March 4, 2021

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‘Just not equal at all:’ Vaccine rollout in Chicago a microcosm of racial disparities nationwide

15 min read

CHICAGO — Angelina Zayas has turned her Grace and Peace Church, which serves the greater Belmont Cragin community on the city’s northwest side, into a food bank. Instead of Sunday services these days, she hands out winter coats and canned goods.

Her phone rings at all times of the day and night with grieving congregants. Often, she doesn’t know what to say.

“It’s a very hard situation, because you really don’t know how to console people in these circumstances,” said Zayas, a lifelong Chicago resident and former teacher.

Grace and Peace is located in the majority-Hispanic zip code 60639, which has one of the highest COVID-19 death rates in the city – and one of the lowest vaccination rates so far.

Angelina Zayas, co-founder of the Grace and Peace Community Center, has turned her church into a food bank on Chicago's northwest side.

Angelina Zayas, co-founder of the Grace and Peace Community Center, has turned her church into a food bank on Chicago’s northwest side.
Grace Hauck, USA TODAY

Just 4% of residents in the zip code have received the first dose of COVID-19 vaccine as of Sunday, according to data from the Chicago Department of Public Health. And similarly low vaccination rates exist in other majority-Latino and majority-Black neighborhoods across the city’s south and west sides, despite COVID-19’s disproportionate impact on those populations.

A USA TODAY analysis of data from the city and the U.S. Census Bureau found that, citywide, the vaccination rate in Chicago’s majority-Black or Latino zip codes averaged 5%. Majority-white zip codes averaged 13%. Four of the city’s majority-white zip codes exceeded 20% initial vaccination, while the highest rate for any majority Black or Latino area was 12%.

Chicago is not alone. The data shows similar trends in Washington, D.C., and Austin, Texas, two other places that have reported vaccination rates at the neighborhood level. Statistics from the Centers for Disease Control and Prevention also show gaping disparities nationally, and a recent study of the small number of states reporting race and ethnicity for vaccine recipients showed a widespread pattern of inequity.

It’s possible some majority-white zip codes have higher rates of vaccination in part because they have higher concentrations of people in groups prioritized for the first round of vaccines.

But experts say the findings reflect festering systemic problems, including poor health care access and distrust of the vaccine, colliding amid a chaotic rollout that failed to ensure equal access to communities of color.

“There was so much pressure on the health departments to roll out the vaccine quickly, they built up their systems as quickly as they could but they weren’t built in a way that was necessarily equally accessible to all,” said Dr. Julie Morita, vice president of the Robert Wood Johnson Foundation and former commissioner of the Chicago Department of Public Health.

Ethel Walton lives in a majority-Black south side neighborhood, Auburn Gresham, located in a zip code where just 4% of residents have received a first dose of the COVID-19 vaccine and nearly 120 people have died. The rate of COVID-19 deaths in that zip code is three to four times higher than several majority-white north side neighborhoods. The vaccination rates in those white neighborhoods are six times higher.  

Walton, a nurse, and president of the Chicago Chapter of the Black Nurses Association, said the repeated, disproportional suffering is disheartening. She reflected on the high death rates among Black people, remembering a friend who died after contracting the virus.

“It’s a stressful situation, because no one wants to hear that their (people are) dying of COVID in massive numbers,” she said. “It’s unfair that the immunization has again been made … just not equal at all.”  

Walton said a huge barrier to seniors in her area is transportation. Her group also has been hosting virtual question-and-answer sessions on the vaccine to fight hesitancy stemming from unethical medical injustices throughout the nation’s history. 

“It’s like we’re fighting an unending battle, as well as trying to overcome the myths and the misconceptions,” she said.

The situation in Chicago reflects the slow vaccine rollout in communities of color nationwide.

Data on the topic is spotty. In a recent CDC study, just half of the 12 million patients vaccinated through mid-January provided race or ethnicity information.

However, a Kaiser Family Foundation study analyzing 23 states that reported demographic data found a consistent pattern of people of color falling behind. 

Chicago leaders attempt to help communities of color get COVID-19 vaccines

Communities of color around the U.S. have been lost in the rollout of COVID-19 vaccines, but these Good Samaritans in Chicago are trying to help.

USA TODAY

The CDC study urged authorities to gather better data.

“More complete reporting of race and ethnicity data at the provider and jurisdictional levels is critical to ensure rapid detection of and response to potential disparities in COVID-19 vaccination,” the authors wrote.

More: ‘It’s not a pretty picture’: Why the lack of racial data around COVID vaccines is ‘massive barrier’ to better distribution

Snapshots from places where more detailed information is being collected support the early, incomplete national findings.

In Washington, D.C., for example, majority-white wards are receiving doses at higher rates than wards that are not predominantly white, data from D.C. Health show. A similar trend is seen among zip codes in the state capital of Austin, Texas, according to data from the state analyzed by USA TODAY.

In Florida, where 16% of the state’s population is Black, only about 5% of Black residents were fully vaccinated as of Feb. 9, according to state data. 

Once the epicenter of the pandemic and its disparities, New York’s dashboard shows about 5% of essential workers receiving an initial dose of vaccine are Black, while 17% of all eligible workers are Black. Meanwhile, 74% of essential workers receiving the vaccine are white, a number that nearly matches their share of all eligible essential workers.

Officials are rushing to increase vaccination allocations to leverage clinics and centers that serve low-income people and communities of color.

Dr. Marcella Nunez-Smith, chair of the Biden administration’s COVID-19 Health Equity Task Force, acknowledged Tuesday that structural barriers prevent many from accessing vaccine. 

During a press briefing announcing plans to deliver more vaccine to community health centers, she said the location of vaccination sites is “critical” and nodded to the importance of establishing pharmacies in underserved communities.

“Equity is our north star here. This effort … really is about connecting with those hard-to-reach populations across the country,” Nunez-Smith said.

Communities in Chicago know all too well the impact of so-called “pharmacy deserts,” where pharmacies have closed or don’t exist, making it hard for residents to adhere to medication schedules. The gap contributes to disproportionate ailments and poor health outcomes. Zayas’ greater Belmont Cragin area is one of those communities.

“If pharmacies are not available in specific neighborhoods, specifically majority-minority, majority-Black or -Hispanic neighborhoods in Chicago and elsewhere, you’re going to really have disparities in COVID vaccinations,” said Dima Qato, a University of Southern California School of Pharmacy professor, who led an extensive study of pharmacy deserts in Chicago.

Dima Qato, University of Southern California School of Pharmacy professor
It’s pretty simple: If pharmacies are playing a critical role … first with testing and now it’s with COVID vaccinations, and they’re not available or accessible in minority neighborhoods, it’s not going to make it better for these neighborhoods. It could only make it worse in terms of the COVID pandemic.

“It’s pretty simple: If pharmacies are playing a critical role … first with testing and now it’s with COVID vaccinations, and they’re not available or accessible in minority neighborhoods, it’s not going to make it better for these neighborhoods. It could only make it worse in terms of the COVID pandemic,” Qato said, adding that officials should bring vaccine into neighborhoods to remove transportation as a barrier.

Many experts also have been pointing to occupational disparities concentrated at the zip code level.

Dr. Helene Gayle, a physician and CEO of the Chicago Community Trust, said Chicago’s affluent and majority-white neighborhoods have more health care workers, who were prioritized in the first phase of vaccine distribution.

“In some of the big health care systems that got access to vaccine earlier, those are also more likely to employ people who come from more affluent, more privileged zip codes,” Gayle said.

As the phases continue to roll out, Gayle said officials shouldn’t prioritize speed over equity.

People from across Chicago trickled in and out of Roseland Community Hospital on the city's far south side in the 12-degree weather on Feb. 5, 2021. The hospital has been offering COVID-19 vaccinations by appointment.

People from across Chicago trickled in and out of Roseland Community Hospital on the city’s far south side in the 12-degree weather on Feb. 5, 2021. The hospital has been offering COVID-19 vaccinations by appointment.
Grace Hauck

“People often talk about, ‘Let’s vaccinate as quickly as we possibly can,'” she said. “We can’t let speed get in the way of equity. … We want to go where the risk is highest, because that’s where this vaccine will have the greatest impact.”

About a year ago, the trust launched an initiative focused on closing racial wealth gaps, and recently, an equitable recovery program.

“We found that it was so core to some of the other challenges we see here in the city, in the region: education, violence, health disparities,” Gayle said. “Underlying a lot of those issues is this wealth gap that has in fact been deepened as a result of the COVID pandemic.” 

The gravity of disproportionate suffering from the pandemic became apparent early on  in Chicago: 70% of the city’s early deaths were among Black people, according to reports from the first week of April 2020.

“Anyone who does research or activism around health inequities in Chicago would have anticipated this – just because of the way that opportunity is structured in the city of Chicago,” said Jeni Hebert-Beirne, University of Illinois at Chicago community health professor and director of the Collaboratory for Health Justice.

“Given our history of segregation and redlining, Chicago is a hyper-segregated city. This pattern we see of more favorable opportunity for health, whether it’s vaccinations or healthy food … aligns with race.”

Jeni Hebert-Beirne, University of Illinois at Chicago community health professor and director of the Collaboratory for Health Justice
Given our history of segregation and redlining, Chicago is a hyper-segregated city. This pattern we see of more favorable opportunity for health, whether it’s vaccinations or healthy food … aligns with race.

On Jan. 25, as the city of Chicago moved into its second phase of vaccinations, Mayor Lori Lightfoot sounded the alarm on disproportionate vaccination rates.

“Unexpectedly low numbers of Black and brown Chicagoans have taken the vaccine so far, a percentage that is so alarmingly low that if we do not reverse this trend, we will continue to see more Black and brown fathers, mothers, grandparents, sons, daughters die of the virus when a vaccine is right here, right now, for free, for all.” 

In its first six weeks of vaccinations, Chicago gave shots to 108,000 frontline healthcare workers and residents of long term care facilities. Approximately 17% of people who received a first dose were Latino and 15% were Black, city officials announced last month. 

“Our city is two-third people of color, and yet we are falling woefully behind in the number of people of color who have been vaccinated to date,” said Lightfoot, who received her first vaccine dose Jan. 25 at St. Bernard Hospital in Englewood. The predominantly Black community is in a zip code that has experienced one of the city’s highest COVID-19 death rates – 248 per 100,000 residents – yet has one of the lowest vaccination rates: 3.5%. 

Roseland, on Chicago's far south side, includes part of the 60628 zip code, where approximately 4% of residents have received a first vaccine dose, according to city data.

Roseland, on Chicago’s far south side, includes part of the 60628 zip code, where approximately 4% of residents have received a first vaccine dose, according to city data.
Grace Hauck

“You are the most reluctant,” Lightfoot said. “We want to do everything possible to break through the noise to address your fears and anything else that may be holding you back from taking this life-saving vaccine.”

Another Black-majority neighborhood where city officials hope to improve vaccine access sits just five miles south of Englewood. In Roseland, grocery stores are scarce and about a quarter of residents live in poverty and rely on public transportation to get to work – twice the rates for Chicago as a whole. And like Englewood, the area has seen both high COVID-19 death rates and low vaccination rates.

In  Roseland, nearly 14% of residents are essential workers included in phases 1B and 1C vaccination plan; phase 1B launched Jan. 25 and includes first responders, teachers, grocery store workers, childcare and transit professionals and more. According to city data, nearly 18% of Roseland residents are 65 or older, and almost 70% of adults under 65 have at least one comorbid condition increasing their risk for severe COVID-19 outcomes. And while about 80% of Chicago adults report having a primary care doctor, nearly a third of adult residents in Roseland do not.

To ensure Roseland residents had access to the vaccine, city officials made sure several hospitals and health centers in the area received doses. 

Last week, residents from neighborhoods across Chicago periodically trickled in and out of Roseland Community Hospital, many shuffling past bundled in coats as a handful waited outside for loved ones in the 12-degree weather, standing on sidewalks lined with piles of snow.

Many receiving vaccinations at the hospital were not locals and hailed from neighborhoods across the city, including several from downtown Chicago zip codes that are majority-white. Roseland residents, meanwhile, said they were unsure about the vaccines.

“I need more research in order to get the vaccine. As of right now, I wouldn’t take it,” said Varnard Maggiefield, 52, a service technician. “A lot of people, they’re not going to take it.”

Jerry Stokes, 38, said he wasn’t sure when or how he would get the vaccine.

“I don’t know. Do the vaccines work or not?” he asked as he walked past the hospital wearing a sweatshirt and White Sox hat, headed home from the store. “I hope it don’t make it worse.”

Stokes said a few of his friends have had COVID-19, but they don’t leave their homes much anymore. Now he’s becoming “paranoid” about catching the virus. Stokes said he was recently discussing the vaccines with his mother and siblings. “They’re scared,” he said.

Jerry Stokes, 38, a Roseland resident of 20 years, stands outside Roseland Community Hospital on his way home from the store in Chicago on Feb. 5, 2021.

Jerry Stokes, 38, a Roseland resident of 20 years, stands outside Roseland Community Hospital on his way home from the store in Chicago on Feb. 5, 2021.
Grace Hauck

In recent weeks, city officials have dedicated additional vaccine resources to 15 neighborhoods disproportionately impacted by COVID-19 and are uniquely vulnerable to barriers to vaccinations. Seven are majority Latinx, and eight are majority Black. Nine are on the city’s northwest and southwest sides, and six on the south side.

City officials say the north side neighborhoods of North Center and Lake View are the least vulnerable to COVID-19 and have the fewest barriers to vaccine access. The neighborhoods include zip codes 60613 and 60657 – largely younger and white areas where the median household income is about 50% higher than the citywide average and as much as four times higher than that found in poorer parts of the city.

Those two north side zip codes have COVID-19 death rates three times lower and vaccination rates three times higher than in the zip codes that contain majority-Black Roseland and majority-Hispanic Belmont Cragin.

Former pharmacist Marissa Hampton, 35, walked her dog, Renly, in Chicago's north side North Center neighborhood on Feb. 5, 2021. Hampton said she has administered dozens of shots in the past for other viruses and plans to get a COVID-19 vaccine as soon as possible.


Former pharmacist Marissa Hampton, 35, walked her dog, Renly, in Chicago’s north side North Center neighborhood on Feb. 5, 2021. Hampton said she has administered…
Former pharmacist Marissa Hampton, 35, walked her dog, Renly, in Chicago’s north side North Center neighborhood on Feb. 5, 2021. Hampton said she has administered dozens of shots in the past for other viruses and plans to get a COVID-19 vaccine as soon as possible.
Grace Hauck

Marissa Hampton, 35, walked her dog, Renly, Friday night in North Center. They passed rows of town homes, some with bushes and porches still strung with colored lights from the holidays. A former technician and pharmacist for CVS, Hampton has administered dozens of shots in the past for other viruses. She plans to get a coronavirus vaccine as soon as possible.

“I’ve always wanted people to get their vaccines, for flu shots, shingles, pneumonia – anything that anyone’s qualified for, obviously if they don’t have any allergic reactions to it,” said Hampton, who now works on the business side of a pharmacy.

Her mother, who works at a hospital in her hometown of Springfield, Illinois, received both doses of vaccine and had mild side-effects, Hampton said. Her grandparents have also been vaccinated.

“Obviously the virus mutates, but that happens with the flu virus every year anyways,” she said. “It’s just more important to get everybody vaccinated to get that herd immunity.”

North Center stands in stark contrast to Belmont Cragin, a community Zayas’ Grace and Peace Church serves.

One in five residents there is an essential worker, according to city data, with many working in manufacturing, educational services and social assistance. The median household income in its primary zip code is about $46,000, half of that found in North Center.

Census data also shows the average household size there is 72% higher than the average in white-majority zip codes, increasing the odds someone will contract COVID-19.  A third of adults lack a primary care doctor and the neighborhood, where income caps at $46,000 and about 20% of people live in poverty, has a dearth of pharmacies.

James Rudyk, Jr., executive director of the community’s Northwest Side Housing Center, says those are real barriers to vaccine access. Most residents in the Belmont Cragin struggle to navigate online registration systems, he said, and can’t take time off work to get vaccinated or may not have the means of transportation to get to a vaccination site.

In white-majority zip codes, about 3% of homes do not have internet access compared to 7% in other Chicago neighborhoods, including some where the figure is as high as 14%.

“We haven’t made things simple for folks,” said Rudyk, who is working to improve vaccine distribution through direct community outreach and grassroots efforts. His organization also is working with the city to stand up a mass vaccination site at a nearby school. People who want to receive a shot will need to show proof of residence.

“Everyone I’ve interacted with, at the city, public and private clinics, is working extremely hard and doing their best to try to figure this out. I do believe the city is trying to get vaccine to Black and brown folks on the south and west sides,” he said last week, coming off of back-to-back calls on vaccine distribution. “With that said, I have come to realize that the structure is not set up to support equity.”

Chicago's North Center area is home to a couple of the city’s top public schools, including Lane Tech College Prep, pictured here Feb. 5, 2021. The 60618 zip code, where the school is located, has large white and Latino populations, and nearly 8% of the residents have received a first vaccine dose, according to city data.


Chicago’s North Center area is home to a couple of the city’s top public schools, including Lane Tech College Prep, pictured here Feb. 5, 2021….
Chicago’s North Center area is home to a couple of the city’s top public schools, including Lane Tech College Prep, pictured here Feb. 5, 2021. The 60618 zip code, where the school is located, has large white and Latino populations, and nearly 8% of the residents have received a first vaccine dose, according to city data.
Grace Hauck

Belmont Cragin resident and retired nurse Darlene Ruiz, 65, said it’s been difficult to figure out how, when and where to register for a vaccination. Ruiz said she tried to register online for a vaccine with the city of Chicago and was “kicked out” of the website three times.

“They’re making it complex as far as registering, using identification codes or passwords and then when you go to register, they’re no longer valid or they had expired,” Ruiz said. “I was almost discouraged.”

Ruiz said she received her first dose Thursday at a vaccine a pop-up clinic in her independent living facility, Senior Suites, which houses people 62 and older. If the shots hadn’t come to her, she’s not sure when she would have gotten it, Ruiz said.

At the same time, many of the people in her building chose not to get vaccinated, she added. Even her daughter, who lives down the street, is skeptical about getting the vaccine.

“Some people didn’t do it. I think that they’re worried. They’re just scared,” she said.

Rudyk said residents are more inclined to get vaccinated if someone they trust does first.

“Folks want it to be real, they want to see someone from their community,” Rudyk said. “Like, I don’t know Joe Biden, do you? People want it to be real to them.” His group has asked people in the neighborhood to share their vaccination stories on social media.

Grace and Peace Community Center, located on Chicago's northwest side, has turned into a food bank.

Grace and Peace Community Center, located on Chicago’s northwest side, has turned into a food bank.
Grace Hauck, USA TODAY

Back at Grace and Peace, Zayas is working with Lurie Children’s Hospital and the city to turn the church into a vaccination site. In the meantime, when she and her husband received their vaccinations, they posted videos celebrating the event online.

Zayas, who is Puerto Rican and Black, wants to dispel skepticism of the vaccine within her communities and reassure them of its safety while directing people to how and where to get the shot.

“It’s really important for us to stand in the gap for our people,” she said.

Reach Nada Hassanein at nhassanein@usatoday.com and Grace Hauck at ghauck@usatoday.com.

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