Vermont will receive $28.5 million over two years to identify and address health equity problems, many of which were accentuated by the COVID-19 pandemic.
The money is part of a U.S. Centers for Disease Control and Prevention grant program aimed at improving access to health care for all, including minorities and rural populations. The CDC plans to invest $2.25 billion nationally by 2023.
State officials learned June 3 that the state would receive the award, said Heidi Klein, director of planning and health care quality at the Vermont Department of Health. Klein said she’s been told the state won’t have the authority to spend the money for at least another month or two.
It’s not yet clear how the state will spend the money, but Klein said the health department plans to hire about 20 people to work in the area of health outcome disparities, at least for the grant term of two years. Before COVID, she said, the department had only one half-time position devoted to equity work, as well as a 12-person workgroup that met every two weeks before the pandemic to discuss the topic of advancing health equity — a federal requirement for public health accreditation. The department established a six-person health equity community engagement team when the pandemic began.
Most public officials agree that the pandemic has highlighted disparities in the way that different minority groups — including ethnic and racial groups, people with disabilities, LGBTQ Vermonters, migrant workers and women — fared in the pandemic at home, at work and in the health care system.
Last year, the CDC reported that Black and Latino people across the country were three times more likely to contract COVID-19 than white people, and nearly twice as likely to die from it. According to the Vermont Medical Society, Black, Indigenous and people of color make up 6 percent of Vermont's population but accounted for 18 percent of the state's COVID-19 cases. The society has declared racism a public health threat.
"Systemic racism destroys the social cohesion of our state and nation, and has produced devastating health impacts born from trauma, chronic stress and differential access to health care," Jill Sudhoff-Guerin, the society's policy and communications manager, said in testimony at the Statehouse in February.
Lawmakers this year passed a bill that creates a health equity advisory commission that will aim to eradicate health disparities, particularly among BIPOC communities, people who are LGBTQ, and people with disabilities. Now law, Act 33 also has health care clinicians work with the Health Equity Advisory Committee to develop recommendations for improving cultural competency and cultural humility for a report due in October.
The Vermont Department of Health has already completed some work on assessing where the disparities exist in the state. Its 2014-2019 five-year strategic plan included health equity as a goal, calling for cultural competency training for its own staff and improving access to translation services. In that plan, it called for 90 percent of new grant applications and renewals presented to the department's review committee to include a plan for addressing health disparities.
The department said that its own research shows Vermonters don’t have equal access to conditions that favor health, including access to doctors and dentists.
“Some face prejudice or discrimination because of the color of their skin, their gender, sexuality, gender identity, age, country of origin, socioeconomic status, geography, or for having a disability,” the department says on its website. “These conditions or characteristics can affect a person's ability to lead a healthy life."
The CDC said the grants are intended to reduce health disparities related to COVID-19, improve testing and contract tracing among higher-risk and underserved populations, and improve health departments’ capacities to prevent and control COVID-19 infection.
The grants are also aimed at addressing health equity disparities in general. Although infection rates are relatively low in most places in the U.S., many health departments will continue to monitor COVID-19 infection rates, promote vaccination and watch for variants.
Gov. Phil Scott said on Monday that 80 percent of Vermonters have received at least one dose of COVID-19 vaccine. As promised, he dropped the last of the pandemic-era restrictions that had been in place since March 2020.
As it prepared its proposal to the CDC for spending the money over the next two years, the state health department got in touch with many of the community groups that it works with regularly to ask them for feedback, Klein said.
“We heard hugely fabulous ideas from lots of communities of ways that we could collectively invest to improve equity in the state of Vermont — ranging from providing more services to dismantling white supremacy,” she said. “We know we can only be effective in state government on equity issues if we are in partnership with communities.”
Correction, June 16, 2021: A previous version of this story misidentified Jill Sudhoff-Guerin's title and incorrectly described elements of Act 33.