Pharmacy deserts may limit COVID-19 vaccine access in communities of color

From treatment to vaccines, pharmacies can aid patients in a pandemic, but they are harder to find in poorer communities of color.

ByAshley Mackey and Grace Manthey KABC logo
Wednesday, February 17, 2021
In LA county, some poorer communities of color lack equal pharmacy access
From treatment to vaccines, pharmacies can provide information to patients about the coronavirus pandemic, but it can be harder for those living in poorer communities of color to get to one.

LENNOX, Calif. (KABC) -- Michael Ahdout has owned LAX Pharmacy in Lennox for 13 years. He's noticed the personal touch of independent pharmacies, especially in disadvantaged communities, that could be key in fighting the COVID-19 pandemic and getting people vaccinated.

"Most of the independent pharmacies know their patients by first name and their families and such. In which case, it's a lot easier for them to go to them and seek help with the virus and how they can prevent the virus," Ahdout said.

Help and knowledge coming from pharmacies is crucial in getting people vaccinated against COVID-19, especially in communities of color, according to Cheryl Wisseh, a health scientist and assistant clinical professor at the UC Irvine School of Pharmacy and Pharmaceutical Sciences.

Wisseh said this is largely due to historical distrust regarding medical care within communities of people of color.

But, as some pharmacies prepare to administer the COVID-19 vaccine to eligible residents across California and the country, there are some areas of Los Angeles where people don't have equal access to pharmacies, according to an ABC7 analysis of retail pharmacy license data from the state.

"In the face of not having a pharmacy that's close by, you might not have a pharmacist there who's trained to be able to deliver that accurate information in a lay-person's way, if you will, and facilitate that risk-benefit analysis that's needed for a patient to make the decision take the vaccine or not," Wisseh said.

Ahdout's pharmacy is just one of two pharmacies in its zip code with a population of nearly 26,000 people.

Nearby zip code 90302 in Inglewood has no retail community pharmacies within its boundaries for its roughly 30,000 residents. Inglewood zip code 90305 also has no pharmacies for its 15,000 residents. More than 92% of residents in both these areas are people of color.

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Minority communities have a history of structural inequity and systemic racism, said Wisseh.

"That same systemic racism you see play out in disproportionate test positivity incidents, mortality rates in COVID-19 for racial and ethnic minorities," she said.

In fact, in all of LA County, zip codes with more than 80% people of color had an average of just 1.5 pharmacies per 10,000 people. Zip codes with less than 40% people of color had more: nearly 3 pharmacies per 10,000 people.

A similar trend holds true when looking at income differences.

Zip codes where the median household income was less than $60,000 a year, there were less than two pharmacies per 10,000 people. That's compared to more than two pharmacies per 10,000 people for zip codes where the median household income was more than $60,000 a year.

"If there isn't that many pharmacies that can serve the local population, as far as getting vaccinations, the vaccination rates will be lower," said Ahdout.

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And in communities of color, distance is just one barrier in the way of getting to a pharmacy.

Wisseh and her team at UC Irvine, in a study published in the Journal of Racial and Ethnic Health Disparities, using the same pharmacy license data from the state, found two types of what they call "pharmacy deserts."

In Type 2 pharmacy deserts, the only factor is distance: the nearest pharmacy is a mile or greater away.

Conversely, Type 1 deserts are in more densely populated communities of color that may have more people who speak English as a second language, who don't have access to a car or who live below the poverty line. All of these barriers compound on each other, said Wisseh.

"If you don't have transportation you have to think about how you're going to get there, how long is that going to take? Is that going to take away from my job? If I am low income I have to think about being able to pay for certain things," she explained. "I can't necessarily take time off from work because I need that money to pay for other competing needs. So, it starts to compound and starts to build on top of that."

Another barrier Wisseh noted was crime. Even if you have a 24-hour pharmacy down the street and aren't able to go during normal working hours, you may not feel safe going after dark, she said.

The Inglewood area has a mixture of both Type 1 and Type 2 deserts, according to Wisseh.

In Service Planning Area 6, which borders Inglewood and Lennox, 93% of the 58 pharmacy deserts are Type 1. Meanwhile none of the pharmacy deserts in SPA 5, West LA, were Type 1. The only factor in those deserts was distance.

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A possible solution, according to Wisseh is an "all hands on deck" approach.

"Everyone partnering in areas where you're likely to see those who are disproportionately affected by COVID, whether it's churches, barber shops, libraries, places where people are, to set up these types of vaccine clinics so that people can come for mass vaccinations," Wisseh said.

The county and the city have some of these vaccination sites already set up. But Wisseh said, perhaps even more important is education.

"I can't stress enough, the information. Because you can give all the vaccines you want to give to communities, but if people aren't taking it, it becomes a waste."