Communities and policymakers working to meet the challenges of a global pandemic may need to take a range of targeted actions, such as building awareness, launching preventive measures, boosting health care infrastructure, or allocating emergency funding. These decisions, which can influence health outcomes significantly, highlight the importance of having the information needed to evaluate options.
Timely data on infections, hospitalizations, vaccinations, and lab testing provides critical insight on the spread of COVID-19, the disease caused by the novel coronavirus. But a clearer picture of current and future health impacts on the population—especially among high-risk groups such as seniors and low-income families—requires consistent demographic details. Without this knowledge, it can be difficult for decision-makers to respond in ways that maximize health benefits and minimize preventable consequences.
The federal government recently created a new coordinated national tracking system that collects and reports information about confirmed coronavirus cases, but it does not provide state-by-state demographic information on age, race, or ethnicity. The Centers for Disease Control and Prevention (CDC) also collects data and reports on testing, but the information is limited to the 96 CDC-verified labs across the U.S. and does not include demographic or state-by-state breakdowns.
So far, many states have reported data on cases, hospitalizations, and testing differently, which creates challenges for those looking for broader patterns. Although many states do not make demographic information publicly available, others, such as Illinois, Michigan, and North Carolina, provide county-by-county data that includes breakdowns by age and ethnicity.
Such information can illuminate whether specific populations are affected more than others and help policymakers tailor responses. Strong evidence collected by the federal government and others shows persistent and long-standing disparities in the health and quality of care of different populations, especially among low-income and uninsured people. The data indicates that ethnic minorities receive worse care than white Americans on up to 40% of health care quality measures, according to the Agency for Healthcare Research and Quality, an office of the U.S. Department of Health and Human Services.
People with low incomes are more likely to have many of the chronic health conditions that experts have identified as risk factors for complications from COVID-19. These factors, such as hypertension and obesity, are also more prevalent among African Americans than among non-Hispanic white adults. In addition, asthma is more prevalent among black and Hispanic adults and children than among white adults and children. Overall, research shows that the root causes of these health conditions are often linked to living conditions that can be beyond any individual’s control.
State demographic numbers can highlight racial disparities. In Michigan, for example, African Americans make up 14% of the population but account for about a third of the state’s confirmed cases of COVID-19, data shows, and 40% of those who have died from complications of the disease were black. As of April 15, nearly half the state’s cases—48%—were in Wayne County, which includes Detroit and has a higher share of African Americans than most counties in the state.
Quality data on affected communities is essential to support efforts to address health equity, the principle that factors such as race, income, and geography should not determine health outcomes and that all people should have the opportunity to be as healthy as possible. Tools such as health impact assessments (HIAs) can help communities and decision-makers systematically consider how proposals could affect public health and provide recommendations to manage those effects.
The HIA process relies on data and stakeholder input to understand how decisions might disproportionately affect different groups and how that distribution can influence health outcomes. To be effective, these efforts require detailed demographic data.
As policymakers and communities continue to evaluate and coordinate responses to the coronavirus, the effectiveness of their actions will depend on having the information they need to identify the most vulnerable communities. By using demographic data to select evidence-based strategies to address the needs of the most vulnerable populations, decision-makers boost the opportunities for the entire community to be as healthy as possible.
Stacey Millett directs the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts.