In 1966, Reverend Dr. Martin Luther King, Jr. said, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”
As we think about a potential end of the pandemic, on which our attention has necessarily been focused, we take pride in our city, though with concerns about inequities.
Berkeleyans should be pleased that our vaccination rates are at 93% (including UCB) and deaths still below 100. Our shopping areas have not completely returned to business as usual; however, we are seeing more people in our parks, and kids have returned to school. The wisest of us are still wearing masks and getting our boosters, which in Berkeley are easily available regardless of income, zip code, or health coverage.
For these outcomes, praise is due to the Public Health Division, our community-based organizations, faith-based community, and others who walked Berkeley neighborhoods, door-knocking to provide education, resources, and information about the pandemic.
A living example of how well some systems worked during COVID is proof of cooperation and coordination among certain public and private entities, who recognized their interdependence: this cooperation brought services to the community quickly and efficiently.
However, before we bring out the champagne or other sparkly stuff, let’s note how unevenly the pandemic affected the city’s people.
African Americans are overrepresented in COVID-19 deaths. Black residents make up just 8% of the city’s population, yet account for 33% of deaths from the virus.
Among Latinx, with a 96% vaccination rate, death rates are evenly represented in the city’s COVID-19 fatalities. About 15% of residents are Latino, and they make up 14% of fatalities.
White people and Asian Americans and Pacific Islanders (AAPI) are more lightly hit by the pandemic. White people make up 50% of Berkeley’s population but only 38% of the city’s COVID-19 deaths; AAPI people, at 20% of the population, make up just 8% of deaths.
Those of us with health security, housing security, income and assets security, transportation and food security fared much better during the pandemic than Berkeley residents who do not have those privileges. It is time to focus on Health Equity.
When challenged by an outbreak of disease, it became clear that our systems of response improved and stepped up, and relationships were put in place which will serve us well over time.
Services to the Homeless
Under the leadership of Alameda County’s Office of Homeless Care and Coordination, Health Care for the Homeless was instrumental in the formation and ongoing operation of Operation Comfort, the isolation and quarantine hotel for those with a positive test result or who are symptomatic. In addition, the City added a Covid-19 section to its website. This team worked closely with shelter sites early on, conducting site visits and making recommendations around ventilation, bed spacing, and masking, as well as providing testing and testing supplies and holding vaccine events.
Street Health teams along with Lifelong Medical Care provided services to their scheduled encampment sites which included testing, vaccine, and supplies (water, food, etc.) to those who chose to isolate in their tents.
Berkeley’s own Public Health Division (BPH) took the lead on responding to outbreaks (three or more positive cases at one time) in shelters, providing testing and vaccine clinics. Two staff members from the City’s Department of Health, Housing and Community Services provided a weekly outreach meeting that brought together outreach providers for updates. They distributed food, water, and supplies such as test kits and masks, and also coordinated ongoing vaccine efforts at all shelter sites, working with BPH to bring vaccines to sites regularly.
Further Needs
Looking at the 2020 Census, Berkeley continues to have a large population in poverty: 17.8% of residents. Living in poverty = poor health status.
The most recently published “City of Berkeley Health Status Report” (2018) included a look at health inequities in Berkeley.
Key themes of this report were inequities in Health, Prevention and Emerging Health Threats. The report showed that two major health challenges in Berkeley are the lack of adequate mental health care and of a plan to deal with the high rate of alcohol and substance use in our city and on our campuses.
Mental health challenges and the use of alcohol and substances cut across socio-economic, race, education, age, and gender differences. It is important to recognize that there is much greater access to good mental health care and sobriety/recovery services for people with access to care than for the uninsured and the underinsured.
African American respondents noted that African American communities and families are being displaced because of a lack of housing and community development – inequities that are rooted in poverty, racism, and inadequate access to culturally relevant and high-quality health services.
In recent years, the public health perspective has developed an understanding of the social roots, or “determinants,” of health. These include:
- Stable and affordable housing
- Economic development and financial security
- Climate change and justice
- Complete neighborhoods
- Human rights, democratic inclusion, and eliminating historical legacy of discrimination
- Inclusive and safe communities
The 2018 Health Status Report included the attached chart which points clearly to the importance of reducing health disparities and increasing community wellness in Berkeley. We must address these disparities with the same urgency as when we responded to COVID. The health inequities in the report require continued community and City Health staff action to save lives.
