The Biden administration announced in March 2021 that it would invest $ 2.25 billion in tackling COVID health inequalities, the largest federally funded initiative specifically designed to help underdeveloped communities most affected by the virus.
Two months later, the Center for Disease Control and Prevention (CDC) provided grants to state health departments and about 60 city and county health agencies. The money will be used to control the spread of covid among high-risk ethnic and racial minority groups and people living in rural areas.
A year later, when Covid has already killed a million people and hospitalized millions more, public health officials spent little or nothing of the money, according to a KHN survey by a dozen state and county agencies.
Missouri has not spent any of its 35.6 million. Wisconsin, Illinois and Idaho, each receiving between $ 27 million and 31 million, used less than 5% of their grants.
Pennsylvania used about 6% of its 28 million.
California has spent only 10% of its $ 32 million funds.
Public health agencies present various reasons for the delay. They say they need time to recruit staff. They blame their state’s long budget process. They say it takes time to work with nonprofits to set up new programs. And other federal funds have already been used to fight Kovid.
The slow pace of allocations highlights the damage done to the public health system by year-on-year neglect and the cycle of ups and downs of legal funds. “These are investments that suppress a system that has been starving for a long time,” said Dr. Osama Bilal, a professor of epidemiology and biostatistics at Drexel University in Philadelphia.
Dr Kirsten Bibins-Domingo, a health equity expert and new editor-in-chief of JAMA, added that it was difficult for the less resource-poor public health system to fight the epidemic by building relationships with local nonprofits so quickly.
“The epidemic has highlighted these huge health disparities, but it is also true [los sistemas de salud pública] They do not have the necessary structure to engage directly with the community, ”said Bibins-Domingo.
The funding was in response to the impact of the epidemic on minorities. Black, Hispanic, and Native American communities have experienced higher rates of COVID-19 infection and death than non-Hispanic whites, especially considering the age differences between ethnic and racial groups.
Despite the need to address these issues, county health officials say they have had trouble spending money.
In California, the Riverside County Public Health Department spent about $ 700,000 on a 23 million grant.
Wendy Heatherington, head of the agency’s public health program, said: “Public health has historically been underfunded, and suddenly more than we received.” “It’s great that we got this fund because it’s necessary, but it’s hard for us to spend.”
Part of the problem was that county health officials had to wait six months to get local government approval to spend the money. Then, he explained, there were delays in negotiating contracts with local nonprofits to get the job done.
Stan Weiger, a fellow at the Conservative American Enterprise Institute, says the slow allocation of funds, and the ability of states to spend other federal dollars on inequality, shows that Congress sent large sums of money to state governments. They have called on the Biden administration for more funding to fight the virus.
“This raises the question of why this separate grant program was created,” he added.
According to Vigar, state and local governments have received nearly $ 900 billion in Covid aid, more than they need, as their tax revenues have recovered much faster than expected after the epidemic-induced recession.
Rachel Gressler, a researcher at the Heritage Foundation, who opposed Congress funding new Covid aid because of dollars left over from previous initiatives, noted that the slower spending also shows how states need time to absorb revenue injections and develop new programs, especially governments. And supply chain problems.
The CDC said the money could be used to mitigate the effects of covid, improve data collection from those disproportionately affected by the virus, and develop collaborations for “advance health equity”. The CDC initially said the grant should be spent by May 2023, but earlier this year told states that they could request an extension.
The grants are designed to prevent the spread of the virus, improve data collection, expand related healthcare infrastructure, and address social and economic problems that prevent many minority communities from receiving adequate care during an epidemic.
CDC is working with a variety of organizations to implement the grant, spokesman Jade Fools said.
Because the term health inequality encompasses the challenges faced by all types of population groups, counties and cities have the flexibility to spend money on almost anything that affects health.
The Illinois Department of Public Health received $ 28.9 million and spent $ 138,000, according to spokesman Mike Clafi. Funding will be provided for programs including the American Sign Language Translation of Covid content, the Jail Outreach Program, the Mobile Health Unit for Rural Areas, and the Community Health Workers.
“The goal was to design programs that would build health infrastructure and address these historical inequalities in meaningful and meaningful ways,” Claffey added.
The Florida Department of Health is spending $ 236,000 on a $ 35 million grant for newborn hearing screening. Spokesman Jeremy Redfern said the covid-related closure has led to a major reduction in screening and diagnosis of hearing loss and will help the team expand statewide hearing tests.
The Miami-Dade County Health Department, which has spent $ 4 million of its $ 28 million grant, has funded local groups to address housing and food insecurity. The department paid াদ 100,000 to Haitian health researcher Saradzain Batrani to help improve English literacy in the county’s large Haitian community. He received the money in January and hopes to help 100 people starting in May.
“Language barriers prevent people from getting vaccinated,” said Batroni, a researcher at the University of Miami who focused on translating health-related documents into Haitian Creole before starting his own company last year.
About $ 4.5 million of the Pennsylvania CDC grant went to the state’s rural health office, which planned to fund 20 counties last fall. As of May, it has not financed any of them.
Rachel Foster, the agency’s rural COVID-19 program manager at Penn State University, said, “Over the past two months, we, the county leaders, have been losing momentum and interest in working against COVID-19.” “In rural Pennsylvania, the case is low, interest in vaccines has waned, and most residents believe the epidemic is over.”
The Penn State School of Medicine uses its nearly $ 3 million grant to train community health workers to help patients access resources for their social needs and their health problems. According to Dr. Benjamin Frederick, the grant’s supervisor, more than 45 people have already received online training for the grant.
In some cases, diversity issues have already been addressed. The Philadelphia 8 million grant follows “other CDC grants, including funding for staff positions responsible for planning and implementing activities to combat inequality or promote equity,” spokesman Matthew Rankin said. Philadelphia spent about $ 147,000 on the grant.
The University of Florida Health System in Jacksonville received 1. 1.25 million from Duval County last July to expand services to communities unequally affected by Covid. But according to spokesman Dan Leveton, in early May, the university had not yet received the money. “We’re not concerned because we have other funds for COVID, which we’re currently using, and we’ll use the CDC funds when they arrive,” Levitan said.
The Mississippi Department of Health received $ 48 million, the largest award ever given to a state health agency. So far, the agency has spent 8 8 million, spokeswoman Liz Charlotte said, although it has already used other federal aid dollars to address health inequalities from Covid.
With states deciding how to spend money, health experts are concerned about the consequences.
“There is a dire need for money, but you have to keep in mind that these health departments have been under extra burden for a long time and there are not enough staff to deal with it,” said Bilal of Drexel.
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