# Achieving Health Equity During the COVID-19 Pandemic: Lessons Learned from Nurses and High Performing Hospitals

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2024 · $406,250

## Abstract

Project Summary
The COVID-19 pandemic catapulted long-standing racial/ethnic health inequities onto the national stage.
Hospitalization and mortality rates for Black and Hispanic individuals with COVID-19 have been 2-3x higher than
the rates of their White counterparts, drawing attention to the patient and system level factors underlying these
differences, including the quality of hospitals to which minority patients are admitted. Of these studies, few have
been able to identify the specific features of hospitals that explain the observed racial/ethnic differences in
outcomes. Our study focuses on differences in nursing resources across hospitals, an important factor that has
not been adequately addressed in the COVID-19 disparities literature. In this mixed methods proposal, we
leverage administrative claims and unique survey data collected from over 22,000 nurses working in 244 New
York and Illinois hospitals during the COVID pandemic (April-June 2021). We employ tapered multivariate
matching, a novel approach which allows us to carefully control for differences in clinical risk and social factors
between minority and white patients to clearly identify the basis of COVID-19 outcome disparities. Our primary
objective is to examine how variations in nursing resources were associated with disparities in minority COVID-
19 outcomes, including mortality and readmissions. A second objective is to identify the nursing and hospital
characteristics of “high performing” hospitals where such disparities were minimized. After identifying high and
low performing hospitals, we will explore the open-ended responses of thousands of nurses who shared their
perspectives of supports and barriers to care delivery for socially “vulnerable” populations, including racial and
ethnic minorities. By examining patient, community, nurse and system-level factors, we seek to uncover whether
there are particular combinations of nursing resources, organizational supports and care processes that are most
effective in reducing COVID-19 disparities. If our study hypotheses are supported and we can identify
characteristics of high performers, it will 1) strengthen the evidence regarding the link between nursing resources
and equitable outcomes, and 2) provide a necessary composite and a set of best practices that can be shared
with other hospitals. Our proposal is well-aligned with multiple goals of NINR, including dismantling structures
that impede health equity, using lessons learned about health disparities from the COVID-19 pandemic and
identifying upstream factors that influence health disparities. Collectively, the results of this study will provide the
foundation for the next phase of our research, which includes the development of innovative models of care
delivery that integrate evidence-based nursing resources and best practices that are associated with equitable
outcomes.

## Key facts

- **NIH application ID:** 10815744
- **Project number:** 5R01NR020471-02
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** JACQUELINE MARGO BROOKS CARTHON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $406,250
- **Award type:** 5
- **Project period:** 2023-03-27 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10815744

## Citation

> US National Institutes of Health, RePORTER application 10815744, Achieving Health Equity During the COVID-19 Pandemic: Lessons Learned from Nurses and High Performing Hospitals (5R01NR020471-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10815744. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*