RECOMMENDATIONS FOR ADDRESSING EQUITY IN THE COVID-19 RESPONSE

DSC leadership and faculty share their thoughts on the impact of COVID-19 on communities of color and responses aimed at achieving equity in a 3-part series on the Harvard Health Blog. Visit the links below for recommendations and lessons learned during the pandemic.

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Part 1: Communities of color devastated by COVID-19: Shifting the narrative

Joseph R. Betancourt, MD, MPH, Founder of the Disparities Solutions Center and Chief Equity and Inclusion officer as Mass general, discusses the disproportionate impact of COVID-19 on communities of color. Social conditions, from systemic racism and discrimination to the social determinants of health, are the key factors that led to higher rates of COVID-19 infection and hospitalization among Black, Hispanic, and non English-speaking residents in Boston neighborhoods and surrounding cities. 

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Part 2: Promoting equity and community health in the COVID-19 pandemic

Dr. Betancourt and Sarah Wilke, MS, discuss approaches deployed at Mass General to improve equity in the COVID-19 response, including:​​

  • Examining COVID data by race, ethnicity, language, and other factors to target interventions where they were needed most

  • Focusing on improving communication for all patients and families, with particular focus on patients with limited English proficiency and people with disabilities

  • Identifying ways to make rapidly changing information about COVID-19 available for patients and employees, especially those with little or no access to the Internet, low tech literacy, and/or limited English proficiency

  • Building on existing community partnerships to distribute critical supplies, provide COVID education, and screen for and address unmet social needs 

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Part 3: Driving equity in health care: Lessons from COVID-19

Aswita Tan-McGrory, MBA, MSPH, Director of the Disparities Solutions Center, shares lessons learned about disparities and health equity during the COVID-19 pandemic, including:

  • The need to redesign our healthcare system and reimagine emergency preparedness based on the lived experiences and input of marginalized populations at greatest risk

  • The importance of acknowledging how history has shaped present-day inequities and led to mistrust of the healthcare system among marginalized communities

  • The need to invest resources and time to ensure that patients with limited English proficiency receive the necessary interpreter services, have equitable access to telehealth, and receive educational materials in their preferred language

  • Understanding that the social determinants of health have the greatest impact on inequities in COVID-19 and must be addressed in how we provide care for patients 

  • The importance of collecting reliable data on race, ethnicity, and language and monitoring for disparities in access and quality of care during COVID-19

  • The need to address privacy and immigration concerns, particularly among undocumented immigrants

1.

FACILITATE COMMUNICATION FOR PATIENTS WITH LIMITED ENGLISH PROFICIENCY (LEP)

  • Ensure that COVID-19 patient hotlines are equipped to communicate with patients who speak languages other than English.

  • Provide updates on COVID-19 related policies and guidelines in multiple languages.

  • Disseminate information to patients with LEP through various platforms to reach as many patients as possible (website, text messaging, etc).

  • Develop uniform processes for language translation and distribution across the hospital system.

  • Create a registry of multilingual clinical staff to support patient-facing COVID-19 operations.

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2.

ENSURE EQUITABLE ACCESS TO INFORMATION FOR EMPLOYEES WITH LIMITED ENGLISH PROFICIENCY

  • Identify and implement mechanisms to share information with employees who may not have regular access to email. 

  • Provides updates on COVID-19 related policies and guidelines in multiple languages.

  • Coordinate information sessions in multiple languages for employees (e.g., Environmental Services, Food and Nutrition Services, etc).

3.

ENSURE EQUITABLE ACCESS TO INFORMATION AND APPROPRIATE SERVICES FOR PATIENTS WITH DISABILITIES

  • Ensure that COVID-19 patient hotlines are equipped to connect patients with disabilities to staff with expertise in the areas needed to address their individual needs.

  • Ensure that interpreter services are available for patients who are deaf or hard of hearing.

  • Stock surgical masks with clear windows designed to enhance communication, particularly for use with patients who are deaf or hard of hearing.

The recommendations below reflect some of the early initiatives at Mass General to ensure an equitable response during the initial surge of the COVID-19 pandemic. This is by no means a comprehensive list but instead offers a starting point for hospitals working to ensure equity.

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