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Steady Habits: Is Connecticut’s vaccine rollout inequitable?
Connecticut continues to be among the leading states in getting its residents Covid vaccine shots. The most recent CDC data show that only two states have administered first doses to a higher percentage of its population. Gov. Ned Lamont says the state is in a race. “We are racing to get as many people vaccinated as quickly as we can, ahead of what could be this super contagious strain,” he said in his COVID briefing last week.
Most of the state’s healthcare personnel, first responders, and many in long-term facilities have gotten the shot, and those 75 and older – not already in that group – are getting theirs now (although, as the Mirror reported this week, that’s proven to be more difficult than many seniors would like).
But as Connecticut moves toward its next phase of vaccinations, those 65 and older, there’s a big issue looming: residents in that age group are overwhelmingly white, which means younger Black and Latino residents – including those working in jobs considered essential – will have to wait.
And data show the threat to those younger workers of color is roughly equal to that of older white residents who are slated to get the next doses. The Mirror’s analysis shows that the COVID mortality rate for a 65-year-old white person is comparable to that of a 55-year-old Black person and a 60-year-old Hispanic person.
That equity issue is what CT Mirror reporters Jacqueline Rabe Thomas, Kasturi Pananjady and Jenna Carlesso uncover in their story today. While the state’s age-based plan makes efficiency a priority, it raises the question: Is Connecticut’s vaccine rollout leaving behind Black and Latino residents?
John Dankosky: This is Steady Habits, Connecticut Mirror podcast, it’s where we take a look at life here in the land of steady habits, what works, what doesn’t, and how to make things work just a little bit better. I’m John Dankosky. Thanks so much for joining me. Connecticut continues to be among the leading states at getting its residents covid vaccine shots. The most recent CDC data show that only two states have administered first doses to a higher percentage of its population. Here’s Governor Ned Lamont in his covid briefing last week.
Gov. Ned Lamont: This is the race. We are racing to get as many people back as quickly as we can ahead of what could be this super contagious strain.
John Dankosky: Most of the state’s health care personnel, first responders and many in long term care facilities have gotten the shot. And those 75 and older, not already in that group, are getting theirs now. But as Connecticut moves towards its next phase of vaccinations, those 65 and older, there’s a big issue looming. Residents in that age group are overwhelmingly white, which means younger, black and Latino residents, including those working in jobs considered essential, will have to wait. And data show that the threat to those younger workers of color is roughly equal to that of older white residents who are slated to get the next doses. The Mirror’s analysis shows that the covid mortality rate for a 65 year old white person is comparable to that of a 55 year old black person and a 60 year old Hispanic person. That equity issue is what Connecticut mirror reporters Jacqueline Rabe Thomas, Kasturi Pananjady, and Jenna Carlesso uncover in their story today. While the state’s age-based plan makes efficiency a priority, it does raise the question: Is Connecticut’s vaccine rollout leaving behind Black and Latino residents? Jacqui and Kasturi Join me now. Welcome to Steady Habits. Thanks for joining me.
Jacqueline Rabe Thomas: Thanks for having me.
Kasturi Pananjady: Thanks for having us.
John Dankosky: What do we know right now, Jacqui, about why the state is distributing vaccines in this way? We understand it’s similar to what’s happening around the rest of the country. What is the state saying about why it’s doing it that way?
Jacqueline Rabe Thomas: So it really comes down to a matter of efficiency, and especially now we have an overburdened health care system. So we’re now having to somehow verify, you know, younger populations of preexisting conditions. It adds a level of complexity to it. And so it has the potential to slow things down in some people’s minds history.
John Dankosky: Tell me about the data that you found on this. What data sets were you working with, first of all?
Kasturi Pananjady: Yeah, so I was working with a Department of Public Health Data set in runs through October to present, and it lists all the deaths in the state. So step one was to cover deaths. And as part of those death certificates, it includes information about race and ethnicity. So once we were able to isolate COVID due to the pandemic, the next step was to try and understand how you can compare different races, because we live in a state that is predominantly white. So then how do you start to think about disparity? How do you start to think about disproportionality? And the way that you do that is to then find out what the baseline population is for each face by age, and then we calculate the mortality rate. And that’s when you start to see that people who are black or Hispanic or younger have similar mortality rates to people who are white people older, which brings into question this whole idea of a strict age cutoff. If you argue that age is a strong predictor of mortality and it is the older you are, the more likely you are to die of this. Then if that’s the rationale, then there’s clearly something else at play here. It’s not just age, but it’s also your race that determines your likelihood of dying from this disease.
John Dankosky: And as you talk about those numbers, it really is startling that Black and Latino residents, regardless of the work that they do who are much younger, are actually just as much at risk. Maybe you can talk through the data a little bit more for USCA story and show us what it means, because it feels very alarming. As we say it out loud.
Kasturi Pananjady: You know, race in this analysis is essentially standing in for a number of other things and standing in for your likelihood of having good access to health care and standing in for your likelihood of having a preexisting condition, standing in for your higher risk of exposure to the disease if you have a job that doesn’t let you self-isolate. So when you think about it that way, it’s actually not that surprising that you see this very mortality rates by age race is essentially standing in for all these other factors that a strict age-based cutoff and vaccine allocation would not account for. What our analysis finds is that
White people who are between sixty five and sixty nine have similar rates of dying of covid to Black people who are 55 and fifty nine and Hispanic people who are between 60 and 65. If you are trying to design a vaccine allocation system that takes into account people’s likelihood of dying than age is the only thing you should be looking at is probably age in combination with race and it might be in combination with other things. And that’s what the that’s the question of the story is raising.
Jacqueline Rabe Thomas: I spoke with Georgia Goldburn, who is a child care worker. She runs a child care facility down in New Haven. She’s not surprised that there is a difference in access to these vaccinations. In her mind, this is the system that was set up to to work this way. She has a really powerful interview that I did with her, talking about sort of every step of the way, sort of this lack of access.
Georgia Goldburn: And until we begin to address the structural issues, the structural racial issues, we’re always going to come to this place of it’s interesting that we seem to have the same result. We always have the same result because structurally racism is broken from the people who historically have had access to the resources, whether its financial, economic, health, health resources have always been white versus black. And so if we continue to use the same structure, a mechanism to try to get to people, we’re always going to have the same result. And instead, if you look at that, is basically using the same infrastructure to bring about a certain type of resources to the community, it’s always going to show that there is OK, it’s always going to point to the structural inequity, the racial inequity that’s built into the system. So I’m not surprised that whatever structure or mechanism that they have designed to try to make the vaccine available, that is breaking out that white people are disproportionately receiving vaccines because that’s how the system was set up to function and to operate.
Jacqueline Rabe Thomas: So, you know, if you look at Lamont deciding to do access based on age, he really does follow what other places in the country have have done and what CDC guidance, their advisory panel, they did actually recommend this path to go for, starting with those in in assisted living and nursing homes and those who are seventy five and older. But the big question is, so who goes next? And that’s really where states start to sort of diverge in their approach. There are 10 states that presently offer vaccines to those with pre-existing conditions in younger populations. Right now, another six are expected to go online very soon after they’re done vaccinating those in nursing homes and those over age seventy five. But Connecticut decided to go a different way and do this, this efficiency model versus sort of an equity model. And so it raises all these questions among health experts as well.
John Dankosky: Jacqui, this next group of people who are scheduled to be vaccinated after those 65 and over, that’s going to include a lot of these health care workers and other essential workers. What have we been hearing from people who represent those workers?
Jacqueline Rabe Thomas: So who comes to mind? Our grocery store workers. And I interviewed the president of the union who represents thousands of grocery store workers. And it comes down to an inventory in his mind that we just don’t have enough shots to hand out right now. But he also sees a disparity of his mom actually is able to get a vaccine. But the people who work at his store are not another individual that I interviewed. He represents child care workers and he’s white and his mom was getting a shot. She’s able to stay home all day, every day and sort of sequester herself, whereas the workers that he represents are still having to go to work if they want to get paid. And so there’s sort of this inequity in who is able to get the shot and who’s not.
Kasturi Pananjady: I was double checking one of your statistics from the beginning when you said Connecticut was second or the two states before Connecticut and the number of vaccines administered. Here’s my issue with using the population as a denominator. Think about it this way. The real limiting factor here is not how many people you’ve got is how many vaccines you’ve got, how many vaccines at the federal government gave you. And the real measure of success, in my mind is not, you know, how well that number of squares up with the number of people you’ve got, but how good a job you’re doing and pushing those vaccines out and putting them into people’s arms. That’s the true metric of how well the states distributing stuff. It’s what have you got? How much of it you used to know, how many people you’ve got? That, to me, is sort of not the it’s it’s not the metric to be looking at to assess the success of the distribution plan. And if you look at the success of the distribution plan, Connecticut’s data suggest that sixty five percent of the doses that have been distributed have been administered…we start to fall in that regard. In North Dakota, that’s at the top is like eighty four percent of the vaccines that have been distributed have been administered. So to me, that’s the metric to be looking at, to see if the states doing a good job distributing what it’s got.
John Dankosky: Many people have said, including quite a few epidemiologists I’ve talked to, that if you get the vaccine into the arms of younger people who are essential workers, it actually will more quickly slow the spread of the disease than just getting it to people who are 65 and over, who may not be going out into into public all that much. It’s a it’s an interesting, you know, conundrum the states sort of put itself in.
Kasturi Pananjady: Yeah, I think it’s it’s a question of what it is that you’re when we say efficiency, we’re talking about optimizing something. And my question is, what is the sampling? Are we trying to minimize the number of deaths we see? We’re trying to minimize the number of cases we see. Are we trying to what’s the metric that we’re trying to reduce here? And I think that depending on the metric that you pick, the answers to this are different to my mind, if we’re trying to reduce the number of people dying. You know, age is a good place to start because the older you are, the more likely you are to die. But I think the story is basically saying it’s a great starting point. But do we need to do more to actually understand who’s at risk and how and why, if it is indeed our end goal to reduce the number of people dying of this disease? I don’t necessarily see the efficiency and the equity things as being opposed. It’s not to say the choice here. I think that’s just a false dichotomy that’s been presented where it’s not a choice between, you know, a fair distribution of the vaccine as being the priority and on the other hand and reducing deaths.I think that those go hand in hand and I don’t see why it is that we’re talking about them as if they don’t.
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On “Steady Habits,” our goal is to foster meaningful conversations with newsmakers and the journalists who cover them. We’re planning to dig into some of Connecticut’s biggest stories in policy and politics.
John Dankosky, a 25-year radio journalist in Connecticut, will serve as the program’s host.