Black/African American/African refugees and immigrants in our region remain at higher risk for severe COVID-19

May 28, 2021

Black, African American and African immigrant and refugee residents in our region remain at higher risk for severe COVID-19.

Health Officers are issuing this call to action: Increase efforts to promote SARS-CoV-2 testing and COVID-19 vaccination; engage patients in culturally specific care for underlying conditions; recognize the structural barriers to health and commit to long-term efforts toward health equity for this and other historically marginalized groups.

Executive summary: We continue to see elevated percent positivity in individuals who identify as Black, African American and African immigrant and refugee. This indicates inadequate testing and increased disease prevalence. We are seeing a new increase in age-adjusted Black, African American and African immigrant and refugee COVID hospitalizations after previous declines and continue to see more severe outcomes with patients who have cardiovascular stressors. In addition to improved COVID-19 specific care, we seek a commitment from our health care partners to an equity approach in engaging Black, African American and African immigrant and refugee patients in care for chronic conditions. We support system level changes that address long-standing health disparities. 

We are asking Multnomah, Clackamas, and Washington County health care providers to:

  • Implement a protocol that requires staff to offer / encourage SARS-CoV-2 testing to patients who report exposure and/or symptoms during routine visits, scheduling calls and/or during any other points of contact 

    • Focus on historically marginalized groups and increase efforts to reach Black/African American communities 

  • Encourage patients to speak with public health to ensure access to supportive services and guidance around isolation and quarantine

  • Offer an “after-testing” guidance and educate patients about isolation and quarantine /  limiting transmission to close contacts

  • Establish a robust and culturally relevant communication and support plan to ensure access to a COVID-19 vaccine

  • Evaluate / improve your care for chronic conditions in an effort to address health disparities

Local data summary: 

  • Black, African American and African immigrant and refugee individuals in our region were 

    • 2X more likely to test positive for COVID-19 compared to whites

    • 80% more likely to be hospitalized compared to white cases 

    • Diagnosed with SARS-CoV-2 infection in the emergency department / urgent care setting 40% of the time (compared to 25% for whites) - indicating these individuals are sicker when they seek testing

    • About 40% less likely to be immunized than white individuals.


Each of the three metro counties have lots of resources on their web-sites including community specific vaccine events, testing resources and community based organization (CBO) contact information :

 After Testing Guide

COVID-19 Support Services for African-American and African Immigrant & Refugee Communities

Patients, families and clinicians can also call “211” for regional resources specific to their community.

We thank you for your partnership and look forward to working together to address and reverse these health disparities,

Jennifer Vines, MD, MPH

Health Officer, Multnomah County 

Christina Baumann, MD, MPH

Health Officer, Washington County

Ann M Loeffler, MD

Deputy Health Officer, Multnomah County 

Sarah Present, MD, MPH

Health Officer, Clackamas County