IMPAQ Health News
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This edition of IMPAQ Health News highlights stories on the intersection of COVID-19 and movements for social justice, racial and ethnic disparities of the pandemic, and the growing mental health crisis.
“From investigating how we address health equity amidst COVID-19 , to promoting access to nutrition, issues of racial justice are inextricably linked to the challenges we work to solve here at IMPAQ,” says IMPAQ President Dr. Adaeze Enekwechi in this personal message to the IMPAQ community and beyond. “Long-standing systemic biases in the justice system, but also in education, health care, and other institutions meant to serve all people, have grown more insidious with time. Only by calling them out as unacceptable and keeping them in the spotlight do we stand a chance to dismantle them through action.”
Government Response
As protesters in all 50 states and DC march for critical social justice reforms, some states are revising COVID-19 testing guidelines to ensure all protesters can access tests, hoping to prevent a spike in cases. At the federal level, though Congress continues to debate the details of the next coronavirus stimulus package , both chambers of Congress and President Trump approved a bill to ease conditions on relief loans for small businesses. After receiving a letter from a bipartisan group of congressional leaders, Alex Azar, the Secretary of Health and Human Services (HHS), announced on June 9 that HHS would distribute $25 billion to safety net hospitals and other health providers that treat Medicaid patients. The Trump Administration also released new requirements for states to report demographic information (i.e., race, ethnicity, age, and sex) within COVID-19 data. This decision comes after widespread criticism about insufficient demographic reporting and mounting evidence that the virus is disproportionately affecting minorities in the United States. To fast-track a vaccine, the Trump Administration  selected five candidates that are most likely to produce a vaccine  to receive additional federal funding and support. Dr. Anthony Fauci predicts that clinical trials occurring now in the United States should lead to 100 million COVID-19 vaccine doses of one vaccine by the end of 2020. 
Here are some resources for following the latest COVID-19 news:
  • Opportunity Insights created a tracker of the economic impacts of COVID-19 policies on local and national communities.

  • Johns Hopkins developed a frequently updated worldwide map of confirmed COVID-19 cases and deaths.

  • To better understand racial disparities at the state level, NPR analyzed demographic data by comparing each racial or ethnic group’s share of infections to their share of the population.
Social Justice, Protests, & COVID-19
The killing of George Floyd has led to large-scale protests for racial justice across the United States. Public health officials are now concerned that protests could pose a new health risk for a population that has already been disproportionately affected by the virus.  Politico (6/3)
Social determinants of health have long been a key facet in the health care system’s plan to move to a more value-based care system. However, the inequities highlighted by the recent killing of George Floyd and COVID-19’s disproportionate impact on Black communities have laid bare the economic, political, and social determinants of health fueled by decades of systemic racism in the US health care system. Alan Weil, the editor-in-chief of Health Affairs, argues that in order to create lasting change, health care institutions will need to do more than just stand against racism—they must use their power to actively fight against it and divert resources to non-health care settings. Health Affairs (6/3)
Public health officials are concerned that there will be an increase in COVID-19 cases as a result of large protests for social justice. Many protesters are not adhering to social distancing protocols, and in some cases are not wearing face masks. Minneapolis, the epicenter of the movement, ranked the eighth highest in new cases per capita in the past two weeks. Additionally, experts are concerned that the use of tear gas and smoke from fires could exacerbate the spread of the virus. CBS News (6/3)

  • While epidemiologists predict the number of positive COVID-19 cases will grow over the next few weeks as a result of the mass protests, experts point out that COVID-19 cases were already rising as a result of states opening too early and not having the necessary testing and tracing resources at their disposal. Additionally, many public health experts emphasize that the root cause of the protests—systemic racism—has a far greater impact on health. The Verge (6/3)
Jails and prisons have been identified as a major hotspot for COVID-19 transmission. A recent Health Affairs study evaluated the relationship between jailing practices and community spread using data from Cook County Jail in Chicago, one of the largest hotspots of COVID-19. The study found that jail cycling, the process of a person being arrested, released, and then arrested again, accounted for almost 16 percent of coronavirus cases in Chicago as of April 19, 2020. Health Affairs (6/4)
COVID-19 Amplifies Racial & Ethnic Health Inequities Across the Country
Early in the COVID-19 pandemic, most states did not publish detailed demographic data on confirmed cases. As states began publishing these statistics, a pattern emerged showing that racial and ethnic minorities are disproportionately affected by COVID-19. Scholars emphasize the importance of these statistics, stating they make it possible for state and local officials to direct resources to the hardest-hit areas. The Washington Post (5/26)

  • Modern Healthcare explains that much of the health care system has yet to fully acknowledge how racial discrimination and bias have helped to create socioeconomic disadvantages in minority communities. (6/6)
To better understand racial disparities at the state level, NPR analyzed demographic data by comparing each racial/ethnic group’s share of infections to their share of the population. Results show that the rate of Black Americans dying from COVID-19 is two times greater than expected and that Latinos make up a greater share of confirmed cases than their total percent of the population in 42 states and DC. NPR (5/30)
Dar’Yana Dyson is now one of the youngest people to die of COVID-19 in Maryland. Dar’Yana’s story exemplifies the long-standing health disparities for low-income African Americans, and shows that more needs to be done to address health inequities among communities of color. The Washington Post (6/6)
COVID-19 & the Mental Health Crisis
In the areas hardest hit by COVID-19, the direct effects on mental health services are severe. Behavioral health workers found themselves overburdened and residential programs and call centers had to reduce or close their services. These issues are a result of insufficient emergency preparedness measures, including a lack of training and funding around acute mental health issues that could develop during and after a pandemic. Kaiser Health News (6/4)
Samaritans of New York, a 24-hour suicide prevention agency, had to put their anonymous suicide hotline on hold permanently for the first time in 37 years. People are now asked to leave their name, number, and a time for a volunteer to call them back. The New York Times explores a day in the life of one of those volunteers, and how his role as a mental health worker is helping New Yorkers to cope. New York Times (6/5)
With stay-at-home orders and social distancing in effect across the United States, organizations are finding it harder to get resources to those struggling with substance use disorder. To counteract these fears, some non-profits have flooded hard-hit neighborhoods with Narcan, a lifesaving drug, and new relaxed federal restrictions have made it easier to access medications that curb opioid cravings. Kaiser Health News (6/2)
Beyond the Headlines
In a letter to HHS Secretary Alex Azar, House and Senate lawmakers requested a timeline for distributing $100 billion in funds Congress earmarked for providers months ago in the CARES Act. Delaying the distribution of this aid, the letter argues, could shut down safety net hospitals and clinics nationwide as a result of the effects of COVID-19. Politico (6/2)
In an effort to sustain value-based care models implemented by the Center for Medicare & Medicaid Innovation (CMMI), CMS recently released new flexibilities and adjustments to current and future CMMI models as a result of COVID-19. These include changes to model payment methodologies and delaying certain reporting requirements. Learn more about these changes in a blog post authored by CMS Administrator Seema Verma. Health Affairs (6/3)
Community health workers provide tailored support based on individuals’ specific needs and preferences and can advocate with employers. However, according to the Bureau of Labor, there are only approximately 59,000 community health workers employed in the US and they are paid through a patchwork of funding, making it difficult for these workers to fill the labor gap as thousands of health workers are being laid off. Scaling up community health workers and establishing clear funding channels are key to ensuring these workers can support long-term public health. Health Affairs (6/5)
Spotlight on IMPAQ
On May 28, IMPAQ hosted a free webinar featuring nationally recognized health and social justice experts . Led by IMPAQ President Dr. Adaeze Enekwechi, topics included overcoming major data gaps related to COVID-19, creating access to telehealth for low-income communities, and tackling implicit bias and structural racism in the US health care system.

The sudden and sometimes unexpected decrease in working beneficiaries’ public benefits (such as TANF, SNAP, and Medicaid) that can occur with modest increases in earnings is referred to by many as the “welfare cliff” or “cliff effect.” IMPAQ was recently awarded a contract by Maine’s Office for Family Independence to evaluate new state policies and programs aimed at ameliorating or alleviating this “cliff effect.”
Feel-Good News Stories
Below are a few feel-good stories to remind us that no matter what, people always find a way to help one another, even in times of crisis.
Stephen Wamukota, a nine-year-old in Kenya, received an award after he developed a touchless hand-washing machine. The machine, build out of wood, allows a user to wash their hands by pushing a pedal with their foot. The BBC (6/2)
Mickey Nelson, a World War II Veteran, is walking 100 miles in an initiative that he has named “Walking to 100.” Nelson, who turns 100 on June 27, plans to walk 100 miles to raise money for the Salvation Army’s feeding and emergency programs. To date, Nelson has raised over $42,000. CNN (5/30)
Graphic of the Week
There is a strong body of research that highlights the link between experiencing the chronic stress caused by racism and poor health outcomes. In an  op-ed for the Washington Post , Michelle A. Williams, dean of the faculty at Harvard T.H. Chan School of Public Health, and Jeffrey Sánchez, a former Massachusetts state representative and current Harvard lecturer, explore why racism is a public health issue.
Upcoming Events, Trainings, Tools, & Webinars
A new analysis estimates that homeless individuals infected with COVID-19 are more likely to require critical care and die compared to the general population. This webinar will evaluate the state of homelessness in the United States and offer strategies to improve outcomes for this population in the short and long term. Register .
This discussion will highlight how the COVID-19 pandemic and ongoing systemic racism impact homelessness and housing inequity. The webinar will explore links between racism, health, and housing. Register .
Virtual care and digital health have become increasingly popular as a result of COVID-19. This webinar, sponsored by Stat News, will discuss the benefits and challenges of the increased use of virtual and digital care, as well as how virtual care will shift in a post-pandemic world. Register .
Community-Campus Partnerships for Health (CCPH) and the UNC Center for Health Equity Research at the University of North Carolina at Chapel Hill have partnered highlight the disparate impact of COVID-19 in the nation’s most vulnerable communities. Each session will be recorded and transcribed and linked on this webpage. Subscribe to the CCPH mailing list to be notified of upcoming sessions.
NOTE: The information, analyses, and opinions expressed in the articles, publications, or comments contained therein are those of the authors and should not be considered verified or endorsed by IMPAQ or any of our partners or clients.