to 84.6 years at West Hartford Center, so a smaller proportion of its residents have been eligible for vaccination. The state only opened vaccinations for 65 to 75 year olds this week. “You are missing a significant portion of the population in Hartford,” said Donelson of the Connecticut Health Foundation.
Online reservation systems have also contributed to the differences. A vaccine distribution system that sets appointments for those who can book them fastest inevitably rewards those with the time and connections. People often have to call around five different health centers to get on a vaccination schedule, said Georges Benjamin, executive director of the American Public Health Association. “It tells you a lot about the lack of planning,” he said.
Online booking systems require a computer, WiFi, and the ability to navigate a complicated system, Wright said. Richer people can more easily take time off and have easier access to the means of transport that need to be vaccinated.
“People who are richer will be more involved in the vaccination rollout,” he said. “It shows how much more we need to do to put in proactive efforts to reach out to the most vulnerable.”
STAT examined discrepancies in 10 countries with the highest wealth gap. measured by the Gini coefficient, which provided district-level or equivalent local data on population vaccination rates.
For each state, we looked at vaccine distribution rates in the richest 10% and the poorest 10% of the counties. We used federal data for most of the states median household income. In Connecticut, we used vaccine dates and median household income for cities and municipalities. And we analyzed that median household income and vaccination rates for each station in Washington, DC In New Jersey, which has 22 wards, we compared the three richest and poorest counties.
STAT used vaccination rates published on the local Department of Health websites February 6-10. Connecticut, Florida, and New Jersey indicated the percentage of residents who received their first doses; Mississippi provided vaccination doses are administered by the district; California provided vaccine doses are given per 10,000 population; Washington, DC provided the number of residents has been fully vaccinated by the station.