What to know
Recipients of the National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities grant are telling their success stories of how they are addressing COVID-19-related health disparities and advancing health equity through programs and activities funded by the grant.
Overview
During the COVID-19 pandemic, expanded, accessible testing for COVID-19 was needed for underserved and rural communities in Nevada. The Southern Nevada Health District placed six vending machines across Clark County to provide free COVID-19 antigen test kits in these communities.
Challenge
Residents living in medically underserved and rural areas have significant challenges accessing healthcare services, including COVID-19 testing. At the same time, data demonstrate that these populations are likely to experience higher risk of exposure, infection, hospitalization, and mortality12.
Expanded, accessible testing for COVID-19 was needed in both disadvantaged urban and rural areas of Clark County in Southern Nevada, where 13.3% of the population lives in poverty, according to the U.S. Census Bureau's 2022 estimates3. Private companies offering testing were shutting down and creating gaps in accessible testing as they demobilized. Local elected officials expressed concerns about the lack of regularly accessible COVID-19 testing in rural areas.
With funding from the Centers for Disease Control and Prevention's National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities grant, the Southern Nevada Health District (SNHD) implemented a test kit vending program to address this disparity.
Solution
SNHD placed six vending machines across Clark County to provide free COVID-19 antigen test kits for Clark County residents. SNHD used surveillance case data and the 2022 Health Equity Index (HEI) to select sites in areas accessible to populations who are at high risk for experiencing health inequities and infection. To encourage community use, SNHD selected well-known community sites, considered ease of access for community members, and prioritized sites with extended hours of availability. All six locations were placed in ZIP codes of communities at the highest risk of experiencing health disparities. Three of the vending machines were available 24 hours a day, 7 days a week.
Impact
From May 25, 2022 to November 4, 2023, SNHD distributed 31,545 test kits through this program, including 11,160 kits in rural communities. Vending registration information from the first year revealed that 30% of registrants live in a rural Nevada ZIP code, and 62% of registrants live in areas at highest risk for experiencing health inequities. These data show that the intended underserved and rural communities have highly utilized this intervention, which removed barriers that many might have faced when trying to get a COVID-19 test. These barriers include traveling long distance to a location, creating appointments, or paying for a test kit [4]. SNHD used a five-question survey to evaluate the use and satisfaction with the intervention. More than 200 vending machine users responded to the survey and results indicated that most users were very satisfied with the vending program (70%), found it very easy to use (74%), and are willing to continue using it (95.6%). Overall, the vending machines were successful in reducing barriers to accessing COVID-19 test kits and may serve as a model for disseminating other public health services, testing, and prevention materials to underserved populations in the future.