Scaling Up Equitable Access to Community-Based COVID-19 Testing: Strategies from the RADx-UP Initiative

Publication Cover Art

Policy Brief

Scaling Up Equitable Access to Community-Based COVID-19 Testing: Strategies from the RADx-UP Initiative

Published date

May 10, 2022

The COVID-19 pandemic has magnified how structural racism and other structural determinants of health affect the lived experience of the public health emergency on marginalized and minoritized communities. These communities include Black, Latino or Latinx, American Indian, Alaska Native, Asian, and Native Hawaiian and Pacific Islanders communities as well as people who are incarcerated, low-income, or disabled, in addition to older adults, children, LGBTQIA, and birthing people. Achieving an equitable response to COVID-19 and future public health emergencies requires: reducing barriers that preclude populations from reaching health services in a timely manner, centering equity in policy making decisions, and engaging communities. Community-based COVID-19 testing can ensure all populations have access to testing, which is a key step to linking people to treatment and reducing disparities in COVID-19 health outcomes.


Insights from the Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) Initiative offers a timely perspective into strategies for supporting community-based testing to respond to COVID-19 surges and variants. In this policy paper, we propose a policy framework to identify common barriers to equitable COVID-19 testing and facilitate the scaling-up of the solutions that emerged to address them. We identify five key policy levers and three foundational components that are necessary to lead to measurable improvements in health equity. We aim for health leaders—including policymakers, community organizers, and other health care practitioners—to use these community-engaged policy strategies to inform community-based testing for future COVID-19 surges and variants.

Duke-Margolis Authors

Kamaria Kaalund Headshot

Kamaria Kaalund

Policy Analyst
Anti-Racism and Equity Committee Member

Andrea Thoumi

Andrea Thoumi, MPP, MSc

Health Equity Policy Fellow
Faculty Director of Health Equity Educational Programming
Senior Team Member
Anti-Racism and Equity Committee Member
Core Faculty Member
Adjunct Assistant Professor
2020 Intern Mentor