Congress should move quickly and aggressively to combat COVID-19 by encouraging testing and vaccinations, focusing on equity and improving efforts around contact tracing, according to the American Psychological Association. “The pandemic highlighted long-standing systemic health and social inequities that put many racial and ethnic minorities at increased risk of contracting the coronavirus and of becoming ill and dying from COVID-19,” APA CEO Arthur C. Evans Jr., PhD, said in written testimony (PDF, 286KB) submitted Wednesday to the House Energy and Commerce Subcommittee on Health. “Research documents that even when these groups can access care, a variety of factors—including providers’ implicit biases and the inequitable distribution of health care resources—contribute to a lower overall quality of care and worse outcomes for these groups relative to white patients.” Evans’ testimony came as Congress considers an array of proposals to address the pandemic, which has led to the death of more than 441,000 people in the U.S., while debating the best ways to provide relief to businesses and people affected by the economic downturn spurred by the virus. Among the actions Evans recommended to Congress: Enact the $1.9 trillion COVID relief plan proposed by the Biden administration, which includes $4.5 billion for mental and behavioral health care, and invest in national recovery efforts and sound public health measures through FY 2022 appropriations. Implement federal programs to incentivize vaccination following the leadership of programs initiated by private industry. Address racial and ethnic barriers to mental health care and promote testing, vaccinations and other efforts in culturally competent ways. Promote wide availability, usability and use of Food and Drug Administration-approved at-home test kits to ensure that those without access to technology are not omitted from data-reporting systems. Incentivize robust investment in rapid research examining disparities among people of color, including disparities in infections and deaths, adoption of attitudes regarding safety precautions, vaccine acceptance, and clinical trials participation. Allow Medicare to continue to pay for a broad range of mental and behavioral health services furnished through audio-only telephone after the public health emergency ends. Require the Employee Retirement Income Security Act health plans to cover telemental health, at parity, and through multiple channels to ensure equitable access to essential mental and behavioral health care. It is important to include behavioral scientists on federal agency panels and task forces focusing on the COVID-19 response, Evans said. “Comprehensive reviews of the psychological literature reveal that successful vaccination campaigns involve understanding how people think and feel about vaccination, the multitude of social processes leading to vaccination and optimizing approaches to changing vaccination behavior directly,” he said. “Promotional materials, informed by psychological science and empirical evidence, can mitigate these obstacles and increase vaccine uptake during this crucial period.” An APA analysis of contact tracing (PDF, 169KB) found that many states have devised testing plans that rely on overly broad categories of various communities, such as “racial,” “ethnic” or “minority” rather than specifying characteristics, such as Black, Latino or other underrepresented communities. “The CDC reports that only 20 states include race and ethnicity data on their vaccine dashboards, even though people of color make up a large segment of the health care workforce and the long-term care workforce whom many states identify as priority populations for vaccination,” he said. “We also understand that contact tracing data is not systematically collected or reported publicly, which misses an opportunity to obtain and disseminate data identifying the sources of infections.” Source
