Governor Chris Sununu’s COVID-19 Equity Response team has released its report about New Hampshire’s response to the pandemic. The team was created in May to investigate how COVID-19 disportionately impacts communities of color.
The group’s recommendations include a list of immediate, short-term and long-term steps to address the disparities.
Some of the immediate recommendations include increasing testing, deploying COVID-19 response community health workers, and providing isolation and quarantine housing.
Dottie Morris is one of five people on the response team, and she’s also the associate vice president of Institutional Equity and Diversity at Keene State. She says a key point in the report is that equity needs to be a part of many institutions – not just the healthcare system.
“Why did we talk about employment, why did we talk about education? All those things play a role in how we are healthy,” she said.
The team has planned community forums to talk about the initial report and its recommendations.
Morris has a few tips for people who may not have time to read the full report but still want an overview. She suggests reading through the executive summary, which starts on page 4, and then looking at the chart of recommendations in 13 different areas that the group has drafted.
Bobbie Bagley, the Director of the Division of Public Health & Community Services in Nashua, is another member of the equity team. She joined NHPR's Peter Biello to talk about the report and what comes next.
So one of the big takeaways from this report was that COVID-19 didn't create inequities, but it did reveal the connection between infection and mortality rates in some of what are called upstream factors. Can you talk a little bit about the upstream factors that led to this disproportionate impact of COVID-19 on communities of color?
Sure. So when we think about upstream factors, we're really focused on some of the systems that are in place that help us provide access to services of important resources for all of our populations to help maintain health, safety and well-being. And so what we've seen with the onset of this pandemic, you know, is where some of those gaps exist in those upstream factors of making sure that all populations are served equitably.
New Hampshire has not yet issued a mask mandate. How does that impact communities of color?
Not having a mask mandate for one, if we understand the importance of the mask with reducing exposure to respiratory droplets, and so if you're in situations where you're the frontline essential worker and individuals do not have face coverings, a mask that keeps their respiratory droplets from being expelled into the environment, then you're exposed to those respiratory droplets, and you're not in a place of safety. And so that's how that impacts those population groups where, you know, if the majority of individuals that represent our racial and ethnically diverse populations are in those types of jobs, where they're essential workers, either in hospitality, working in fast food restaurants, or service industries where they come into contact with people, and that mask mandate is not there? They're at greater risk for exposure.
You wrote in this report about the need for people to trust the state's public health systems. Do communities of color in New Hampshire trust the state's public health system?
At varying degrees, and I think that comes with how we in public health try to build rapport and establish relationships with our community, that's in sharing information. And so, for instance, we love to collect data in public health because data helps inform where we have gaps that need to be closed. And so if we collect data, and that data is not analyzed appropriately or correctly, and that data is not used in the most appropriate way, it creates distrust. And so, for the most part, if we can establish relationships and build rapport within communities, diverse communities and communities of color, we can continue to have that rapport that's there when that's not data. Trust is not there. If the trust is not there, you're not going to have people relying and trusting in that in the public health system. And if we do things that bring on distrust, by not communicating clear information that allows for everyone to have the same opportunities for wellness, for health, for access to services, that's going to create mistrust and distrust as well.
I see the report warns that addressing the health care system in isolation is not sufficient to resolve public health inequities. Why is that?
You have to be able to address all of the other factors that impact health. So that includes socio-economic status, access to well-paying jobs, the opportunities for appropriate housing and affordable housing. And it includes having access to healthy foods. It also includes being in a safe neighborhood. It includes being able to know who your neighbors are, being able to trust your neighbors, and being able to trust some of the systems that are in place and believe that those systems are in place for you as well.
So all of those things can impact, at the end, a person's overall mental health and their physical health.
And the report calls for a standing equity response team that will continue this work, and it calls for bringing more voices as well. How do you see the work of this team continuing?
You know, we had a quick turnaround time to pull together these recommendations, we were given 30 days. I'm really impressed with our work, that we're able to do get it all put together in 36 days. But what we also realized was that our voices, or what we were able to bring to the table with the input from some of the stakeholders and some of the partners across the state that also submitted some information, we still need to be able to continue this work. So it can't be just something else like that as a, you know, a short term task force, because we didn't get to this place where we have these disparities and gaps in a short period of time. These are things that have come into place over decades. So it's going to take decades for us to overcome and be successful at closing those gaps.