How Have Communities Been Faring During COVID-19? And How Will Lessons Learned Inform Future Response and Planning?

Data infrastructure also helped enable communities to quickly and effectively use data to marshal resources, support community members with multiple social needs, and ensure vaccination access. In Harris County, the United Way of Greater Houston and Greater Houston Community Foundation collaborated to create the Greater Houston COVID-19 Recovery Fund, which monitored community priorities via a nonprofit needs data dashboard. Tacoma used its Equity Index, developed before the pandemic, to guide local decisionmaking and help the public understand the differential impact of COVID-19 in the city.

San Juan County, meanwhile, followed a vaccine allocation approach, which used the CDC’s Social Vulnerability Index and COVID-19 rates to reallocate vaccine supply based on community vulnerability and infection rates to prioritize providers in underserved communities. The vaccine rollout in New Mexico was very efficient and equitable, with 57 percent of adults receiving at least one dose of the vaccine by mid-April 2021. Native Americans in the county received the vaccine at a similar rate to white residents, an equity challenge still facing many U.S. communities.

The pandemic catalyzed new collaborations among organizations within and across systems and sectors. In Tampa, former competitors and sectors that had not previously come together partnered to address complex issues related to health and equity. A new collaborative of hospitals and health care systems via the COVID-19 Florida West Coast Regional Data Exchange resulted in agreements to share data, share messaging to the public, pool resources, and collaborate to meet the COVID-19–related health needs of the community.

In Sanilac County the Community Foundation created an Emergency Assistance Fund to support local organizations, eliminating usual funding barriers, lifting grant administrative fees, and allowing organizations to use funds for operating costs as well as direct services. Collaborations also helped to strengthen weak infrastructure to support families. In White Plains, the Child Care Council of Westchester and the Westchester Community Foundation COVID-19 Response Fund helped cover the costs of childcare for first responders, essential workers, and low-income families. In Mobile city officials used CARES Act funds to help those facing eviction navigate the court system.

Where Must Gaps Be Filled in Planning for Future Pandemic Response?
Despite these innovative community solutions, there were clear issues that cannot be papered over as the nation responds to the Delta variant and before the next pandemic or any other disaster appears on the horizon. While some communities were finding new paths to address needs and to collect and distribute resources, sobering system fractures impeded an equitable response.

Communities that had not previously prioritized health equity were challenged to addresses disparities in COVID-19 impact. This included not being able to report COVID-19 data by race/ethnicity, not being able to link health and social service data, and relying on overburdened individual organizations and residents to meet the urgent needs of populations experiencing vulnerability. Some communities faced challenges with cross-sector alignment and governance that predated the pandemic. This created a disconnect between public health leadership and other government leaders about policies like mask mandates, business restrictions, and ownership of responsibility for COVID-19 testing. It also underscored disagreements about the role of public health in local decisions and policymaking.

As communities allocate resources from the American Rescue Plan, there are opportunities to address these system fractures. But these opportunities could depend on improved community-level funding strategies and decisions to ensure that investments support community resilience. With respect to the economy, some communities are prioritizing making budgets whole and supporting small businesses, while others are setting aside funds to better support unemployment systems. As communities get more resources to tackle long-standing challenges, shifts that have occurred during the pandemic could spur long-term, equitable change.

Anita Chandra is vice president and director of RAND Social and Economic Well-Being. Linnea Warren May is an associate policy researcher at RAND. Laurie Martin is a senior policy researcher at RAND.This article is published courtesy of RAND.