Experts available to discuss how inequities have contributed to uneven COVID-19 vaccine uptake.

COLLEGE PARK, MD. – July 30, 2021 – Structural inequalities in the United States are posing “a serious threat to progress” in the push to get people vaccinated against COVID-19, according to research from the Center for Health Information and Decision Systems (CHIDS) at the University of Maryland’s Robert H. Smith School of Business, published Thursday, July 29, 2021, in the Proceedings of the National Academy of Sciences.

Systemic racial inequities – structural racism, medical mistrust, and individual vaccine hesitancy – have long contributed to disparities in vaccination rates among vulnerable populations and offer important context for how racial minorities have been disproportionately impacted by COVID-19, the researchers write.

Investigating the question of which social determinants of health are associated with racial disparities in COVID-19 vaccination among White and Black populations, the researchers identified educational, economic and political factors as being among the key obstacles. 

The researchers, Maryland Smith professors Ritu Agarwal, Guodong (Gordon) Gao and Jui Ramaprasad, Smith senior research scientist Michelle Dugas, along with Smith PhD students Gujie Li and Junjie Luo, combined data from state, federal and other sources. They analyzed vaccination data from April 19 – a time when vaccines were made available to all U.S. adults and when nearly half of the U.S. adult population had reported receiving at least one dose of a COVID-19 vaccine – across 756 U.S. counties and roughly 170.6 million people. The collected data represent about half of the U.S. adult population.

The researchers also compared factors associated with disparities in COVID-19 vaccination to those associated with influenza vaccination disparities, finding that “differences include an amplified role for socioeconomic privilege factors and political ideology, reflective of the unique societal context in which the pandemic has unfolded.”

Among the findings: 

  • Areas with higher overall median incomes displayed lower disparities in vaccination rates. It’s a finding, the researchers write, that may speak to additional vaccines being more accessible to higher-income counties during vaccine rollout.
  • Disparity in high school graduation rates also served as a critical factor in vaccine disparity within counties.
  • Across the political spectrum, meanwhile, the Republican vote share displayed a significant negative association with vaccination disparities, the researchers write. Their further analysis shows that the seemingly reduced disparity is due to a lower White vaccination rate, rather than a higher Black vaccination rate.

“Failure to address these structural barriers poses the dual risks of additional lives lost and a significant slowdown in progress toward ending the COVID-19 pandemic or combatting similar future outbreaks,” the researchers write. States do not report vaccination rates by race consistently, making it difficult to design policy interventions and outreach strategies that can effectively address inequities in vaccination rates.

Go to Smith Brain Trust for related content at https://www.rhsmith.umd.edu/research and follow on Twitter @SmithBrainTrust.

About the University of Maryland's Robert H. Smith School of Business

The Robert H. Smith School of Business is an internationally recognized leader in management education and research. One of 12 colleges and schools at the University of Maryland, College Park, the Smith School offers undergraduate, full-time and part-time MBA, executive MBA, online MBA, specialty masters, PhD and executive education programs, as well as outreach services to the corporate community. The school offers its degree, custom and certification programs in learning locations in North America and Asia.