UCLA study suggests looking beyond area-based vulnerability indicators to identify smaller at-risk populationsResearchers propose that using models may help find the most high-risk groups for pandemic relief and other vital resourcesFebruary 08, 2021 Current data suggests that small ethnic populations in California ─ American Indians and Pacific Islanders, Cambodians, Filipinos, and Koreans ─ may have higher than average COVID-19 infection and death rates, but how can policymakers identify where to allocate needed resources, such as vaccines?
“It would be great to pinpoint for
state and local policymakers where the vaccines should go to help these
vulnerable populations,” said Paul Ong,
PhD, director of the UCLA Center for Neighborhood Knowledge and co-lead
author of a new study that analyzed where at-risk populations
live. “ Unfortunately, it's not that easy, because they are a hidden
diaspora and not tied to a geographic place.”
The study, supported
by a grant from the Robert Wood Johnson Foundation through the center for
health policy research’s National Network of Health Surveys, looks at factors
such as poverty and pandemic-related job risks among these racial and ethnic
groups compared across various census tracts that are identified as the most
high-risk areas in California and LA County. Three pre-pandemic indicators, built
by the Centers for Disease Control and Prevention, Health Resources and
Services Administration, and the Public Health Alliance of Southern California
are used.
The UCLA Pre-Existing
Health Vulnerability (PHV) index, based on data from the California Health Interview Survey (CHIS) and created with the UCLA BRITE
Center for Science, Research and Policy, led by Vickie Mays, PhD, to capture
risks of COVID-19 infection and death due to pre-existing health conditions, was
also used by the researchers to look at simulations that indicate which racial
and ethnic groups in vulnerable state and county areas may be most in need of
services such as health care and other resources. This index is made up of six
different 2016 AskCHIS Neighborhood Edition™ variables ─ adult diabetes, obesity, heart disease, health status, psychological distress,
and food insecurity, and is currently being used by practitioners at UCLA
Health.
“The data we’ve been compiling show that
Pacific Islander and other smaller Asian groups are two to three times more
likely than non-Latinx white workers to be essential workers, who are at a
higher risk of being exposed during a pandemic. But they have received
less attention because their numbers are fewer, which is why we are promoting
more ways to use data to address striking disparities,” said Ninez Ponce, PhD,
director of the UCLA Center for Health Policy Research and CHIS principal investigator.
Percentage scores in the simulation
models show which rates of the overall population live in high-risk census
tracts and what part of the population is captured as high-risk across each
vulnerability indicator. The data show that 25% of all California and Los
Angeles County residents live in highly vulnerable census tracts. As in the previous report,
the findings note that there are limitations in each indicator in getting at
underlying racial disparities and social and economic vulnerabilities. For
example, one indicator may capture a certain racial and ethnic group at a
higher rate due to high poverty rates or other representative data on state and
county levels.
With the exception of the American Indian
group, the smaller racial groups were found to be underrepresented in the
riskiest areas that the four indexes identified. When researchers separated
Asian American groups into three ethnicities ─ Cambodians, Filipinos, and Koreans ─ only Cambodian residents were identified
as having a higher percentage of residents in vulnerable areas.
“While each tool was good at
identifying a specific need, such as post-disaster help or help with hunger,
together they failed to clarify where the small vulnerable groups live and how
we can more accurately deliver them needed resources,” Ong said. “We need
to look at more than just geographic factors, and other measures such as
multigenerational housing, disability status, and occupation, that get at the
social and economic factors related to health in order to address specific
pandemic-related goals and relief efforts should be considered.”
Report authors emphasize that these
measurement tools can be used as a starting point for policymakers,
researchers, and other community stakeholders, and can be finetuned to identify
which groups and places are considered vulnerable, as it shows the strengths
and weaknesses of each indicator by looking at the potential gap in needs and
services across these delicate racial lines.
The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.
The UCLA Center for Neighborhood
Knowledge is dedicated to translating its research to inform actionable
neighborhood-related policies and programs that contribute to positive social
change. We specialize in empirical spatial analysis and emphasizes the study of
diversity, differences, and disparities among neighborhoods, and explicitly
cover immigrant enclaves, low-income neighborhoods and minority communities.
|
|