In September 2020, Matías Valenzuela, Ph.D., Director of the Office of Equity and Community Partnerships for Public Health in Seattle & King County and the Director of COVID-19 Community Mitigation and Recovery, joined the Office of Minority Health (OMH) for a virtual symposium highlighting state, tribal, territorial, and community-based efforts to address COVID-19 among racial and ethnic minority and American Indian and Alaska Native populations.
OMH is focused on the success, sustainability, and spread of health equity-promoting policies, programs, and practices. As part of its blog series, “Advancing the Response to COVID-19,” OMH followed up with Dr. Valenzuela on addressing health equity issues related to COVID-19 and beyond.
How has your COVID-19 response strategy evolved since the beginning of the pandemic and since your presentation at the OMH Virtual Symposium in September 2020?
We need to continue to strengthen our relationship with communities, including creating systems of accountability and transparency that are aligned with our declaration of racism as a public health crisis . Communities demand accountability from us, and as a result, we created an Accountability Tool. Our Accountability Tool helps us report back to community groups after listening to them and communicates what input we incorporated, which input we did not, and why not. With our Pandemic & Racism Community Advisory Group, made up of a majority of Black and Brown community leaders, we have used this tool as we have worked on multiple policies, such as last fall’s vaccine verification policy for businesses.
Another key tenet of ours has been transparency, and we are doing this across issues. For example, we are currently engaging our Pandemic and Racism Community Advisory Group as we develop our 2023-2024 budget. We are still early in the process, but we have done a deep dive with them on an overview of our budget and heard from them about priorities. In the next phase, we will be going to them with our ideas and proposals for the next biennial budget, and we will hear from them about what they value and want to see in our investments.
In your presentation, you mentioned seeing distrust and hesitancy in some communities, particularly regarding vaccinations and the tendency to delay care. How have you addressed these issues in your COVID-19 response?
Early in the pandemic, we honestly had a lot of distrust among community organizations. Now, there has been the development of robust partnerships. We still have a long way to go to continue to dismantle the systems that cause harm and to continue to build trust – which can be quickly broken. But, as we say when we work with communities that have been historically harmed by systems of racism, our work can only move and progress at the speed of trust.
With our declaration of racism as a public health crisis , we focused on “co-creation,” which means working with our Community Navigators, coalitions, advisory groups, and funded community-based organizations from the beginning, including in the design of programs and policies. Those partners are the leaders and trusted messengers in the community, who we have to invest in and resource.
As an extremely diverse county, how have you been able to communicate effectively and equitably with so many different communities?
Since the start of the pandemic, we have continued to refine our strategies, including getting more specific and focused. One of our approaches has been to create “priority populations” teams. These involve the internal Public Health employees who represent our diverse communities teaming up with specific external racial and ethnic communities: Black/African American, African Immigrant, Native/Indigenous, Pacific Islander, Latino/Hispanic, Asian, and South Asian. We have also focused on specific sectors, like small businesses, and populations like people with disabilities and LGBTQ+ communities.
We use the concept of targeted universalism: we have universal goals and focused strategies for each population since they have distinct strengths and barriers. For example, we aimed to get high vaccination rates across all racial groups and geographies, and then we’ve had different teams and partnerships with those communities. This has contributed significantly to us reaching 82% completed vaccination across all races for those 16 years and over in King County. The progress has been enormous, but we still have much work to do to address both COVID-19 inequities and the social determinants of health.
How has data been beneficial to your overall COVID-19 response strategy during the past two years?
Data has been an extremely valuable driver in our response. Though when I think of data, it’s both our COVID-19 dashboards and the qualitative data represented by the rich voices of the community.
For example, in our Principles for Equitable Vaccine Delivery, we committed to equitable vaccine delivery that is data-driven and informed by continuous engagement to understand and respond to community preferences and needs. While the data is key, community engagement and partnerships are critical to continuous learning to unearth and address barriers and inform our operations and outreach.
We recently have highlighted this in a blog by Public Health – Seattle & King County (Equity in Vaccination is a Community Effort – PUBLIC HEALTH INSIDER ), which highlights how we have addressed the problem of not having enough health providers where we have the most inequities.
What are some lessons you have learned addressing COVID-19, determinants of equity, and racism all at the same time? What should other community leaders know when starting similar initiatives?
We have historical shifts right now that are driven by communities fighting for the health of Black and Brown communities, and there is momentum that can’t be lost and an opening that we can’t waste. I thank our communities for this since they have been asking for changes for a long time.
Now for us, leadership commitment is critical and necessary to advance racial and health equity work. At the same time, within institutions, we need to lift up and nurture the voices and creativity of our staff, especially our Black and Brown staff, given that we are trying to do deep cultural work and dismantle systems that have not worked for many of us.
Of course, words and good intentions are not enough. We need tools, frameworks, training plus goals, and plans that are supported by systems of accountability and ongoing relationships with our communities. If you are constantly moving in spaces of discomfort and have healthy conflict with employees and the community where you are challenging business as usual, then you know you are going in the right direction.
Watch Dr. Valenzuela's original virtual symposium presentation on OMH's YouTube Channel
Visit the Minority Health Social Vulnerability Index to see other ways data can be leveraged to support the identification of racial and ethnic minority communities at greatest risk for disproportionate impact and adverse outcomes due to the COVID-19 pandemic.
Visit the Centers for Disease Control and Prevention’s COVID-19 Community Levels resource to find your community’s COVID-19 levels and decide what prevention steps to take based on the latest data.