Beyond Bruin Walk: California’s health equity metric is much-needed step toward tackling inequities
(Emily Dembinski/Illustrations director)
Bruins are faced with everyday issues that extend past the immediate confines of their Westwood campus. Daily Bruin Opinion provides the latest commentary on California state and nationwide issues that go far “Beyond Bruin Walk.”
Public health isn’t immune to the effects of social inequities – despite the lack of policy that says otherwise.
California hopes to change this.
On Sep. 30, the state announced a new equitable health metric that does not permit counties with more than 106,000 people to reopen until they bring down coronavirus infection rates in the hardest hit communities.
Counties must now report the weekly percentage of positive cases and tests for socioeconomically disadvantaged neighborhoods to begin easing the state’s COVID-19 guidelines. The plan, which went into effect Oct. 6, also requires counties, regardless of population, to invest in testing, contact tracing and outbreak control.
California’s health equity metric is an important, if not necessary, step toward addressing the staggering inequities the pandemic has only exacerbated. Its focus on the state’s most disadvantaged communities is certain to push counties to act in the best interest of those who have historically been excluded from public health initiatives.
But saying and doing are two separate things.
To avoid this measure’s becoming another unattainable bar, the state needs to support counties in their efforts to address the pandemic’s disproportionate impacts on marginalized communities. The health metric may be intended for the immediate future, but its true value lies in what it can accomplish once the pandemic ends. As counties rethink their approach to equitable health care, the policies they implement can and should meaningfully address inequities that have long plagued the state.
The exact requirements of the plan are fairly straightforward for such a monumental task. Every county must identify the COVID-19 infection rate of their lowest quartile according to the California Healthy Places Index, which considers different socioeconomic factors, and then produce a plan that shows a corresponding percentage of federal funding will be allocated to those communities.
The immediate effects of this order cannot be overstated. Counties must now give focus to communities that have largely escaped public attention by clearly identifying how they will utilize existing funding.
And there’s plenty of money to go around if California’s leadership can effectively allocate it.
The Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases is a CDC program that aims to reduce the spread of infectious diseases. The program has granted California nearly $550 million to deal with the COVID-19 pandemic, with Los Angeles County alone receiving more than $300 million.
Such a substantial pool of funding can help ensure resources go to communities that have borne the brunt of the health crisis. And with the infrastructure already in place, the state can continue this model well after the pandemic runs its course.
The ELC program gives states and metropolitan areas funds to develop health programs that address emerging infectious diseases – and has been doing so since 1995. California, for example, received more than $10 million in August for life-saving initiatives unrelated to the pandemic. Setting aside a greater percentage of public funds to uplift the most at-risk communities is necessary even when there’s not a public health crisis.
This is precisely why the metric is so important. It not only forces counties to take active steps toward addressing the worrying disparities in COVID-19 cases – it also provides the unique opportunity to seriously consider the disparate impacts of disease when creating permanent policy.
The pandemic, after all, does not exist in a vacuum. Its devastating toll on historically marginalized communities is the culmination of decades of legislative inaction that have left the most disadvantaged Californians hung out to dry.
Latino individuals account for about 60% of positive COVID-19 cases despite comprising less than 40% of the state’s population, according to the California Department of Public Health. One-third of counties graded by the health equity metric have reported higher case rates for neighborhoods that lack access to socioeconomic opportunities than their overall rates. Such regions cannot relax public health guidelines even if they qualify for a less restrictive tier based on other metrics.
And the counties that fall under this umbrella may come as a surprise.
The most disadvantaged tracts in Santa Barbara, Orange and San Mateo Counties all have seven-day positivity rates that are at least 2% higher than the county’s overall positivity rate. This is despite their ranking in the state’s 15 best counties to live.
But housing prices tell a different story. San Mateo and Santa Barbara are some of the state’s most expensive counties for renters while Orange County boasts the title of the nation’s 11th priciest housing market. The seemingly opulent lifestyles of a select few have obscured what the numbers have so clearly revealed – marginalized communities are struggling.
And their challenges existed even before 2020 forced legislators to take a hard look at systemic inequity.
It is painstakingly clear that counties cannot rely on short-term measures to temporarily help them meet the health equity metric. They must pass bold legislation that upends the status quo.
The state’s metric will likely delay reopening and may prolong the state’s severe economic recession – something that should not be taken lightly when people’s livelihoods are at stake. But true recovery requires state and local leaders to work side-by-side to protect the safety of all communities.
Because if there’s one thing the pandemic has shown, it’s that our current system isn’t working.