Serving the Underserved – Accessing Hard to Reach Populations


The pandemic continues to shine a light on the systemic inequities and headwinds underserved communities in the United States are facing. Vaccines are just the latest example. While millions of doses are being manufactured and distributed each day, vaccinations are disproportionately being provided in predominantly white and/or wealthy metropolitan areas, leaving communities of color, residents of rural areas, and people experiencing homelessness without access to their share of the inoculations and prolonging the pandemic for everyone. With distribution and eligibility varying wildly from state to state and county to county, these disparities among underserved and hard to reach populations are likely to continue if governments don’t take deliberate and immediate action to counteract them.

How Are These Inequities Presenting Themselves?

According to recent reports, the death rate for racial minorities is 3.7 times that of white populations within lower income areas. Racial minorities are clearly bearing the brunt of these negative impacts. Low-income residents have been more likely to lose their jobs or had to take a cut in their pay. They’ve experienced economic losses as at a rate of 47% compared to 32% of upper income residents. In addition, broadband internet access is not as widespread in rural and lower income communities, limiting residents’ ability to find answers to their vaccine-related questions or schedule an appointment.

At Granicus, we remain deeply committed to providing the tools and resources that will help governments connect with underserved and hard-to-reach populations and ensure that vaccines are equitably distributed throughout their communities. As part of this commitment, we recently hosted a panel discussion featuring prominent health equity experts Iris P. Frye and Dr. Shelley Brown-Cooper. These distinguished guests talked through vaccination goal rates, ideal communication methods and channels, potential avenues to build trust amongst our most vulnerable populations, and much more.

The Experts Weigh In About Connecting with Hard to Reach Populations

Dr. Brown-Cooper did not mince words when asked about the best way to counteract this crisis. She said, “what the government needs to do—more now than at any other time—is to make sure that testing, treatment, and vaccinations for COVID are equal across all lines, especially with our underrepresented populations.” Building on that point, she was quick to call out the underlying concerns that contribute to vaccine hesitancy among communities of color, stating. “We also need to keep in mind when we think about the hesitation toward the vaccination, there are many examples that continue to keep Black and Brown people from trusting the medical community as a whole and the government in particular. I recommend that we advocate and insist on proper care from health care providers. It really needs to step up.”

Echoing this perspective, Ms. Frye added, “COVID-19 has become the catalyst that has intensified the existing fragile relationship between the government, the healthcare industry, and the at-risk populations. The pandemic has really exposed the state of our healthcare system, specifically in these communities. Lack of health insurance, accessibility to community health facilities, feelings of isolation may even compound existing inequalities. We have a sense of not belonging, and the lack of action to address these populations will make it nearly impossible to control the spread of COVID-19. Even with the rollout of the vaccine. The current reality only serves to highlight that it is past time to dismantle systemic racism.”

A Deeper Understanding of Underserved Populations

In addition, Ms. Fry outlined a clear need to improve outcomes by committing to—and following through with—trust-building initiatives. Include buy-in and participation from community leaders who have long-standing and established relationships with the specific communities governments are attempting to reach. “The government, the decision-makers, the change makers, they must invest in responsible data. They must promote an environment where change and problem solving are met with community collaboration and innovation, piggybacking off of the existing trust,” she said.

“Right now, the trust between Black and Brown communities and the government and the medical industry is broken. It’s embedded in a long history of oppression, and the healthcare system is just one arm of it. We need to embrace an approach that reduces the information gap that exists in these communities. That gap prevents the population for receiving care specific to their needs. The government must do the work to earn back that trust. Create policy changes, take action that improves the public health system and treats all Americans equally with honesty, compassion, and integrity.”

Both speakers went on to share stories and lessons they’ve encountered over the course of their distinguished careers, as well as personal stories and scientific data to support their observations. Their ideas and proven methods are a key component to ensuring equitable outcomes among underserved and hard-to-reach communities and enabling everyone who wants a vaccine to get it.

Consider Your Communications Strategy

Bridging the gap between government and underserved communities may seem daunting. There are multiple potential points of conflict, miscommunication, or even failure. However, it doesn’t have to be this way. While these systemic societal inequities won’t dissolve overnight, a multichannel digital communications strategy can perform a lot of the heavy lifting. A multichannel approach enables you to meet your audience where they are, using the communication platforms they find most familiar and comfortable. That can be email, SMS/texting, partnerships with trusted community members, or a combination of several tools. Many low-income and rural households do not have reliable internet access through smartphones or broadband connections. However, nearly everyone has a mobile phone with SMS and texting capabilities. That makes text/SMS messages a critical tool for disseminating information to hard-to-reach populations, and one with the potential for outsized impact compared to other channels.

The most important thing to remember is there’s never a one-size-fits-all approach for sharing critical messages. Taking the time to understand your residents’ needs, preferences, and challenges is the best way to start.

Watch the on-demand webinar to hear the full conversation and discover more of the valuable insights Ms. Frye and Dr. Brown-Cooper shared.

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