A new challenge and an old obstacle confront West Virginia’s minority health task force.
Getting Black people and other minorities vaccinated against COVID-19 is the mission, but minority leaders say that requires an elusive component: trust.
“They need to hear from African American health and public health officials: ‘I trust the science of this vaccine,’” said the Rev. Matthew Watts, senior pastor of Grace Bible Church on Charleston’s West Side. “They need to be seen. They need to be heard.”
Watts helped organize an April 24 statewide phone call with minority leaders and the state’s coronavirus czar, Dr. Clay Marsh of West Virginia University, and Sen. Joe Manchin, D-W.Va. Concerns then centered on racial health disparities that left minorities vulnerable to the rampant spread of the virus.
That led to the formation of the minority health task force, which increased access to testing in minority communities. Members of the task force from North Central West Virginia turned to Black churches, community organizations, health centers and other services following a church outbreak in March.
Distrust in the system endures here and elsewhere. More than a third of Black adults say they definitely or probably would not get vaccinated, according to a Kaiser Family Foundation study released last month. In states tracking the data, white people are being vaccinated at rates two to three times higher than Black people, the foundation reported last week.
That could be the product of an old foe.
“For a lot of people if you’re approached by somebody who doesn’t look like you, sound like you, understand you — or doesn’t take the time to understand you — then you start to lose the trust,” Marsh said. “Or perhaps you’ve never really earned the trust.”
Minority leaders say Black voices and faces are key. That, Watts said, was a concern following the initial formation of the task force, chaired by Herbert Henderson Office of Minority Affairs Director Jill Upson with health care workers, lawmakers and community and faith groups serving as commissioners.
“I felt that it was critically essential that the governor’s coronavirus task force solicit the support from the top African American health, public health, mental health and medical professionals around the state,” Watts said. “For the most part, there were only Caucasian voices that were being heard in the state of West Virginia, and that’s still pretty much the case.”
Watts has recommended Dr. Anthony Woart, chairman of the Department of Public Health at Marshall University and the founder and director of the state Minority Health Institute, to chair the panel. Woart could work with Black doctors and medical professionals of color at the medical and public health schools at both Marshall and West Virginia University.
During a minority health task force meeting Thursday, West Virginia NAACP President Owens Brown asked what role the Minority Health Institute had been playing during the pandemic.
“We know they’re out there. We’ve not had any real communication with them,” said state Department of Health and Human Resources Secretary Bill Crouch. “At least I haven’t. I shouldn’t say we haven’t in other parts of the department.”
The state health department contracted with the Partnership of African American Churches, a community-based development group on the West Side, to sponsor mobile testing sites in minority communities. A similar contract should be coming for vaccines, Crouch said Thursday.
Upson and the Rev. James Patterson, the partnership’s director, said Friday they are ready to do the legwork to drive vaccinations in minority communities.
With virus death rates soaring, there is no time to waste, Watts said.
Yawning gaps in communication remain between key minority players and state health officials.
Following Thursday’s meeting, the three people who make up the Minority Health Institute said they were in the dark when it comes to receiving first-hand COVID-19 information from the state.
“As chair of [Marshall’s public health] department and as director of that institute, I’m not involved to the level I wish I could have been involved,” Woart said, “and that seems to be — I just don’t understand it.”
LaDawna Walker-Dean, minority health coordinator for the state Bureau of Public Health and one of the institute’s three staffers along with Woart and Georgiana Logan, said her job would hardly change if the office takes on a larger role in West Virginia’s COVID-19 response. She already works in communities of color across the state, developing partnerships and collaborations with hospitals and health departments.
“One of the things that we’ve been doing for the past three years I’ve been here,” Walker-Dean said, “is to coordinate programs and inform the community about health disparities and free services that are out there that a community doesn’t necessarily have.”
State leaders envisioned information flowing from the governor’s office to the health institute to communities. That requires the institute being in the know.
“We need information. We need resources. Most importantly we need to be included,” said Logan, a professor of health science at Marshall and a research associate for the minority health office. “You have the Minority Health Institute here, and you have to be able to utilize us and consider us because COVID-19 is a public health issue. So, if we get left out of the equation, then you do your communities a disservice when you have an entity such as us who can have such a powerful impact.”
If the institute lacks information, Walker-Dean said, minority communities likely will, too.
“So, if you start from the top and trickle down the information,” she said, “you can get the information, spread it out quickly to minorities because we’re already in the community and we know what our communities look like.”
Just as there are communication fractures, state COVID-19 data on race is incomplete.
Race is not identified in more than a third of all positive cases or in 542, or more than a fourth, of the state’s 1,856 virus deaths as of this writing.
The state is tracking vaccinations by race, but not always. The number of vaccinations in which the race is unknown doubles the number of Black people vaccinated.
Inconsistent tracking means no one knows how many Black people have been infected by the virus. If the reporting flaw for vaccinations isn’t fixed, that problem will be repeated.
“We’re completely in the dark now as far as data is concerned,” said Zakee McGill, a medical doctor and Berkeley County NAACP president.
Trust starts with information.
“The biggest issue is transparency,” Logan said.
That comes in different forms. Black people want to know to what extent Black people were included in clinical vaccine trials. They want to know how many had underlying health conditions or comorbidities — the simultaneous presence of two or more diseases — and they want to know whether those patients have the same health problems they do, Logan said.
Black people’s historical distrust of the health care system is fueled by such abuses as the Tuskegee experiments, in which the federal government tracked a group of Black sharecroppers infected with syphilis but didn’t treat them.
“You have to consider even though we have this historical context,” Logan said, “a lot of folks feel the vaccine was just rushed.”
People are confused over which vaccine to take or whether there’s a difference, Logan said. Misinformation can be overwhelming.
“If you don’t address those concerns people have, that fear factor sets in and it makes them ultimately not want to take a vaccine because of the unknown,” Logan said.
Knowing friends, relatives or other Black people who have been vaccinated helps, Walker-Dean said. Assurances of the vaccine’s safety is the most pressing issue, Woart said.
“My major concern is those people who actually need the vaccine may end up not getting it,” Woart said, “and I believe it’s because we have not been addressing the concerns they have. That’s pure and simple.”
In former Charleston NAACP President Rick Martin’s mind, the way forward was identified during the statewide call in April: Bring West Virginia’s best Black medical minds together and let them speak directly to those who have questions.
“Part of the purpose behind impaneling such a group,” he said, “would be some immediate, automatic and expected connectivity between that panel and the African American communities, particularly local Black churches, community-based organizations and other entities that advocate for the community of color.”
Martin cited an hour-long video interview, “Making it Plain: A Conversation with Dr. Fauci,” in which a Black health advocate from Washington took community questions to Dr. Anthony Fauci, the federal coronavirus czar. Martin said that could serve as a starting point.
While Fauci is white, he’s the most trusted person in the United States on vaccine guidance, according to an October Morning Consult and Politico poll.
Martin said Black West Virginians need the same kind of face-to-face access to the state’s Black medical professionals. The conversation must be continuing rather than a one-time deal.
Failing to include Woart, as Watts recommended, and other top Black medical minds was a mistake, McGill said.
“It’s really irresponsible that the state has not looped in people like Dr. Woart, who is on the ground, in the community, with the knowledge of the community and how to access it,” McGill said.
Woart, who lived in Mercer County for 19 years studying minority health in Southern West Virginia, said his work long has been aided by faith organizations.
“All the work I have done in West Virginia would not have been done, and I’ve done a lot, would not have been possible without my partnership with the African American churches,” he said. “I would not have ended up at Marshall without the work I’ve done and the trust I have built among the community.”
State leaders would be wise to include Black churches, Woart said.
“On an institutional level and historically, African American churches have always been the catalyst for change,” Woart said. “We do listen to our pastors.
“You would think that administrators and politicians, after all these years, would understand that.”
The source of the information, after all, is more important than the information itself, Woart said.
“I can’t imagine having a white social worker going into Bluefield or in Princeton or in Beckley trying to inform the African American community about the vaccine,” he said.
Steady information flow, clear and efficient policy and addressing issues at the community level could save lives, Woart said.
“This is an emergency,” Woart said. “Put aside political and social differences to address this urgent problem.”