393

Systemic racism and implicit bias in health care has resulted in maternal deaths among Black women of all socioeconomic levels. Data disaggregation by city shows that Pittsburgh – an otherwise thriving city by key economic indicators – suffers from an acute racial divide in maternal & infant mortality. The disparity between Black & White maternal mortality rates is greater in Pittsburgh than in 84% of similar cities, and fetal deaths are twice as likely among Pittsburgh’s Black women compared to Pittsburgh’s White women.

Employers are a key group uniquely positioned to close the maternal mortality gap through their collective purchasing power in health benefits. Palladium is collaborating with the Pittsburgh Business Group on Health (PBGH), and Innovu, a fiduciary data analytics partner to address these inequities. We empower employers to support local community-based organizations focused on healthy mothers & babies through innovative financing. We also encourage employers to provide employees with benefits packages which support healthy birth outcomes and help to maintain productivity.

Access to medical care and life-saving drugs for many people living with HIV has improved in the United States, although we still have a ways to go to ensure equitable access among Black and Brown communities, rural communities, and in some geographic regions. Challenges also persist beyond medical intervention. Many people living with HIV experience depression, anxiety, and post-traumatic stress that goes undiagnosed and untreated. Additionally, many people lack basic needs such as a reliable income, food, and housing. All of these factors can affect a person’s capacity to adhere to their medication and maintain a healthy lifestyle. Health providers are increasingly aware of the need to consider a patient’s mental health and basic needs as part of their care, but often lack the tools to help facilitate a patient’s access to appropriate services.

Palladium supported the Cancer Support Community (CSC) to develop a distress screening, referral, and follow-up program for HIV patients who seek care at community-based health clinics―to promote a more holistic approach to their care. The program was based on a similar program developed by CSC for cancer patients, which is widely used in health care settings across the US. With recent research on patient and provider perspectives on the new HIV program and our pilot study, Palladium helped to promote the health and well-being of people living with HIV by creating their greater and more equitable access to a broader range of essential services.

Pima County Health Department was faced with a massive distribution challenge once COVID-19 vaccines became available in December 2020. A critical component of this challenge was to ensure that vaccines were equitably distributed so that the most vulnerable residents could access the vaccine as soon as they were eligible to receive it. In its continued battle against COVID-19 – and to prepare for future infectious disease outbreaks – the health department wanted to learn how they performed in equitable distribution of the vaccine.

Through a series of interviews with health department staff and focus group sessions with community partners, Palladium conducted the Health Department’s COVID-19 vaccine distribution evaluation and gathered insights into the successes, mistakes, and suggestions for future vaccine efforts. The study found that despite enormous external obstacles, the Health Department met its initial goals to vaccinate more than 300,000 people in three months, and in nine months had vaccinated 85 percent of the population 65 years of age and over. Within a year of vaccine distribution, Pima County achieved one of the highest vaccine distribution percentages among the most vulnerable populations in the United States and was as much as 10 percentage points ahead of other large Arizona counties in vaccine uptake. The Health Department is actively refining its distribution approach for COVID-19 boosters based on the study findings, which were published in an article in the American Journal of Public Health. More recently, Palladium conducted focus group sessions among Health Department and interviewed key community leaders to better understand whether the vaccine sites were appropriately located and to see how effective messaging was to reach vaccine-hesitant community members, historically marginalized groups, and people most at risk for severe COVID-19 infection.