A Tool for Biden’s Task Force to Use to Ensure an Equitable Recovery to COVID-19
Among the 24 executive orders issued by President Joe Biden since assuming his role as President of the United States is Executive Order 13995: Ensuring an Equitable Pandemic Response and Recovery. The order addresses the disproportionate impact of COVID-19 on communities of color and other underserved populations, as well as outlines the establishment of a COVID-19 Health Equity Task Force to address this inequity. The task force will provide recommendations for how to mitigate health inequalities caused or exacerbated by COVID-19. It will also offer input on what to do to prevent future inequities, including recommendations for how to best distribute resources and funds. To do this, the task force will need to consider the underlying health and social vulnerabilities of different communities across multiple axes, and integrate that data with COVID-19 infection and mortality rates. This information will allow decision makers to effectively target aid and will ensure the most equitable recovery response possible.
The COVID-19 Community Vulnerability Index (CVI) was created to address this exact need. The science-backed tool incorporates data on a wide range of health, socio-economic, demographic, and infrastructure variables to illuminate the true vulnerability of each U.S. county to the lasting impacts of COVID-19. The risk assessment tool uses predictive modeling to then determine where aid would be most effective. Each county in the United States is assigned a score for each risk metric (‘Severe COVID Case Complications,’ ‘Risk of Severe Economic Harm,’ and ‘Need for Mobile Health Resources’), which would allow the task force to easily rank needs. These scores are visualized on an intuitive, interactive dashboard. This tool also utilizes the “place-based approach to data collection and the response” called for in the executive order.
The CVI has one of the most extensive literature review foundations and depicts the most comprehensive representation of the lasting impacts of COVID-19 of any of the currently available COVID-19 assessment tools. These scores will specifically address the task force’s objectives and allow it to make effective recommendations.
The Severe COVID Case Complications score integrates case count data with historical illness data, which underscores many of the existing socio-economic vulnerabilities that impact the severity of COVID-19 on a community. Very few other dashboards use this methodology, instead relying on solely case counts, which provides a less accurate picture of COVID’s potential impact.
Two scores in particular are relevant to this task force’s explicit objectives: the Need for Mobile Health Resources score and the Risk of Severe Economic Harm score.
The tool’s Need for Mobile Health Resources score provides a metric to assess which communities in the U.S. could most benefit from mobile health services. Mobile health clinics, one of these services, have been shown to improve health outcomes in underserved groups even before the pandemic, by reducing barriers to receiving care. They are also cost-effective, which is a beneficial attribute when available funds are limited. (Stephanie, W. Y. Yu., et al. 2017) Two other cost-effective solutions that this metric takes into consideration are telehealth/virtual visits and health apps, both significant health services for people living in rural and remote areas. (Human Resources & Services Administration) The dashboard also incorporates internet availability and smartphone/tablet usage in an area, for users to cross-reference with the mobile health metric, ensuring aid is provided to areas that can actually utilize it.
The Need for Mobile Health Resources score includes data on communities of color and other underserved populations, as well as a variety of demographic, health and transportation and mobility data, particularly highlighting populations that have a hard time navigating or physically reaching health resources and institutions, like non-white residents, non-English speaking residents, veterans and disabled and elderly persons. The overall risk score for each county is created by combining these individual variables, with weights of each variable informed by relevant public health literature. More information can be found on the open source project’s GitHub page.
The tool’s Risk of Severe Economic Harm score describes the likelihood that a community will experience severe economic hardship due to COVID-19 complications, including business closures and policy interventions. It incorporates classic indicators of the economic health of an area: poverty rate, income levels, rate of those without a college degree, and unemployment rate. This is supplemented with figures provided by the Bureau of Labor Statistics, tracking people who have completely given up looking for work or who are on temporary layoff, a particular outcome of the pandemic. These numbers have elucidated the unequal impact of the pandemic on minority communities, the majority of which are employed within jobs that were impacted by COVID-19. This score is still being updated with new information as datasets are found.
This score is unique in considering people with part-time or shift work, which are often held by the “essential workers” defined by the CDC and do not traditionally come with health insurance or paid time off. It also considers specific industries impacted by the pandemic. Some industries suffered at the beginning of the pandemic and have since recovered, like retail, yet other industries, like tourism, leisure & hospitality, will continue to be impacted further into the future, due to the main industries and jobs in those regions. In the past, areas in a similar situation have seen black and brown community members disproportionately impacted by the change. Historical resiliency will also be considered, which includes the variables of population change in an area and regional GDP, indicating areas in the US that are economically left behind, like The Rust Belt or Detroit, where the 2008 financial crisis both devastated and began with exploitation of black and poor, working class families.
The Covid-19 Community Vulnerability Index can help the COVID-19 Health Equity Task Force assess community risk levels around the United States and provide effective recommendations on how to best distribute recovery funding and mobile health resources. These measures will both ensure the administration’s approach to response and recovery is an equitable one. The team is reachable via covid.vulnerability@gmail.com and has more information on their Github page.
by Annina Christensen
