Reflections from a Discussion on COVID's Impact on Health Equity and Access to Health & Social Services
We recently co-hosted an event with grantees from Evidence for Action (E4A), Policies for Action (P4A), and Systems for Action (S4A), all signature programs of the Robert Wood Johnson Foundation (RWJF). During the discussion, moderated by RWJF Program Officer Jacquelynn Orr, panelists shared insights on the impacts of the COVID-19 pandemic on health equity and access to health and social services. The panelists, Aditi Bhanja (P4A), Nadereh Pourat (S4A), and Julia R. Raifman (E4A), highlighted innovative and impactful policies (e.g., Medicaid expansion, vaccine mandates) and programs (e.g., the California Whole Person Care Program), as well as possible strategies for making them more impactful and equitable.
This post highlights key insights that emerged during the conversation. We encourage you to learn more about each of the research projects and the programs and policies they’re investigating by watching the webinar recording. There are also links to the webinar and individual project pages to the right in the sidebar.
Key Insights on Partnerships & Collaboration
Partnerships and collaborations among sectors, agencies, programs, community groups, policymakers, and other stakeholders can inform and enhance research, making it more useful and impactful.
This was demonstrated in Dr. Pourat’s experience working with different groups from the Whole Person Care Program, an initiative around coordinating health and social services for Medicaid beneficiaries with complex needs. During the pandemic, partnerships formed as part of the program led to expansion of the public health system and an increase in its effectiveness.
Dr. Pourat also noted when discussing the development of partnerships that a deeper understanding of the context and the realities stakeholders are facing will better allow researchers to “know that what you’re going to offer as suggestions actually are implementable and make sense to people who are supposed to be doing those [things] in the future.”
Forming such partnerships takes time, and the process needs to start early. As Dr. Pourat further noted, researchers “need to start much earlier working with [their] partners… trying to translate the goals of the programs and policies into questions that actually can be evaluated and answered.”
Additionally, there should be a broadening of who are considered partners or collaborators in research endeavors. As Dr. Raifman suggested, “I think it’s very important for economics and public health and the people who are essential workers, people who are Native American, who are Black, who are Hispanic, and people who are from low-income communities to really lead us in figuring out how to best respond, how to design our policies equitably to protect those who are most vulnerable, and ultimately to protect the whole of our society.” Together, these partners can provide subject matter, methodological, and practical expertise, as well as lived experience to inform the research, and determine what is most realistic, equitable, and likely to be impactful.
Key Insights on Data Sharing & Access
The COVID-19 pandemic has demonstrated that researchers need to adapt the ways they collect and share data to provide timely evidence to inform fast-paced decision-making.
As Dr. Bhanja mentioned, “Our studies showed the power of surveying patients and getting timely data, and how critical that is to the pandemic. Oftentimes, a lot of researchers will wait on administrative data for enrollment or insurance, and with surveys you can get information really quickly.” She continued, “There are, of course, hiccups with that - small sample sizes, potential margin for errors and limited power, and cost - but I think it allows us to contribute to the policies and decisions that are being made fairly quickly. And to do so as soon as we have some confidence of our findings. And having that ability to be nimble and to shift resources in public health emergencies is important.”
Dr. Bhanja also further reinforced the importance of partnerships and collaborations highlighted above, noting that, “having interdisciplinary teams that can work together to adapt data collaboration efforts is really key.”
This does not just apply to decisions being made in response to public health emergencies - there are other issues and problems that need to be addressed and timely evidence is critical in informing policies, practices, and the development and implementation of programs. We should consider how to turn data around more quickly and not be beholden to the “tried and true” methods of communicating data in the academic sector.
Key Insights on Communication of Findings
Research findings must be actively communicated in accessible ways to the appropriate individuals and groups to support evidence-based decision-making. Effectively doing this heavily relies on forming partnerships early on and getting the data needed in a timely fashion.
In addition to getting data out more quickly and putting together an interdisciplinary team to enhance adaptability, as Dr. Bhanja mentioned, “having access to multiple dissemination pathways and clear messaging is also incredibly important.” Dr. Bhanja posits that all three of these things together are “the main strongholds of researchers who are translating evidence.”
How and what you communicate is also incredibly important. Dr. Pourat said, “journal articles are really not the right venue for transmitting information to broad audiences. So, what we do a lot of times, is provide these alternative forms, such as policy briefs… [to] provide simple and uncluttered analysis that is easy to understand and is actionable for the audience.”
We must also be careful of the language we use, even when it makes for a good soundbyte. As Dr. Raifman highlighted, “when we use language like ‘Pandemic of the Unvaccinated’ that can vilify the people who are unvaccinated, it may just be that they’re underserved. It’s a ‘Pandemic of the Underserved.’ It’s a ‘Pandemic of the Low-Income.’”
Remembering the context and bringing to the forefront the conditions and barriers people are experiencing is vital. This highlights inequities as symptoms of systemic and structural problems and that we should not shame or blame individuals for those conditions which are outside of their control.
These are a few of the many highlights of the Research in Progress event. To learn more about the policies and programs the researchers are evaluating, as well as their approaches to conducting their research and the importance of partnerships, data access, and communication of findings, watch the webinar here. The panel discussion begins at 29:25.