Incorporating Health Equity Into COVID-19 Reopening Plans: Policy Experimentation in California.
Emily A Largent, Govind Persad, Michelle M Mello, Danielle M Wenner, Daniel B Kramer, Brownsyne Tucker Edmonds, Monica Peek
Author Information
Emily A Largent: Emily A. Largent is with the Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia. Govind Persad is with the University of Denver Sturm College of Law, Denver, CO. Michelle M. Mello is with Stanford Law School; the Department of Medicine, Stanford University School of Medicine; and the Freeman Spogli Institute for International Studies, Stanford, CA. Danielle M. Wenner is with the Center for Ethics and Policy, Carnegie Mellon University, Pittsburgh, PA. Daniel B. Kramer is with the Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Brownsyne Tucker Edmonds is with the departments of Obstetrics and Gynecology and Pediatrics, Indiana University School of Medicine, Indianapolis. Monica Peek is with the Section of General Internal Medicine and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL.
Govind Persad: Emily A. Largent is with the Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia. Govind Persad is with the University of Denver Sturm College of Law, Denver, CO. Michelle M. Mello is with Stanford Law School; the Department of Medicine, Stanford University School of Medicine; and the Freeman Spogli Institute for International Studies, Stanford, CA. Danielle M. Wenner is with the Center for Ethics and Policy, Carnegie Mellon University, Pittsburgh, PA. Daniel B. Kramer is with the Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Brownsyne Tucker Edmonds is with the departments of Obstetrics and Gynecology and Pediatrics, Indiana University School of Medicine, Indianapolis. Monica Peek is with the Section of General Internal Medicine and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL.
Michelle M Mello: Emily A. Largent is with the Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia. Govind Persad is with the University of Denver Sturm College of Law, Denver, CO. Michelle M. Mello is with Stanford Law School; the Department of Medicine, Stanford University School of Medicine; and the Freeman Spogli Institute for International Studies, Stanford, CA. Danielle M. Wenner is with the Center for Ethics and Policy, Carnegie Mellon University, Pittsburgh, PA. Daniel B. Kramer is with the Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Brownsyne Tucker Edmonds is with the departments of Obstetrics and Gynecology and Pediatrics, Indiana University School of Medicine, Indianapolis. Monica Peek is with the Section of General Internal Medicine and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL.
Danielle M Wenner: Emily A. Largent is with the Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia. Govind Persad is with the University of Denver Sturm College of Law, Denver, CO. Michelle M. Mello is with Stanford Law School; the Department of Medicine, Stanford University School of Medicine; and the Freeman Spogli Institute for International Studies, Stanford, CA. Danielle M. Wenner is with the Center for Ethics and Policy, Carnegie Mellon University, Pittsburgh, PA. Daniel B. Kramer is with the Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Brownsyne Tucker Edmonds is with the departments of Obstetrics and Gynecology and Pediatrics, Indiana University School of Medicine, Indianapolis. Monica Peek is with the Section of General Internal Medicine and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL.
Daniel B Kramer: Emily A. Largent is with the Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia. Govind Persad is with the University of Denver Sturm College of Law, Denver, CO. Michelle M. Mello is with Stanford Law School; the Department of Medicine, Stanford University School of Medicine; and the Freeman Spogli Institute for International Studies, Stanford, CA. Danielle M. Wenner is with the Center for Ethics and Policy, Carnegie Mellon University, Pittsburgh, PA. Daniel B. Kramer is with the Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Brownsyne Tucker Edmonds is with the departments of Obstetrics and Gynecology and Pediatrics, Indiana University School of Medicine, Indianapolis. Monica Peek is with the Section of General Internal Medicine and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL.
Brownsyne Tucker Edmonds: Emily A. Largent is with the Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia. Govind Persad is with the University of Denver Sturm College of Law, Denver, CO. Michelle M. Mello is with Stanford Law School; the Department of Medicine, Stanford University School of Medicine; and the Freeman Spogli Institute for International Studies, Stanford, CA. Danielle M. Wenner is with the Center for Ethics and Policy, Carnegie Mellon University, Pittsburgh, PA. Daniel B. Kramer is with the Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Brownsyne Tucker Edmonds is with the departments of Obstetrics and Gynecology and Pediatrics, Indiana University School of Medicine, Indianapolis. Monica Peek is with the Section of General Internal Medicine and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL.
Monica Peek: Emily A. Largent is with the Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia. Govind Persad is with the University of Denver Sturm College of Law, Denver, CO. Michelle M. Mello is with Stanford Law School; the Department of Medicine, Stanford University School of Medicine; and the Freeman Spogli Institute for International Studies, Stanford, CA. Danielle M. Wenner is with the Center for Ethics and Policy, Carnegie Mellon University, Pittsburgh, PA. Daniel B. Kramer is with the Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA. Brownsyne Tucker Edmonds is with the departments of Obstetrics and Gynecology and Pediatrics, Indiana University School of Medicine, Indianapolis. Monica Peek is with the Section of General Internal Medicine and MacLean Center for Clinical Medical Ethics, The University of Chicago, Chicago, IL.
California has focused on health equity in the state's COVID-19 reopening plan. The Blueprint for a Safer Economy assigns each of California's 58 counties into 1 of 4 tiers based on 2 metrics: test positivity rate and adjusted case rate. To advance to the next less-restrictive tier, counties must meet that tier's test positivity and adjusted case rate thresholds. In addition, counties must have a plan for targeted investments within disadvantaged communities, and counties with more than 106 000 residents must meet an equity metric. California's explicit incorporation of health equity into its reopening plan underscores the interrelated fate of its residents during the COVID-19 pandemic and creates incentives for action. This article evaluates the benefits and challenges of this novel health equity focus, and outlines recommendations for other US states to address disparities in their reopening plans.
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