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Today we are releasing a report with comprehensive recommendations to address the stark, disturbing racial and ethnic inequities in pandemic outcomes. We called it "The Fierce Urgency of Now". A thread on our key recommendations. https://familiesusa.org/resources/the-fierce-urgency-of-now-federal-and-state-policy-recommendations-to-address-health-inequities-in-the-era-of-covid-19/
2. Racial and ethnic disparities in COVID outcomes are a major driver of our country's overall high hospitalization and death rates. And they derive for a long and ongoing history of injustice and discrimination. But we can take concrete steps in the short and long term.
3. We can take those steps and--after tens of thousands of deaths--we have to. Now. Yesterday. We can't wait any longer.
4. We break the recommendations out into five areas, and then, within each area, list state and federal short-term and long-term options. They are organized broadly from underlying social drivers of health equity to upfront health care delivery.
5. The first area is "social determinants of health". A technical phrase that encapsulates deprivation and inequality so intense that it affects physical health. Our recs here address paid sick leave, food security, child abuse prevention, housing, and mass incarceration.
6. We also recommend new federal and state healthcare funding pathways focused on social drivers of poor health outcomes, with grants, Medicaid peer support funding, and braiding Medicaid with other funding streams.
7. Our second area for recs: "Build Strong Financial Incentives in Our Health Care System for Improved Health Equity". We need to incorporate explicit measurements of health equity into pay for performance in health care. Notably, some state programs are pioneering this effort.
8. Our third area for recs: building public health capacity both in the short-term to implement test trace & quarantine, AND in the long-term to engage in robust community-level community prevention.
9. We're concerned that communities of color will receive too limited resources for testing etc as states scramble and as CDC is--unfortunately--AWOL on pandemic response coordination. We are working for legislative language to direct federal $. https://twitter.com/FishmanEliot/status/1264943799291297795
10. Our fourth area of recs: health insurance. We should expand health coverage to immigrants--but we have been taking it away. We should be doing everything we can right now to sign up people losing employer coverage in Medicaid or subsidized marketplace coverage.
11. Ultimately we should be doing what every other advanced country does and covering everybody automatically. At long last...
12. Our fifth set of recs ties into health care delivery for COVID itself and shifting people out of residential long-term care settings to safer home care options. These recs extend to funding for language services and for clinical trials that include diverse populations.
13. In this context this major national report by the New York Times regarding racial disparities in nursing home COVID deaths is an important--and upsetting--demonstration of home and community-based services as a racial justice issue: https://www.nytimes.com/article/coronavirus-nursing-homes-racial-disparity.html
14. If there were one take-away I hope people get from this report, it is that we don't have to accept what has happened to people of color in the United States the last three months. We can do something about it. Starting with COVID 4 legislation, hopefully in June. /End thread
