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04.08.21 | Sage Advice

Join a Roundtable Discussion About COVID-19 Vaccination

With Biden recently announcing all adult Americans will be eligible to receive the COVID-19 vaccine by April 19th, many are preparing their arms for the shot. But access aside — what if you still don’t want the vaccine or are questioning whether to receive your dose? 

We’re here to listen to your concerns. Tell us how you feel about these issues at our live, virtual roundtable discussion:

Tuesday, April 20, 2021 at 1:00 p.m. CST

During the roundtable, we invite our community members to discuss their decision to receive (or not receive) the COVID-19 vaccine. What makes you hesitant to receive the shot? What are the questions you want answered? Whether you have questions, or you know someone who could benefit from this discussion, all are welcome! 

We’ll be joined by our Leadership Team members Rear Admiral (Ret.) James M. Galloway, MD, FACP, FACC and Dr. Joseph West, experts in the fields of medicine and epidemiology, who will share their sage advice. 

Interested in attending? Please RSVP here


This live roundtable discussion is part of Sage Collective’s robust campaign to begin conversations about COVID-19 vaccination within our community, paying particular attention to older African Americans. 

As we seek to increase awareness of how the COVID-19 vaccine works and why it is important, we recognize that historic and systemic medical inequities in Black communities have bred justifiable mistrust. That’s why we must have meaningful conversations about our communities’ viewpoints on, and relationship to, the COVID-19 vaccination — so that we may find a solution that promotes health, safety and comfort for everyone moving forward.

Image text reads: I can get the COVID-19 vaccine, but I don't want it. Now what? Join us for a live virtual roundtable discussion Tuesday April 20, 2021, 1:00 PM CST. Image includes a photo of a vaccine vial and the Sage Collective logo
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03.25.21 | Sage Advice

Talking COVID-19 with an Epidemiologist: Dr. Joseph West

As we continue our ongoing campaign to encourage and ramp up COVID-19 vaccination, an important part of the conversation includes addressing the disproportionate impact of COVID-19 on Black communities, as well as the impact of centuries of medical inequity in America on Black Americans’ psyche and trust.

We engaged Dr. Joseph West, an epidemiologist, population health and data analytics leader with over 15 years of experience in healthcare, research, and enterprise consulting and a member of the Sage Collective Leadership Team, to discuss these topics and more. 


According to CDC data, COVID-19 disproportionately impacts Black or African American, Non-Hispanic persons at a rate of 1.4x times more than the impact on White, Non-Hispanic persons. What long standing health and social inequities are at play here to put such groups at increased risk of getting sick and dying from the virus?

JW: Several long standing factors, including behavioral, clinical, pharmacological, and socioeconomic, are associated with an increased risk of illness and mortality. Diet, lifestyle, discriminatory medical treatment and access, and environmental hazards such as neighborhood segregation and social isolation are key determinants of risk.

Severe acute respiratory syndrome coronavirus 2 (SARS-2-CoV-2) (COVID-19) causes a significant inflammatory immune response in infected individuals. COVID-19 has magnified the increased risk for this response among persons with pre-existing medical conditions such as obesity, diabetes, heart disease, COPD and asthma.

Seniors, for example, over the age of 70 and mostly male, are particularly vulnerable to infections due to a declined immune system, comorbidities, frailty, and potentially inappropriate polypharmacy.


Especially when thinking about readiness in public health emergencies overall, how do we begin to tackle these challenges and create better equity in our health systems? What might it look like to create better-prepared (equipped, informed) systems and a better-resourced population?

JW: Seniors have been especially vulnerable to public health emergencies like COVID-19, accounting for more than 70% of all COVID-related deaths in many states. 39% of Covid-19 deaths have occurred in nursing homes, and another 20% of deaths have occurred in long-term care and assisted living facilities.

Over the past few years, there have been quite a few studies, including those conducted by the CDC, highlighting these facilities’ vulnerabilities to Legionnaires’ disease and bacteria in water and air systems. Yet, these risks went wholly ignored during the pandemic, especially in the early stages. Underfunding, poor oversight, discriminatory regulation, and ill-prepared workforce stifle public health emergency preparedness for racially and economically under-resourced communities overall.

Seniors prefer to age gracefully and vibrantly in their own homes and communities. An equitable and protective system invests in the equipment, social support, and infrastructure to make this a safer, more viable reality. 


Outside of continued social distancing measures and strict mask wearing, rollout of the COVID-19 vaccine is one of our strongest and most direct defenses against the pandemic. Staying cognizant of the mistrust bred by health and social inequities at play, how do we begin to position vaccination as a component of readiness, and control/agency/choice, especially for the older African American community, in order to help combat the disproportionate impact of COVID-19 on the community?

JW: Vaccination is an individual choice. When the coronavirus is no longer front-of-mind, other infectious diseases like the flu will continue to threaten seniors and their caregivers’ lives. Vaccination is the primary measure used to abate infectious disease risks during epidemics and pandemics.  Studies have demonstrated the efficacy of most vaccines like the influenza vaccine to reduce the chances for pneumonia, hospitalization, and death in elderly persons. 

However, to ease fears and mend distrust, public health officials must employ what I define as the Three-Cs approach.


Compassion. Vaccine hesitancy is rooted in medical mistrust among Black Americans. From the infamous U.S. Public Health Service Study at Tuskegee from 1932 to 1972 to the racial eugenics movement, to more recent evidence of discriminatory access to pain medicines and advanced treatments, Black Americans feel these are not “isolated events.” Public Health officials have to be prepared to face and address this distrust with a significant degree of competent compassion.


Clarity. Messaging regarding risks for COVID-19 and the potential side effects of the COVID-19 vaccines has been mismanaged in communications to the Black, Hispanic, and under-resourced communities. Delivering a more unmistakable message regarding access, patient experiences from the community, and vaccine efficacy stories may go a long way towards uptake.


Consistency. Healthcare providers remain incredibly inconsistent in delivering care and practices that close gaps in quality of care and access. Ability to pay, where one lives, language, structural racism, and age remain essential determinants of health outcomes.  Medical and public health officials have to continue to challenge our fragmented and unbalanced health care system to instill confidence in the vaccine, the delivery systems, and persons providing the jab. 

Image reads: Talking COVID-19 with Dr. Joseph West, Epidemiologist over an image of a doctor holding a vaccine vial
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10.15.20 | Sage Advice

Understanding Telehealth, and The Challenges That Come With It

Though intended to streamline the doctor-patient interaction, telehealth can prove particularly challenging to a vulnerable population it otherwise has potential to serve: older adults. To unpack the topic of telehealth, and to address the challenges that come with it, we sat down with Dr. Joseph K. West. Dr. West is an epidemiologist, population health and data analytics leader with over 15 years of experience in healthcare, research, and enterprise consulting, as well as a member of the Sage Collective leadership team.

What Is Telehealth?

Telehealth (also called telemedicine) is the provision of healthcare through electronic communications. Dr. West describes in greater detail: “Telehealth is the opportunity to use technology (such as a tablet, mobile device or desktop computer) to connect any recipient, older adult or otherwise, to their care provider whether that’s a nurse, RN, physician or specialist.”

“This online connection allows healthcare providers and patients to do a couple things remotely: to conduct initial screenings, to ask and answer questions related to physical or mental health and to conduct medication adherence followup. And because telehealth appointments are conducted over video conferencing technology, it gives healthcare providers the ability to actually see the patient and assess how they’re doing more intimately,” explains Dr. West. 

Overall, Dr. West says, “telehealth is really an opportunity to expedite the physician patient interaction, which is of particular benefit when access to transportation may be an issue, or when patients have other safety concerns about physically going to their healthcare provider.” 

Particularly during the time of COVID-19, the ability to connect online rather than in-person has proved beneficial for many. But telehealth isn’t always an accessible option for all.

Challenges Related to Telehealth

Like any technology, telehealth is intended to streamline an oft complicated process, but the experience is only as seamless as one’s access to infrastructure and understanding of the technology. And access can be a barrier for some, says Dr. West: “For some areas, like high-concentration urban centers with strong Internet access, telehealth can be great. But we have to remember the extent of telehealth’s capability is built upon whether or not you have the right infrastructure, and in rural areas oftentimes where telehealth can be most necessary the infrastructure isn’t always there, and therefore, neither is access.”

Another hurdle to overcome, particularly for older adults, is building understanding and trust of the devices used in telehealth. “There’s a number of wearable devices, which can track anything from blood pressure to gait, that can further streamline telehealth communication between provider and patient. But for a generation that’s already weary of technology, many older adults see these devices as intrusive. And addressing those concerns can be tricky,” explains Dr. West.

And building trust is a challenge now more than ever. “Throughout the COVID-19 pandemic, we’re finding that people are more and more distrustful of their providers and of information. They’re trying to decipher what’s accurate and what’s in their best interest, and there are so many conflicting sources,” says Dr. West.

As telehealth’s popularity rises, many older adults have been receiving free tablets in the mail (or similar offers), from invested parties that see the device as an opportunity to hook business down the line, Dr. West tells us. For seniors, this becomes an increasing source of confusion, because they don’t know whether the third party truly has their best interest in mind. With so many players in the field, and so many different agendas, the subsequently bred mistrust flourishes amongst older adults, who feel they have no advocate to help them navigate a confusing new arena.

“When we think about finding solutions to these challenges, in telehealth and beyond,” reflects Dr. West, “the core issue is ensuring older adults have ample access to care and ample access to information. We have to build trust not just in providers, but in healthcare itself, and demonstrate that those in charge are invested in providing care that’s in older adults’ best interest. What older adults truly need are more people on their side, and more people advocating for them. Otherwise, we’re not providing the right kind of support for one of our most vulnerable populations.”

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