Increasingly, policymakers are exploring how disadvantage indices can help guide efforts to dismantle structural discrimination by identifying—and then allocating resources more equitably to—marginalized communities that disproportionately lack equal access to health care, education, safe housing, and other social determinants of health. The COVID-19 pandemic marks a major widespread use of disadvantage indices to guide more equitable resource allocation, providing an opportunity to learn from early state and local experiences using these tools to guide vaccine allocation and distribution. This brief summarizes a June 2021 AcademyHealth workshop where public health officials shared their on-the-ground experiences using disadvantage indices to locate COVID-19 testing sites, allocate vaccines, set up vaccination sites, and conduct community outreach to overcome vaccine hesitancy. While early experiences indicate that indices helped guide more equitable responses to the pandemic, formal evaluation is needed to examine the comparative advantages and effectiveness of various indices. Moreover, the pandemic has highlighted the critical need for greater investment in data infrastructure, especially accurate race and ethnicity data, to both prepare for and respond to future public health emergencies.
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