In the latest Conversation of Understanding, healthcare professionals in the SIU System discussed possible solutions for vaccine hesitancy in minority populations due to historical mistrust of the healthcare system.
Lakesha Butler, clinical professor in the School of Pharmacy Department of Pharmacy Practice and SOP Director of Diversity, Equity and Inclusion, said minoritized communities have not been disproportionately affected by COVID-19 due to biology, but institutional racism.
“Race is not a risk factor for COVID-19,” Butler said. “Racism is, due to the historical policies and continued practices of this country, such as redlining, federal and state policies resulting in past and present-day segregation, under-resourcing of housing and schools, limited access to hospitals, pharmacies and food deserts, being forced to live in areas close to industrial and toxic waste plants that result in higher rates of asthma, which can in fact exacerbate COVID-19 because both affect the lungs, not having the privilege to work from home during the pandemic due to lack of wealth and limited access to education and employment.”
Riane Greenwalt, director of Health Service, said COVID-19 brought attention to disparities within the SIUE community as well.
“We currently do not mandate medical insurance, and this put many of our students at a disadvantage. The real challenge, if they were no longer on campus, they had no access to our office. Mental health conditions were exacerbated by what we called pandemic-related stress — separation from roommates, classmates, faculty and adult supporters, and struggling with virtual appointments that may or may not have been in private spaces,” Greenwalt said. “And meeting our mission of education was a barrier, as we understood the struggles many experienced. Faculty, staff and students had to compete with resources at home, and the class load was increased by the competition of family.”
Dr. Melodi Ewing, a physician at the SIUC Student Health Center, said she generally sees hesitancy concerning the COVID-19 vaccine, in addition to other vaccines, in students from minoritized populations. Ewing said these concerns need to be addressed with respect and understanding.
“The number one thing I hear is, ‘My parents, or my grandparents, told me not to get that shot.’ When I press them on what’s behind that, many of them, the college students these days, are not aware of specific incidents in the past that have taken place that most of us are aware of … they just know that their family has taught them from birth to be leery of the healthcare system,” Ewing said. “And we need to feel comfortable addressing and educating these students on what these past incidents were, to educate them and explain why we have safeguards in place now so that we can limit those experiences happening again.”
Ewing said in Carbondale, the university is the driving force of the town, so the university should work with and support the local healthcare system in order to ensure efficient distribution of the vaccine.
“We’ve been holding our vaccination clinics on campus. For many townspeople, campus is a frightening place. These large sparkling buildings, they’re too intimidated. We need to support our communities and go out into the communities with the local healthcare system to support their efforts to provide vaccinations,” Ewing said.
Dr. Jerry Kruse, dean and provost of the School of Medicine and CEO of SIU Medicine, said trust in the healthcare system must be earned back by healthcare professionals getting proximate, listening and being allies.
“Racism works through a power structure that perpetuates inequities, and racism accounts for the trust that was lost and defines vaccine hesitancy … because of racism and the power structure that upholds it, trust has been lost and must be earned back. It has to be earned back, and we have to give effort to that. That’s a solution, but it’s a hard one,” Kruse said.
Panelists were asked what their top priorities would be if they were leading the Pandemic Response Team.
“My first priority would be education, and that’s not necessarily about the vaccination. Education about healthcare, how to access it, and how to advocate for yourself. My second priority would be then, access, making sure that what patients need is where they need it to be, not where it’s convenient for us to supply what they need,” Ewing said. “And then the third priority would probably be providing reassurance, and encouraging those to spread the word among their community that they’ve had an experience that’s good, and it is possible.”
The full video of the conference can be viewed on the SIU System YouTube channel.