[BostonCard]

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/fu...dium=email

As for the ethics, the authors write:
  

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.

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

[BostonCard]

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/fu...dium=email

As for the ethics, the authors write:
  

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.

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