Racial and ethnic disparities in COVID-19 outcomes are rapidly emerging. As our leaders grapple with response options, it has become increasingly important for them to leverage data to drive policy.
Data broken down or disaggregated by race and ethnicity allows policymakers to identify patterns such as disproportionate disease incidence, underutilization of health services, or higher rates of housing instability. Using this information, plans can be made or adjusted to address unmet needs in specific communities. As Penman-Aguilar et al., states “What is not measured cannot readily be remedied.”
Last week, in recognition of Connecticut’s second annual Health Equity Week, Health Equity Solutions and the UConn Health Disparities Institute issued a call to center health equity in the COVID-19 pandemic. Due to structural racism and related outcomes, people of color in Connecticut are more likely than their white counterparts to live in densely populated settings, rely on public transportation, work wage-based jobs, have less wealth, and suffer from chronic health conditions such as asthma and diabetes. Research, including a study on influenza in New Haven, demonstrates that these circumstances leave communities of color more susceptible to COVID-19 infection and complications.
Without race and ethnicity data, we have no way to evaluate whether the current and long-term COVID-19 responses provide adequate access to health care and social and economic supports. In Connecticut, we know most, if not all, of these data are already being collected. Yet, only limited race and ethnicity data on confirmed COVID-19 cases and deaths is published.
Reporting of race and ethnicity data must expand to include COVID-19 testing and hospitalization and be used to target emergency response efforts to groups in need. Otherwise, we risk dramatically widening the already enormous disparities faced by Connecticut’s people of color.
We propose improving race and ethnicity data by:
Immediately establishing guidelines for improved collection and public reporting of race and ethnicity data: Guidelines should be given to providers and consistent reporting should be required. For data to be easily compared across outcomes, race and ethnicity data should be collected using standardized categories.
Tracking distribution of and access to resources: Race and ethnicity data are needed to assess which communities have access to health care and basic needs during the COVID-19 pandemic, recovery period, and beyond. For example, who enrolled in Medicaid, qualified health plans, SNAP, or unemployment? Who received loans for their business?
This pandemic has highlighted the vulnerabilities of our systems. The opportunity to be proactive and attenuate the widening of health disparities is grounded in having the informational infrastructure and data guidelines needed to act.
This data points to long-term solutions. Long before this crisis, people of color in Connecticut were far more likely than other residents of the state to lack basic necessities. Now, throughout the long period of recovery from this pandemic, and beyond, Connecticut’s underserved communities must have access to food, sustainable and healthy housing, transportation, and affordable and quality health care.
We can improve outreach:
The disparities revealed by disaggregated data highlight which communities experience unmet needs and can be used to address these. We know that community health workers – people from a community who know state systems and understand their neighbors’ needs and culture – can bridge these gaps. They can also identify and enable their clients to address potential health problems to prevent health crises. Now, more than ever, community health workers can take pressure off our strapped call centers and clinics by connecting people to community-based supports, clarifying application processes, and navigating lifestyle advice from clinicians. Disaggregated data can show where outreach is needed and ensure that emergency response and recovery efforts do not leave any community behind.
COVID-19 is a double threat to the health and economic security of communities who already face systemic oppression and injustice due to race, ethnicity, or other identities. Centering health equity in Connecticut’s pandemic response measures and aftermath is crucial to mitigating the long-lasting impacts of this crisis on the economy and, most importantly, the well-being of our state’s residents. Having access to race, ethnicity, and language data now keeps health equity in the forefront and is vital to the health of our state in the future.
Dr. Tekisha Dwan Everette, is executive director of Health Equity Solutions, and Dr. Wizdom Powell, is the director of the UConn Health Disparities Institute.
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