Demographics & Information Sharing Matters
In light of the ambitious goals set forth by the HNC 2030 Task Force, NC DHHS and DPH that highlights the need for all of us to integrate a broader view of the drivers of health and well-being of the population — with a deliberate and proactive focus on health disparities; It is my hope that the state will share key demographic information [ for example, the race of those who are infected and dying ] re: COVID 19 — while encouraging other relevant stakeholders to do the same — in order to make North Carolina a place where everyone can live a healthy life!
On Wednesday March 25, 2020 we shared the relevant brief below with the NC DHHS and DPH. As a result the following response was provided: “Thank you so much. Great piece. We are committed to being as transparent as possible and will be sharing more demographic data on our dashboard.” As promised the NC DHHS is currently providing Racial & Ethnic Demographics as well as other key data and information on their COVID 19 Dashboard. Thank you NC DHHS and DPH!
We write to call on the U.S. Department of Health and Human Services (HHS) and its sub-agencies, such as the Centers for Disease Control and Prevention (CDC), the Centers for Medicare and Medicaid Services (CMS), U.S. Food and Drug Administration (FDA), the Agency for Healthcare Research and Quality (AHRQ), and other relevant agencies, to monitor and address racial disparities in our nation’s response to the coronavirus disease 2019 (COVID19) public health emergency.”
To start, the CDC is currently failing to collect and publicly report on the racial and ethnic demographic information of patients tested for and affected by COVID-19. 1 Our concerns echo those from some physicians: that decisions to test individuals for the novel coronavirus may be “more vulnerable to the implicit biases that every patient and medical professional carry around with them,” potentially causing “black communities and other underserved groups …[to] disproportionately mis[s] out on getting tested for COVID-19.” 2 Without demographic data, policy makers and researchers will have no way to identify and address ongoing disparities and health inequities that risk accelerating the impact of the novel coronavirus and the respiratory disease it causes.”
On Monday March 30, 2020 the Robesonian published this article about Southeastern Health posting demographics online. On Friday April 3, 2020 Propublica released the article ‘Early Data Shows African Americans Have Contracted and Died of Coronavirus at an Alarming Rate’ and noted that: “Illinois and North Carolina are two of the few areas publishing statistics on COVID-19 cases by race, and their data shows a disproportionate number of African Americans were infected.” And on Saturday April 4, 2020 NPR released an article entitled “CDC Unveils 1st National Coronavirus Pandemic Tracking System.”
Having access to multiple layers of data and demographics helps us to better understand multidimensional challenges and gaps that exist within diverse communities and our collective ecosystem. For example, On April 1, 2010 NPR released the article “Underlying Health Disparities Could Mean Coronavirus Hits Some Communities Harder.”
“I would expect there would be racial and ethnic disparities simply based on the disease burden that is already present,” says Leonard Friedman, a professor of health policy and management at George Washington University.”
The coronavirus could also exacerbate regional disparities, as heart disease takes a greater toll on some areas of the country than others. The map [below] shows that Appalachia, rural northwest Mississippi and eastern Michigan, including Detroit, are among areas with high percentages of Medicare recipients hospitalized for heart disease.
Notice in the above map that Robeson County North Carolina, the most unhealthy county in the state sticks out, as well as a regional cluster of other counties in southeastern and northeastern North Carolina.
Finally, while over the last few days as a growing number of media outlets are helping to amplify the need for local, state, and national public health officials to share racial demographics and more information, it is important for us to remember that some public health officials, doctors, public health advocates, and diverse members of communities across the country have been voicing this need for quite some time. And as more data comes in we see that there are legitimate reasons for concern. Therefore going forward we must all be willing to objectively listen to, integrate, and value the expert wisdom and knowledge that exists across all sectors and throughout the whole community. After all data is important, but so too are the voices of the people who are being impacted.
Relevant Videos & Links:
The 2019 State of Health Equity at CDC Forum applied a health equity lens to public health emergency preparedness, response, and recovery activities through deliberate communications and interdisciplinary partnerships. Top experts in public health emergency preparedness and response made presentations focused on preparing and responding to emergencies through a health equity lens, using CDC’s social vulnerability index for public health emergency preparedness, notes from the field: addressing disparities and vulnerabilities in public health emergencies, and taking action: advancing equity in community resilience for public health emergencies