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Vital Stories

Reaching the Most At-Risk: Mayors Work To Address COVID-19’s Inequitable Impact

As cities continue to recalibrate their COVID-19 response, certain indicators rise to the top: fatality rates, case counts and hospital capacity, among others. It’s becoming clear, however, that these numbers are not uniform across a city’s entire population. Some urban communities are more affected by COVID-19 than others.

These vulnerable populations may lack access to the tools of public health and social measures that are helping bring down the infection rate elsewhere—sufficient space for physical distancing or water for hand-washing, for instance. For others, the challenge is surviving without income, health care, social services, housing or accurate information.

The effects are clear: “We have seen some fairly significant variation in mortality rates and a real inequality in impact on different population groups,” London Head of Health Vicky Hobart told a Partnership for Healthy Cities webinar. Dr. Santino Severoni of the World Health Organization added, “Every time we are not serving a part of the population, we are basically losing a battle toward defeating the virus.”

The Partnership is working with many of the 70 cities in our global network on strategies for reaching groups whose lives are at greatest risk from the pandemic, whether because of poverty, a language barrier, racial disparities or other obstacles.

Six Partnership cities are taking action to target key communities during these difficult times:

The Hellenic Liver Patients Association “Prometheus” is building on its expertise in reaching out to people who inject drugs and are unhoused, a population left particularly vulnerable by the pandemic. In collaboration with the Greek Association of people living with HIV “Positive Voice,” city government and the private sector, a new campaign provides direct support with basic supplies such as food and water, as well as information on how to access services.

Philadelphia has enlisted local artists to design posters and space pads for use in the city’s food distribution sites within the Philadelphia Housing Authority—a way to remind residents while they wait in line to stay at least 6 feet apart and wear face masks. The project will be scaled up to future sites with support from the Partnership.

Birmingham is working with Partnership support to develop culturally sensitive COVID-19 messaging and engagement strategies for targeting Black, Asian, LGBT and migrant communities. Special outreach is also planned for persons with disabilities, including sight- and hearing-impaired residents who experience many barriers in accessing advice and support.

Smokers with lung disease or reduced lung capacity may be more susceptible to serious illness if they contract COVID-19. Meanwhile, people sharing homes with smokers during the city’s lockdown are likely exposed to more secondhand smoke than before. In a campaign launched on World No Tobacco Day on May 31, the city is reaching out to the public about these risks through a citywide poster and social media campaign.

Melbourne is famous for being one of the most linguistically diverse cities in the world. During the pandemic, the city is offering COVID-19 information and support using the five most common local languages after English: Mandarin, Cantonese, Arabic, Somali and Vietnamese.

The city is concerned that suitable public health messaging about COVID-19 may not be reaching the high proportion of residents living in extreme poverty. Instructions on hand-washing, for instance, need to be adjusted because running water is scarce in these neighborhoods. Because few have internet access, the new campaign will be through radio, TV, and loudspeakers mounted on vehicles.

The Partnership for Healthy Cities has made available a number of resources for cities working to support their vulnerable communities, including recordings of webinars and technical guidance on the PHC COVID-19 Response Center

About the Partnership for Healthy Cities:

The Partnership for Healthy Cities is a prestigious global network of cities committed to saving lives by preventing noncommunicable diseases (NCDs) and injuries. Supported by Bloomberg Philanthropies in partnership with WHO, as well as Vital Strategies, this initiative enables cities around the world to deliver a high-impact policy or programmatic intervention to reduce NCDs and injuries in their communities. For more information, visit:

The Partnership for Healthy Cities COVID-19 Response is part of the $40 million Bloomberg Philanthropies COVID-19 Global Response Initiative. By collaborating with the WHO and Resolve to Save Lives, an initiative of Vital Strategies, the Partnership for Healthy Cities COVID-19 Response is working hand-in-hand with the world’s leading experts on epidemic prevention.