Vaccination Distribution Plans - the Looming Political Disaster - Printable Version
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RE: Vaccination Distribution Plans - the Looming Political Disaster - Genuine Realist - 10-26-2020
(10-26-2020, 04:37 PM)murky Wrote:Prostate screenings and colonoscopies don't have to be rationed.(10-25-2020, 02:51 PM)BostonCard Wrote: uh
(10-25-2020, 02:45 PM)Genuine Realist Wrote: None of these factors (and I don't quarrel with any of them) reflect governmental policy or the proverbial barriers. All of them reflect the cultural overhang I mentioned.
More than that, very few of them apply to that sizable fraction of the demographic that stands on the other side of the wealth divide. I'm not going to grant a preference to a wealthy minority resident of Atherton or Los Altos Hills simply on the basis of ethnicity. That is actual racism,
I wasn't saying they did. I was just saying that they are factors that might result in Black and Hispanic victims of COVID-19 dying at a greater rate than whites. If you talk about vaccinating the most vulnerable first, and your research finds that Black and Hispanic patients are disproportionately dying, and you can't find (or measure) the underlying factors that explain that difference, then you will either have to accept using race as a blunt proxy and realize that some otherwise lower risk people might inadvertently be given priority or accept that you will not give a bunch of higher risk people priority.
BC
BC, I appreciate your well articulated arguments in this thread, as I generally do.
I'm posting here, but in response to the thread. I wonder if GR takes exception to beginning prostate cancer screenings, or colonoscopy at an earlier age for African Americans compared to others. In many ways, I see that as a parallel to using race in determining vaccination eligbility.
Of course, with an infectious disease, there's also the matter of not just saving individuals, but also disrupting the spread.
I find some perverse humor in imagining the bizarre scenario of the Trump administration telling Black people that they should get vaccinated first. Let's just say there's a severe trust deficit.
(10-25-2020, 09:27 PM)akiddoc Wrote: Wish I could access some of GR's old CEB posts.
As do I.
It may not be a fair recollection, but I shared your general impression that his past arguments left on me.
If you want to address the actual argument, consider the hard case - the African American Atherton resident, employed in marketing, who works at home, getting priority over a food distribution worker, who is at risk. Like that outcome?
RE: Vaccination Distribution Plans - the Looming Political Disaster - BostonCard - 10-26-2020
As a practical matter, I would put money on an Atherton (or Telluride) resident (regardless of race) getting priority of a food distribution worker (regardless of race).
https://www.livescience.com/colorado-ski-town-coronavirus-antibody-testing.html
This was back in March when testing was still hard to come by.
BC
RE: Vaccination Distribution Plans - the Looming Political Disaster - Genuine Realist - 10-26-2020
(10-26-2020, 07:38 PM)BostonCard Wrote: As a practical matter, I would put money on an Atherton (or Telluride) resident (regardless of race) getting priority of a food distribution worker (regardless of race).You got that right.
https://www.livescience.com/colorado-ski-town-coronavirus-antibody-testing.html
This was back in March when testing was still hard to come by.
BC
RE: Vaccination Distribution Plans - the Looming Political Disaster - BostonCard - 10-27-2020
This is a good piece that discusses the ethical and legal issues that would be involved in prioritizing ethnic and racial minorities in vaccine distribution.
https://jamanetwork.com/journals/jama/fullarticle/2771874?utm_source=silverchair&utm_campaign=jama_network&utm_content=covid_weekly_highlights&utm_medium=email
As for the ethics, the authors write:
Quote:These elevated death rates are unlikely to be explained by biological differences but more likely are influenced by social determinants of health, including economic privation and systemic bias. To avoid further compounding these disparities, the NASEM expressly includes “mitigation of health inequities” as 1 of the 3 foundational principles of its framework.
As for the legal aspects, the authors don’t believe vaccine allocation that explicitly takes race into account would survive strict scrutiny. I’m not a lawyer, but based on my understanding of the term I see no reason to doubt it.
To get around this issue, the authors suggest vaccine distribution by a measure called the “area deprivation index” that captures economic deprivation but does not capture measures of race.
Quote:For strategies that would increase the allocation ratio above that proportionate to the population, the Supreme Court is likely to uphold racially neutral vaccine allocation criteria, which are designed to capture worse-off minorities but not explicitly. A vaccine distribution formula, therefore, could lawfully prioritize populations based on factors like geography, socioeconomic status, and housing density that would favor racial minorities de facto, but not explicitly include race.
An example of such a legally permissible approach would be to use a measure called the Area Deprivation Index (ADI), which is similar to the SVI, but does not explicitly prioritize on the basis of race. The ADI reflects the level of socioeconomic deprivation of a geographic area at the block-group level (600-3000 people) and is associated with health outcomes.
The index integrates income, education, employment, and housing quality. Although it does not use race as a variable, the ADI still captures structural disadvantage and systemic racism because racial minorities are far more likely to be economically worse off.
The ADI therefore closely tracks racial and ethnic divides and significantly reduces potential legal concerns that are associated with using the SVI.
The whole piece is worth a read.
BC
RE: Vaccination Distribution Plans - the Looming Political Disaster - Genuine Realist - 10-28-2020
(10-27-2020, 11:48 PM)BostonCard Wrote: This is a good piece that discusses the ethical and legal issues that would be involved in prioritizing ethnic and racial minorities in vaccine distribution.Thanks for this. From the summary, the article apparently matches my own views, which of course means it must be accurate.
https://jamanetwork.com/journals/jama/fullarticle/2771874?utm_source=silverchair&utm_campaign=jama_network&utm_content=covid_weekly_highlights&utm_medium=email
As for the ethics, the authors write:
Quote:These elevated death rates are unlikely to be explained by biological differences but more likely are influenced by social determinants of health, including economic privation and systemic bias. To avoid further compounding these disparities, the NASEM expressly includes “mitigation of health inequities” as 1 of the 3 foundational principles of its framework.
As for the legal aspects, the authors don’t believe vaccine allocation that explicitly takes race into account would survive strict scrutiny. I’m not a lawyer, but based on my understanding of the term I see no reason to doubt it.
To get around this issue, the authors suggest vaccine distribution by a measure called the “area deprivation index” that captures economic deprivation but does not capture measures of race.
Quote:For strategies that would increase the allocation ratio above that proportionate to the population, the Supreme Court is likely to uphold racially neutral vaccine allocation criteria, which are designed to capture worse-off minorities but not explicitly. A vaccine distribution formula, therefore, could lawfully prioritize populations based on factors like geography, socioeconomic status, and housing density that would favor racial minorities de facto, but not explicitly include race.
An example of such a legally permissible approach would be to use a measure called the Area Deprivation Index (ADI), which is similar to the SVI, but does not explicitly prioritize on the basis of race. The ADI reflects the level of socioeconomic deprivation of a geographic area at the block-group level (600-3000 people) and is associated with health outcomes.
The index integrates income, education, employment, and housing quality. Although it does not use race as a variable, the ADI still captures structural disadvantage and systemic racism because racial minorities are far more likely to be economically worse off.
The ADI therefore closely tracks racial and ethnic divides and significantly reduces potential legal concerns that are associated with using the SVI.
The whole piece is worth a read.
BC
It's not that race no longer signifies. It's that, with the expansion of a Black middle and upper class, it is no longer as directly correlated as once it was. You have to look at the way people, regardless of race, actually live. Spouting off racial generalizations may make you feel wonderfully sanctimonious, but it doesn't do you much good even in the short run.