Hostname: page-component-77f85d65b8-7lfxl Total loading time: 0 Render date: 2026-04-21T02:04:14.564Z Has data issue: false hasContentIssue false
  • English
  • Français

Enacting Relational Public Health: Federally Qualified Health Centers During the COVID-19 Pandemic

Published online by Cambridge University Press:  31 May 2024

Danielle Pacia Open the ORCID record for Danielle Pacia [Opens in a new window] ,
Johanna Crane ,
Carolyn Neuhaus ,
Nancy Berlinger  and
Rachel Fabi
Danielle Pacia
Affiliation:
THE HASTINGS CENTER, GARRISON, NEW YORK, USA.
Johanna Crane
Affiliation:
ALDEN MARCH BIOETHICS INSTITUTE, ALBANY, NEW YORK, USA.
Carolyn Neuhaus
Affiliation:
THE HASTINGS CENTER, GARRISON, NEW YORK, USA.
Nancy Berlinger
Affiliation:
THE HASTINGS CENTER, GARRISON, NEW YORK, USA.
Rachel Fabi
Affiliation:
SUNY UPSTATE MEDICAL UNIVERSITY, SYRACUSE, NY, USA.
Get access Rights & Permissions [Opens in a new window]

Précis

Federally Qualified Health Centers (FQHCs) proved to be critical points of access for people of color and other underserved populations during the COVID-19 pandemic, administering 61% of their COVID-19 vaccinations to people of color, compared to the 40% rate for the overall United States’ vaccination effort. To better understand the approaches and outcomes of FQHCs in pandemic response, we conducted semi-structured interviews with FQHC health care providers and outreach workers and analyzed them using an inductive qualitative methodology.

Keywords

COVID-19FQHCsRelational Public HealthVaccine EquityCommunity Health

Information

Type
Independent Articles
Information
Journal of Law, Medicine & Ethics , Volume 52 , Issue 1 , Spring 2024 , pp. 34 - 40
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of American Society of Law, Medicine & Ethics

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Haldar, S., “Latest Data on COVID-19 Vaccinations by Race/Ethnicity,” KFF (blog), available at <https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-by-race-ethnicity/> (last visited February 23, 2024).+(last+visited+February+23,+2024).>Google Scholar
Lopez, L., Hart, L. H., and Katz, M. H., “Racial and Ethnic Health Disparities Related to COVID-19,” JAMA 325, no. 8 (2021): 719, https://doi.org/10.1001/jama.2020.26443.CrossRefGoogle ScholarPubMed
“FQHC PPS | CMS,” available at <https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FQHCPPS> (last visited February 23, 2024).+(last+visited+February+23,+2024).>Google Scholar
Rosenbaum, S., et al., “Community Health Centers: Growing Importance in a Changing Health Care System - Issue Brief,” KFF (blog), (2018), available at <https://www.kff.org/report-section/community-health-centers-growing-importance-in-a-changing-health-care-system-issue-brief/> (last visited February 23, 2024).+(last+visited+February+23,+2024).>Google Scholar
KFF, “A Profile of Community Health Center Patients - Demographic Characteristics,” available at <https://www.kff.org/report-section/a-profile-of-community-health-center-patients-demographic-characteristics/> (last visited February 23, 2024).+(last+visited+February+23,+2024).>Google Scholar
Nath, J. B., Costigan, S., and Hsia, R. Y.. “Changes in Demographics of Patients Seen at Federally Qualified Health Centers, 2005-2014,” JAMA Internal Medicine 176, no. 5 (2016): 712, https://doi.org/10.1001/jamainternmed.2016.0705.CrossRefGoogle ScholarPubMed
HRSA, “Ensuring Equity in COVID-19 Vaccine Distribution,” U.S. Health Resources & Services Administration, February 7, 2021, available at <https://www.hrsa.gov/coronavirus/health-center-program> (Last visited November 16, 2022).+(Last+visited+November+16,+2022).>Google Scholar
Cole, M. B. et al., “Assessment of Administration and Receipt of COVID-19 Vaccines by Race and Ethnicity in US Federally Qualified Health Centers,” JAMA Network Open 5, no. 1 (2022): e2142698.CrossRefGoogle ScholarPubMed
Crane, J. T., et al., “‘We’re Here to Take Care of Our Community’: Lessons Learned From the U.S. Federal Health Center Covid-19 Vaccine Program,” Health Promotion Practice, January 23, 2023, 152483992211511, https://doi.org/10.1177/15248399221151178.Google Scholar
Oyserman, D., Coon, H. M., and Kemmelmeier, M., “Rethinking Individualism and Collectivism: Evaluation of Theoretical Assumptions and Meta-Analyses,” Psychological Bulletin 128, no. 1 (2002): 3–72.Google ScholarPubMed
Baylis, F., Kenny, N. P., and Sherwin, S., “A Relational Account of Public Health Ethics,” Public Health Ethics 1, no. 3 (2008): 196–209.Google Scholar
See Baylis et al., supra note 11.Google Scholar
See Baylis et al., supra note 11.Google Scholar
Powers, M. and Faden, R. R., Social Justice: The Moral Foundations of Public Health and Health Policy, Issues in Biomedical Ethics (New York: Oxford University Press, 2006): 61.Google Scholar
Wiley, L. F., “Health Law as Social Justice,” Cornell Journal of Law and Public Policy 24, no. 1 (2014): 47–105.Google Scholar
See Baylis et al., supra note 11.Google Scholar
Katz, A. B., “A Long and Winding Road: Federally Qualified Health Centers, Community Variation and Prospects Under Reform,” Center for Studying Health System Change 21 (2011): 1–9;”Cahaba Medical Care,” Cahaba Medical Care, available at <https://www.cahabamedicalcare.com> (last visited November 16, 2022);”Mission & Overview,” Howard Brown Health, available at <https://howardbrown.org/about/mission/> (last visited November 16, 2022);”Leadership Statement,” Open Door Health Center, available at <https://odhc.org/leadership-statement/> (last visited November 16, 2022).Google Scholar
Lefkowitz, B., Community Health Centers: A Movement and the People Who Made It Happen, Critical Issues in Health and Medicine, (New Brunswick, N.J: Rutgers University Press, 2007): 1–10.Google Scholar
See Lefkowitz, supra note 18.Google Scholar
Crane, J. T., et al., “Advancing COVID Vaccination Equity at Federally Qualified Health Centers: A Rapid Qualitative Review.” Journal of General Internal Medicine 37, no. 4 (2022): 1012–13, https://doi.org/10.1007/s11606-021-07273-8.Google Scholar
Njoku, A., Marcelin, J., and Felix, R.. “Changing the Narrative: Structural Barriers and Racial and Ethnic Inequities in COVID-19 Vaccination.” International Journal of Environmental Research and Public Health 18, no. 18 (2021): 9904, https://doi.org/10.3390/ijerph18189904.CrossRefGoogle ScholarPubMed
See Baylis et al., supra note 11.Google Scholar
See Baylis et al., supra note 11.Google Scholar
See Baylis et al., supra note 11.Google Scholar
Kistnasamy, B., “Migrant Workers and Covid-19,” Safety and Health at Work 13 (2022): S53, https://doi.org/10.1016/j.shaw.2021.12.892.Google Scholar
Chinchih, C., Frey, C. Benedikt, and Presidente, G., “Culture and Contagion: Individualism and Compliance with COVID-19 Policy,” Journal of Economic Behavior & Organization 190 (2021): 191–200.Google Scholar
“COVID-19 Vaccination Federal Retail Pharmacy Partnership Program | CDC,” June 9, 2022, available at <https://www.cdc.gov/vaccines/covid-19/retail-pharmacy-program/index.html> (last visited November 16, 2022).+(last+visited+November+16,+2022).>Google Scholar
Ratzan, S. et al., “Missing the Point — How Primary Care Can Overcome Covid-19 Vaccine ‘Hesitancy,’” New England Journal of Medicine 384, no. 25 (2021): e100.CrossRefGoogle ScholarPubMed
Mackey, K. et al., “Racial and Ethnic Disparities in COVID-19–Related Infections, Hospitalizations, and Deaths: A Systematic Review,” Annals of Internal Medicine 174, no. 3 (2021): 362–73.CrossRefGoogle ScholarPubMed
“Chapter 20: Board Composition | Bureau of Primary Health Care,” available at <https://bphc.hrsa.gov/compliance/compliance-manual/chapter20> (last visited November 16, 2022).+(last+visited+November+16,+2022).>Google Scholar
See Baylis et al., supra note 11.Google Scholar
See Wiley, supra note 15.Google Scholar
See Baylis et al., supra note 11.Google Scholar
Wright, B. et al., “Will Community Health Centers Survive COVID‐19?” The Journal of Rural Health 37, no. 1 (2021): 235–38.CrossRefGoogle ScholarPubMed
“FQHC PPS,” available at <https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/FQHCPPS> (last visited November 16, 2022).+(last+visited+November+16,+2022).>Google Scholar
Rachel, R. Pradhan Bluth, “Community Clinics Shouldered Much of the Vaccine Rollout: Many Haven’t Been Paid,” Kaiser Health News, October 11, 2021 , available at <https://khn.org/news/article/community-clinics-shouldered-much-of-the-vaccine-rollout-many-havent-been-paid/> (last visited November 16, 2022).+(last+visited+November+16,+2022).>Google Scholar
“FY 2021 American Rescue Plan Funding for Health Centers (H8F) | Bureau of Primary Health Care,” October 5, 2022, available at <https://bphc.hrsa.gov/funding/coronavirus-related-funding/fy-2021-american-rescue-plan-funding-health-centers-h8f> (last visited November 16, 2022).+(last+visited+November+16,+2022).>Google Scholar
“Chapter 19: Board Authority | Bureau of Primary Health Care,” available at <https://bphc.hrsa.gov/compliance/compliance-manual/chapter19> (last visited February 23, 2024).+(last+visited+February+23,+2024).>Google Scholar