NH75OT000043

Maine's initiative to address COVID-19 health disparities among populations at high risk and underserved, including racial and ethnic minority populations and rural communities.

COVID-19 made evident systemic health inequity through a lack of sufficient, quality data to understand the nuanced needs of Maine's underserved communities, a state public health infrastructure lacking an equity framework and adequate staffing at the local level, weak investments in community-based organizations most able to administer local services, and a lack of culturally and linguistically appropriate interventions tailored to the individuals we serve.

Further, we are only beginning to see long-term health impacts of the pandemic on the psycho-social wellbeing of communities, substance use, overdose deaths, and infant mortality.

Maine is the most rural state in the nation (with over 60% of the state's population living in rural areas) and the poorest state in New England. 10.9% of individuals and 13.8% of children live in poverty, with higher rates in rural areas. COVID-19 vaccination rates are dramatically lower in rural counties. Rural areas have been hit hard by COVID-19: Oxford County has the third highest rate of cases, and Piscataquis County has the highest per-capita hospitalization rate for COVID-19.

While racial and ethnic minorities make up six percent of the state's population, they boast a rich diversity which results in many communities within communities, each with unique needs and assets. Many of those communities have been the hardest hit by COVID-19. In June 2020, Black people accounted for 24% of all COVID-19 cases but only 1.6% of Maine's population. Hispanic and Asian Mainers experienced COVID-19 rates at double their share of the population. Maine has also struggled with high rates of missing data on race, ethnicity, zip code, making it hard to implement targeted strategies.

To reduce disparities, we need to fill gaps in the information used to design local interventions in partnership with affected communities. This grant will be used to improve data infrastructure by: aligning multiple data systems to decrease the share of missing demographic data; working with community partners to design demographic questions that better align with the way Maine communities understand their own identities, while still rolling into OMB categories for consistency; designing standard questions to collect demographic data that we have failed to adequately capture; and supporting local community-led needs assessments to better understand the unique needs and social determinants of health that contributed to the noted disparities, and the community assets that can be leveraged to improve health equity.

While Maine once held the nation's greatest racial disparities for COVID-19 cases, that gap has narrowed, in large part due to the partnerships that DHHS formed with over two dozen community-based organizations to provide culturally and linguistically appropriate services like education about COVID-19 precautions, social services to support those in isolation and quarantine, and activities to promote vaccine confidence and equitable access to vaccine clinics. But the recent surge in cases and low vaccine rates in rural areas underscore the need to expand and strengthen local strategies. If awarded, DHHS would prioritize better integration of social services in our public health infrastructure. To enhance internal capacity, funding will support an equity audit and provide robust training for all staff to better understand social determinants of health, racial equity, and diversity, equity, and inclusion best practices. DHHS will also fund additional staff for equity initiatives and local health districts. Significant funding will support direct investment in community-based organizations for public health sustainability measures, technical assistance, and professional development. The outcome will be a more robust public health system that centers community needs and addresses health disparities.

Maine Department Of Health And Human Services

NOT APPLICABLE

93.354 - Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response

CDC Office of Financial Resources (OFR) [HHS - CDC]

Center for State, Tribal, Local, and Territorial Support (CSTLTS) [HHS - CDC]

Maine United States

State-Wide

National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities (CDC-RFA-OT21-2103)

Amendment Since initial award the End Date has been extended from 05/31/23 to 05/31/26.