Community Health Centers Are Fueling Vaccine Equity. The Relief Bill Funds Them.

President Biden approved $7.6 billion in emergency funding for community health centers when he signed the $1.9 trillion American Rescue Plan for combating the effects of the COVID pandemic on Thursday. Community health centers are public clinics that primarily provide health care in medically underserved areas and are proving crucial for overcoming massive racial disparities in vaccination rates.

The Biden administration launched a program last month that provides vaccines directly to community health centers, where the majority of people vaccinated so far are people of color, according to analysis by the Kaiser Family Foundation. A longtime priority for progressive lawmakers such as Sen. Bernie Sanders, federally funded community health centers provide comprehensive health care to more than 29 million people, including 14 million people living below the federal poverty line, regardless of their insurance status or ability to pay.

Vaccine shots, of course, are free at community health centers and other sites working with the government. As of March 7, federal data show that 54 percent of people who received one or more vaccine doses at a community health center are people of color, according to Kaiser’s analysis. While there are gaps in the data, roughly 26 percent of people who received vaccines are Latinx and roughly 12 percent are Black. Another roughly 17 percent identify as Asian, mixed-race or Indigenous.

Higher vaccination rates among people of color at community health centers suggest that these clinics are doing a better job at vaccinating communities of color hard-hit by the pandemic than the national effort overall. Nationally, only 9 percent of people who have received at least one shot are Latinx and 7 percent are Black, but Latinx and Black people make up about 19 percent and 13 percent of the total United States population, respectively.

The American Rescue Plan provides more than $60 billion in additional funding to staff and expand public health systems that work with community health centers on the front lines of the effort to contain the virus, according to the National Association of Community Health Centers (NACHC).

Despite disproportionately high rates of COVID infection and deaths in communities of color and especially among Black people, systemic racism has caused racial disparities in vaccine distribution and access. In February, the vaccination rate among white people in 35 states was more than double the vaccination rate among Latinx people and nearly double the rate among Black people, according to Kaiser.

Experts point to multiple reasons for these disparities, including longstanding barriers to medical care faced by people of color and a lack of trust in a medical system with a legacy of racist abuse and experimentation. Research shows Black people are far less likely to trust doctors than white people are, due to legitimate fears that they will be denied care and face other forms of racism that undermine medical treatment. Racist immigration enforcement has also created barriers to vaccines, especially in the South.

Community health centers are designed to address disparities in health care by tailoring their services to the needs of specific communities, whether that means providing access to care in multiple languages, expanding addiction treatment services or focusing on HIV prevention and treatment, to name a few examples. Hundreds of clinics serve rural areas where there are few other providers. Doctors and staff often reflect the people they serve, such as immigrants, people of color and LGBTQ people.

The percentage of people of color receiving vaccines has increased at community health centers nationally since the Biden administration began working directly with the system to provide vaccines, with the share of patients of color receiving their first shot growing from 47 percent in January to 56 percent in February. This reflects the population served by community health centers, where 63 percent of patients were people of color in 2016.

Currently, about 250 health centers with more than 4,000 sites are working to make sure that all three COVID vaccines (Pfizer, Moderna and Johnson & Johnson) are available to low-income people, houseless people, migrant workers, residents of public housing, patients who speak little English and people living in rural areas, according to NACHC.

At this time last year, federal funding for community health centers was on the rocks in Congress, even as the clinics worked directly with the Centers for Disease Control and Prevention to contain the virus in marginalized communities. Staring down a potential fiscal cliff, community health centers nationwide were forced to consider hiring freezes and delay expansions and improvements in clinics and infrastructure.

“Nearly one year ago we were fighting this pandemic with one hand tied behind our backs and a multitude of challenges that included diminished revenues, shortages of protective gear, supplies and tests,” said NACHC president Tom Van Coverden in a statement this week.

However, community health centers proved to be crucial for providing care and extending public health messaging about COVID into vulnerable communities, including rural areas with few medical providers and among immigrant communities. In 2020, Congress pumped money into community health centers as the pandemic spiraled out of control under President Trump. The Trump administration attempted to take credit for the funding, even though community health centers often served recipients of Medicaid, the federal insurance program for low-income people that the Trump administration and Republicans worked to severely weaken and defund.

About 91 percent of people served by the 12,000 community health clinics and satellite sites nationwide are low-income. Community health centers serve about 1.4 million houseless people and one third of people living in poverty.

Each of the 1,400 health center organizations are run by boards where at least 51 percent of members are patients, according to NACHC.

“Health center advocates across the country have worked tirelessly to let their leaders in Congress know that to successfully fight the pandemic, we need to have adequate resources,” Coverden said.