Equitable Access to Health Care

Economic and social differences can isolate people from the resources they need during public health emergencies, such as COVID-19. VCU Health’s office of health equity works to ensure all communities have access to the care they need during COVID-19, including the vaccine.

Today, we’re talking with Byron Hunter, MPH, FACHE VCU Health director of community health initiatives, about how VCU Health is reaching those hardest hit by COVID-19.
Equitable Access to Health Care
Byron Hunter, MPH, FACHE
Byron Hunter, MPH, FACHE is Director of community health initiatives at VCU Health.

Evo Terra (Host): Economic and social differences can isolate people from the resources they need during public health emergencies, such as COVID-19. VCU Health's Office of Health Equity works to ensure all communities have access to the care they need during COVID-19, including the vaccine. Today, we're talking with Byron Hunter, VCU Health Director of Community Health Initiatives about how VCU Health is reaching those hardest hit by COVID-19.

This is Healthy with VCU Health. I'm Evo Terra. Let's start our conversation with the focus on you, Byron, and your role as Director of Community Health Initiatives. What is that? What do you do?

Byron Hunter (Guest): Sure. Great question. So, in my role as Director of Community Health Initiatives, I'm responsible for a couple of different bodies of work. First, I'm the Administrator for our Community Health Partnership Fund, which is our innovative grant making fund, established to address health needs and social issues for patients and community members. And we partner with multiple community agencies and organizations to fulfill those initiatives. I also conduct needs assessments and build our health education programs to support a lot of our work around value-based care and population health management, particularly developing programs that are built through a sort of diversity, equity and inclusion lens. I also help build out strategic community-based partnerships across Richmond City and other service areas to support our vulnerable patients and our high-risk patient populations. And I work very closely with a lot of our academic units to support student learning and community health improvement.

Host: I see, I know that one of the many ways VCU Health responded to the racial disparities that happened with COVID-19 was through vaccine clinics. Tell me about how VCU Health used a community wellness center to respond to the racial disparities of the COVID-19 pandemic.

Bryon: Sure. Great question. We opened our Health Hub at 25th, about two years ago. So, it's located in Richmond City east end, probably about two miles away from our main campus in the Church Hill community. There are four of the city's six public housing communities in this area. So, it's a largely African-American population. Many individuals have low incomes. And so it's been a focal area for the city as well as for our health system. About 7% of our patients actually live in this area. So, the wellness center we opened as I mentioned about two years ago, and it is really a site that provides care coordination, navigation and connection to social and health resources.

We have several of our academic units and our health system programs that work out of this space to provide access to services for community members free of charge. So, quite naturally, when the vaccine program rolled out, we thought we should probably start in the east end and help our neighbors that are most and patients that are closest to us. Sort of listening and following the guidelines, the health equity guidelines as outlined by VDH to increase vaccine access to communities of color, we started in our east end. And we began working with several of our community partners and community members to help streamline the process to make it easy for individuals to set up their appointments We did reminder calls to individuals. We assisted individuals with transportation. We've provided health education resources to answer questions really to help community members make informed decisions about vaccines, but really to remove the barriers so that they could come in, receive it and feel comfortable about their decisions and choices.

Host: Of course. And that's something we need to do, remove those barriers so that more people in our communities get vaccinated. What do you see as some of those barriers, or the biggest ones, perhaps that people face when accessing the vaccine and specifically, how does VCU Health address those barriers?

Bryon: Sure. Some of the common barriers would include medical and vaccine mistrust. Access to care will be another barrier and limited vaccine knowledge. There are multiple vaccines available. There's Pfizer, there's Moderna, there's Johnson and Johnson. We recently saw pause in Johnson, so that sort of confuses some people.

So, many of our early adopters have received their vaccines. And so we've shifted our outreach strategy to provide vaccine education to increase confidence and uptake amongst community members. We've also reached out to several community partners to help us spread that message. And that's been really helpful. You know, hearing it from us is one thing, but hearing it from a neighbor or community member or a city council person is another issue. And that trust factor is really important. Sorta thinking about barriers, when the vaccines were approved for use, there was limited access and only a few community clinics provided appointments.

So, individuals had to register online or have access to certain pieces of technology to find appointments. And so individuals who might have low health literacy or limited technology, they were most impacted and have the least access to vaccines.

And so, over time as additional sites have become available, that has increased access, but our Health Hub continues to operate. And has an open door policy. And we sort of hand-hold people through the process of scheduling, getting transportation, actually getting to the facility and getting back home in some cases so that there really is no barrier for people to come and receive their vaccines with us. We have a very coordinated approach.

Host: It sounds that way. And you're doing critical lifesaving work in the community. Why do you think it is that VCU Health is uniquely positioned to do health equity work?

Bryon: You know, as an academic medical institution, you know, our mission really focuses around, you know, patient care, education and research. I think that VCU has great, you know, programs and community partners and infrastructure to really help us mobilize very quickly. We've got really good resources and connections with the community.

Many of the conversations that we've had with our community members are facilitated through work with community partners. And when we began our vaccine work and other bodies of work that you know, drive health equity, we work with several pastors, we've worked with you know, other community partners to help us kind of carry out our message.

And then we also work with our faculty, our staff, our students, to make sure that they understand barriers and challenges faced by our community members. And then we're very research focused. And so thinking about all of our opportunities to be innovative you know, apply for grants and really get individuals involved in health equity in thinking about how we can get many of our people involved in clinical trials is really important. So, it's really a systematic approach for us. And when all of those systems interact together, then we are really able to drive behavior change and improve health outcomes.

Host: Absolutely. And I know we still have quite a few people that are still impacted by this pandemic, but at some point it'll be in our rear view mirror. What upcoming community health initiatives have you excited right now?

Bryon: So, VCU looks very different today than it did when I first arrived, you know, almost four years ago. We have expanded our campuses to include New Kent, our south hill campus which is our community Memorial Hospital campuses. Our children's hospital is expanding, our BTCC, which is our center that's on our Brook Road Campus. Those locations have opened. And so as we think about doing additional sort of outreach work, and community benefit work, we've got to account for those additional campuses. So, for me, I think, you know, my sort of scope of work grows. My team grows and our impact overall grows. And that enables us to do really good work to support our local community and the other communities that we serve as a health system.

Host: And we're always going to need to take care of our local communities without a doubt. Byron, thank you very much for your time today.

Bryon: Thank you. It's been a pleasure sharing with you today. And I look forward to working with you in the future.

Host: Once again, that was Byron Hunter VCU Health Director of Community Health Initiatives. For more information on the myriad community health initiatives currently underway, please visit VCUhealth.org and look for our community impact section. To listen to other podcasts from VCU Health, visit VCUhealth.org/podcast.

This is Healthy with VCU Health. I'm Evo Terra. Thank you for listening.