​Summary: This brief summarizes an assessment of the number of American Indians, Pacific Islanders and select Asian American ethnic subgroups that are included in neighborhoods designated as highly vulnerable along multiple dimensions by four indicators, including the UCLA Pre-Existing Health Vulnerability (PHV) index. The PHV, which uses 2020a data from the California Health Interview Survey, was created with input from the UCLA Center for Neighborhood Knowledge, UCLA BRITE Center, and UCLA Center for Health Policy Research. The four indices are potential analytical tools that policymakers could use to prioritize the most-at-risk places for interventions, including the distribution of COVID-19 vaccines. The analysis examines the distribution of these small, at-risk populations by census tracts in California and Los Angeles County. Although other dimensions of vulnerability should be primary in distributing vaccines (e.g., working on the front line, caring for infected patients, other essential workers), place-based information could play a supporting role.

Findings: The findings show that inclusion rates (the proportion of a group living in an area of need) for American Indians and Cambodians are better than for the other small ethnic groups. The outcomes are contingent on which indicator is used, thus having profound implications in terms of providing services, relief, and attention. The authors found considerable differences (non-agreement or low concordance) among the tracts classified as being highly vulnerable; therefore, the choice of indicator inherently translates into significant discrepancies in the places prioritized as eligible or ineligible for interventions. They also found substantial variations among the indicators in racial compositions and number of minority neighborhoods included.