Community Health Centers and Covid-19 — Time for Congress to Act

Kishore, Sanjay; Hayden, Margaret

doi:10.1056/nejmp2020576

Cited by 21 publications

(12 citation statements)

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“…To ease COVID's spread in African American communities and reduce African Americans' greater likelihood of contracting and dying from COVID, barriers to COVID detection in African American communities and follow-up contract tracing must be overcome [21]. African Americans are more likely to reside in areas with fewer testing sites [22] and therefore more testing should be offered in churches, public housing sites, community health centers, and other familiar sites in African American communities [23]. Testing results should be broken down and reported to public health officials by race and ethnicity and should include zip code or neighborhood identifiers for early targeting of hard-hit African American communities.…”

Section: African Americans and Covid-19 Illnessmentioning

confidence: 99%

“…However, CHCs were overlooked in subsequent safety net funding efforts as loopholes denied them appropriations [34]. CHCs should be funded to make up for lost revenue and provide sufficient funding for long-term operations [23]. More stable, longterm funding of CHCs would enable these organizations to address patients suffering from long-term damage from COVID infection [35].…”

Section: African Americans and Covid-19 Illnessmentioning

confidence: 99%

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COVID-19, Social Determinants Past, Present, and Future, and African Americans’ Health

Snowden

Graaf

2020

J. Racial and Ethnic Health Disparities

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As the COVID-19 pandemic progresses, more African Americans than whites are falling ill and dying from the virus and more are losing livelihoods from the accompanying recession. The virus thereby exploits structural disadvantages, rooted partly in historical and contemporary anti-Black sentiments, working against African Americans. These include higher rates of comorbid illness and more limited health care access, higher rates of disadvantageous labor market positioning and community and housing conditions, greater exposure to long-term care residence, and higher incarceration rates. COVID-19 also exposes African Americans' greater vulnerability to recession, and possibly greater susceptibility to accompanying behavioral health problems. If they are left unaddressed, the very vulnerabilities COVID-19 exploits may perpetuate themselves. However, continuing and supplementing health and economic COVID mitigation policies can disproportionately benefit African Americans and reduce short-and long-term adverse effects. The greater impact of COVID-19 on African Americans demonstrates the consequences of pervasive social and economic inequality and marks this as a critical time to prevent further compounding of adverse effects. Keywords African American health disparities. COVID-19. African American economic disparities. Policy

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Section: African Americans and Covid-19 Illnessmentioning

confidence: 99%

Section: African Americans and Covid-19 Illnessmentioning

confidence: 99%

COVID-19, Social Determinants Past, Present, and Future, and African Americans’ Health

Snowden

Graaf

2020

J. Racial and Ethnic Health Disparities

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“…These and other barriers to reaching patients during the pandemic led to the temporary closure of nearly 2000 federally-funded community health center sites, which form the backbone of safety-net health care for many of the most economically and medically vulnerable Americans ( HRSA Bureau of Primary Health Care, 2020 ). For patients who rely on community health centers, clinic closures may mean longer travel distances, greater difficulty accessing health care, and worse clinical outcomes for treatable conditions ( Kishore and Hayden, 2020 ). Fortunately, federal relief funding and increasing adoption of telemedicine have helped many community clinics stay afloat, and community clinics are now poised to play a central role in delivering COVID-19 vaccines in neighborhoods hardest-hit by the pandemic ( Corallo et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

How is the COVID-19 pandemic shaping transportation access to health care?

Chen

Brozen

Rollman

et al. 2021

Transportation Research Interdisciplinary Perspectives

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The Coronavirus disease 19 (COVID-19) pandemic has disrupted both transportation and health systems. While about 40% of Americans have delayed seeking medical care during the pandemic, it remains unclear to what extent transportation is contributing to missed care. To understand the relationship between transportation and unmet health care needs during the pandemic, this paper synthesizes existing knowledge on transportation patterns and barriers across five types of health care needs. While the literature is limited by the absence of detailed data for trips to health care, key themes emerged across populations and settings. We find that some patients, many of whom already experience transportation disadvantage, likely need extra support during the pandemic to overcome new travel barriers related to changes in public transit or the inability to rely on others for rides. Telemedicine is working as a partial substitute for some visits but cannot fulfill all health care needs, especially for vulnerable groups. Structural inequality during the pandemic has likely compounded health care access barriers for low-income individuals and people of color, who face not only disproportionate health risks, but also greater difficulty in transportation access and heightened economic hardship due to COVID-19. Partnerships between health and transportation systems hold promise for jointly addressing disparities in health- and transportation-related challenges but are largely limited to Medicaid-enrolled patients. Our findings suggest that transportation and health care providers should look for additional strategies to ensure that transportation access is not a reason for delayed medical care during and after the COVID-19 pandemic.

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“…The 2020 CARES act allocated $1.3 billion for health centers in response to the pandemic 32 . Prior to the pandemic, over 40% of community health centers had negative operating margins 33 . During the COVID‐19 pandemic, community health centers lost substantial revenues due to the sharp decrease in clinic visits.…”

Section: Discussionmentioning

confidence: 99%

Access to outpatient services in rural communities changes after hospital closure

Miller

Miller²,

Knocke

et al. 2021

Health Services Research

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Objective Between January 2005 and July 2020, 171 rural hospitals closed across the United States. Little is known about the extent that other providers step in to fill the potential reduction in access from a rural hospital closure. The objective of this analysis is to evaluate the trends of Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in rural areas prior to and following hospital closure. Data Sources/Study Setting We used publicly available data from Centers for Medicare and Medicaid Provider of Services files, Cecil G. Sheps Center rural hospital closures list, and Small Area Income and Poverty Estimates. Study Design We described the trends over time in the number of hospitals, hospital closures, FQHC sites, and RHCs in rural and urban ZIP codes, 2006–2018. We used two‐way fixed effects and pooled generalized linear models with a logit link to estimate the probabilities of having any RHC and any FQHC within 10 straight‐line miles. Data Collection/Extraction Methods Not applicable. Principal Findings Compared to hospitals that never closed, the predicted probability of having any FQHC within 10 miles increased post closure by 5.95 and 11.57 percentage points at 1 year and 5 years, respectively (p < 0.05). The predicted probability of having any RHC within 10 miles was not significantly different following rural hospital closure. A percentage point increase in poverty rate was associated with a 1.98 and a 1.29 percentage point increase in probabilities of having an FQHC or RHC, respectively (p < 0.001). Conclusions In areas previously served by a rural hospital, there is a higher probability of new FQHC service‐delivery sites post closure. This suggests that some of the potential reductions in access to essential preventive and diagnostic services may be filled by FQHCs. However, many rural communities may have a persistent unmet need for preventive and therapeutic care.

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Community Health Centers and Covid-19 — Time for Congress to Act

Cited by 21 publications

References 0 publications

COVID-19, Social Determinants Past, Present, and Future, and African Americans’ Health

COVID-19, Social Determinants Past, Present, and Future, and African Americans’ Health

How is the COVID-19 pandemic shaping transportation access to health care?

Access to outpatient services in rural communities changes after hospital closure

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