Op-ed: Non-traditional public health messengers

The Key to Addressing Health Equity During COVID-19

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Dr. Sherita Golden and Rev. Kobi Little. (AFRO screenshot and Twitter photo)

Submitted by Dr. Sherita Golden and Rev. Kobi Little

The year 2020 will likely be remembered forever because of the COVID-19 pandemic. Most heartbreaking this year, has been the disproportionate number of infections, hospitalizations, and deaths impacting the African-American communities in Baltimore and across our country. For Black leaders in healthcare and public service this harsh reality has propelled us to use our leadership platforms to advocate for a health equity agenda for all of those being ravaged by the pandemic – African American, Latinx, immigrant, impoverished, homeless, and other vulnerable populations.

Our current healthcare crisis calls as much for a civil rights campaign as a public health campaign. The pandemic requires healthcare leadership to develop innovative approaches to partnering with and elevating trusted community messengers. In the midst of this crisis the leadership at the Baltimore City Branch of the NAACP and Johns Hopkins Medicine recognized that the most effective conveyors of life-saving public health messages right now are those with influence in the community beyond the healthcare system. In light of this reality, together, we forged a health system-community partnership this past April.

As spring was dawning in Baltimore, the Baltimore NAACP recognized that residents of many communities at the highest risk for adverse outcomes from contracting COVID-19 were not practicing recommended social distancing guidelines. The Branch envisioned sending a mobile public health education unit outfitted with banners and loudspeakers throughout Baltimore City communities to promote key COVID-19 prevention messages – stay at home, if you must go out observe social distancing, avoid congregating in groups, wash your hands, and wear a mask – delivered by local celebrities with whom at risk neighborhood residents could identify. At the same time, the NAACP convened monthly virtual town halls to share the latest information. Medical and public health professionals from JHM participated in the meetings and offered timely and frank updates. 

During the summer, the NAACP and others distributed over 80,000 masks, provided by JHM, to high risk communities in Baltimore City to reinforce the importance of this COVID-19 prevention strategy. Given that nutrition is essential for maintaining strong immune systems, Johns Hopkins Medicine, the NAACP and others have coordinated the delivery of tons of fresh produce to families across the city.

Now we are nearing the end of 2020, and to date have lost over 46,000 fellow African Americans to COVID-19 across the United States. There are now therapies to treat hospitalized patients with severe COVID-19 (e.g. remdesivir and dexamethasone) and emerging monoclonal antibody therapies to treat outpatients with COVID-19. Two companies recently submitted COVID-19 vaccine trial data to the Food and Drug Administration (FDA) seeking an emergency use authorization. African Americans are at high risk of severe disease and death from COVID-19 due to increased exposure (e.g. employment in essential jobs that require on-site work) and to long-standing structural racism resulting in poor access to and quality of healthcare, high prevalence of chronic illnesses (e.g. diabetes, obesity, asthma), and neglected neighborhood and living conditions. This high risk will likely result in African Americans being a high priority group for new therapies and vaccines. 

However, our community’s prior history of being experimented upon without our consent, as well as the rapidity with which new COVID-19 therapies and vaccines are being developed, gives many African Americans cause for pause. In this moment it is critical for healthcare and government leaders to partner with trusted community messengers – civil servants, faith leaders, and others – to ensure that healthcare and government leaders conduct themselves in ways that are ethical, equitable and trustworthy. With this unified collaboration we will be able to make sure that our community is properly educated about these evolving interventions so that we can make fully informed decisions for ourselves and our loved ones. 

Physicians and other healthcare leaders need to recognize that the powerful voices of trusted community messengers are the crucial conduit through which we will disseminate life-saving public health messages and education during this crisis. Additionally, as financial investments are made to expand capacity to implement these interventions, our community must not be excluded from the business of healthcare. From science and supply chains to communications and clinics, African Americans and other people of color must be included in the economic opportunities.

With our JHM-NAACP partnership, we are grateful, in such a time as this, to be on a joint mission to save the lives of our people. We invite other trusted leaders and organizations to join us.

Dr. Sherita Golden is a Professor and the Vice President and Chief Diversity Officer for Johns Hopkins Medicine.

Rev. Kobi Little is President of the Baltimore Branch of the National Association for the Advancement of Colored People (NAACP).