As part of a $2.25 billion investment across the U.S., the Centers for Disease Control and Prevention has awarded Virginia more than $30.6 million to address health inequities fueled by the pandemic.
The primary goals of the grants are to reduce COVID-related disparities over the next two years, improve and increase contact tracing among the most-impacted populations and people in rural areas, and bolster the capacity for health departments to prevent infections.
In a media release, CDC Director Dr. Rochelle Walensky said the grants reflected the federal agency’s “commitment to keeping equity at the center of everything we do” and added that they are a step toward strengthening “our communities’ readiness for public health emergencies — and to helping everyone in America have equal opportunities for health.”
Nearly $4.6 million of the total is allotted for rural parts of the state, and $3.4 million is headed to Virginia Beach’s health department.
Virginia Department of Health spokesperson Logan Anderson said the incoming CDC funding depended on four categories: U.S. territories or freely associated states, state awards, local health districts serving a county or city with a population greater than 2 million people, and local health departments overseeing a city with more than 400,000 people but less than 2 million.
With about 450,000 residents, Virginia Beach is the only city in the state that falls into the last category.
Immediate priorities for the VDH are to ensure the state meets Biden’s goal of having 70% of the adult population vaccinated with at least one shot by the Fourth of July, Anderson said. But its funding overall “is designed to increase organizational capacity and to strengthen our meaningful engagement with community stakeholders.”
The Office of Health Equity will be administering the grant throughout the project period, which began June 1 and will last through May 30, 2023. The VDH has established a COVID Funding Steering Committee dedicated to ensuring equitable distribution of the money statewide. The committee is expected to meet at least monthly to oversee progress.
The VDH has broken down the grant into four separate strategies to ensure success, Anderson added. The first includes expanding existing resources geared toward areas experiencing a high risk of infections and ongoing vaccine skepticism through partnerships and billboards, radio, social media, TV, bus and train ads throughout the state.
The second prioritizes improving data collection — with an emphasis on areas facing high infection, hospitalization and death rates — which would require increasing VDH Central Office’s workforce, assuring infrastructure and resources are in place to meet the need and improve collaboration between local health districts and state VDH when it comes to testing, treatment and vaccination data.
Anderson said the state is also developing a comprehensive plan on how to track these outcomes in rural Virginia, with the overall intent to reduce race and ethnicity data gaps.
The third tier emphasizes the importance of hiring and training more people to focus on testing and contact tracing — especially in Black, Indigenous, Latino and Asian populations and rural parts of the state — while mitigating health inequities on a local level.
Lastly, Anderson noted an expansion of community partnerships through local health districts, historically Black colleges and universities and faith leaders on what solutions have worked in meeting people where they are versus what has not.
This time last year, Latinos in Virginia accounted for 45% of cases, 35% of hospitalizations and 11% of deaths while being less than 10% of the population. Throughout 2021, the VDH has reported Latinos and Black residents were still the most likely to be infected, hospitalized or die from the virus even as vaccinations sped up.
After a heavy decline in April, the number of people getting a dose has risen slightly to a seven-day daily average of 29,150 shots administered. But Black Virginians are the least vaccinated, with only 22% of their population vaccinated with at least one dose. Nearly 1.7 million vaccinations by race and ethnicity, however, are not recorded.
In a weekly report monitoring COVID trends, the University of Virginia’s Biocomplexity Institute noted the pockets of low coverage, adding that “unvaccinated individuals continue to be at risk from COVID-19 with new Variants of Concern increasing the risk of transmission, severe illness and death.”
In April, the CDC awarded an additional $77.1 million to Virginia in hopes of widening vaccine accessibility and ensuring equity in distribution with a requirement that 60% be used to support local health districts and community clinics. Dr. Danny Avula, the state’s vaccine coordinator, had said an already-identified need was engaging rural counties, where vaccination rates have slowed.
Some counties in the more rural Southwest region such as Patrick, Grayson and Carroll barely have a third of their population vaccinated with at least one dose. Statewide, the figure is 56.6%.
The inequities are longstanding, an aftermath of discriminatory lending practices that sent poverty rates soaring, shortened life spans and established medical care deserts in neighborhoods where decades later, people are grappling with poor health outcomes.
A VDH report released last week found death rates among the 35-to-54 age group was 2.3 times higher among Virginians living in high-poverty areas. People living in small town census tracts compared to those in metro areas were 1.5 times more likely to die from COVID-19. Comparatively, residents in rural census tracts were dying at 1.4 times the rate.
State data also shows a link between high income levels and high vaccination rates. Loudoun County, Falls Church City, Fairfax County, Arlington and Fairfax City are ranked as the top 5 localities with highest median household income. All have vaccination rates that surpass the state rate.
These disparities are occurring while Virginia is averaging 176 new infections per day, the lowest recorded since last March when the state announced its first case. As of Friday, almost 70% of the adult population has received a vaccine — less than a month before the federal goal.