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This episode from the podcast 99 Percent Invisible reflects on how the COVID-19 pandemic exposed the American public to a long-standing problem: the disjointed nature of the U.S. health system. Because state and local health departments largely operate independently and use their own data collection and analysis tools, health systems across the country lack standardized data definitions and systems. These inconsistencies made it nearly impossible to collect and analyze comprehensive, standardized data on COVID-19 cases, deaths, and vaccines administered amid the pandemic. Health experts featured on this episode believe that the pandemic made the need for an overhaul of America’s informatics system very apparent. When rebuilding this system, it’s important to focus on remedying existing inequalities in data collection and classification that in some cases render the health status of certain populations – think Native American communities and other communities of color – completely invisible in the data. By virtue of being small populations, it can be difficult for health departments to collect sufficient and/or statistically significant data on minority communities. Another issue discussed in this episode is the use of broad racial categories like “other,” “multiple races,” or even “Asian American,” which, if not disaggregated, obscures the health status of diverse populations who are grouped under the same category. Without comprehensive and inclusive health data, it’s difficult to identify disparities and implement policies and programming that promote social mobility and health equity.

This article discusses what can be learned from the response to COVID-19 within the United States-Affiliated Pacific Islands (USAPIs). Rates of COVID-19 in this region were much lower than those in the mainland US, despite fewer public health resources. The article credits this to strong partnership and collaboration with neighboring islands, the mainland US, and the federal government; strong regional information sharing; creating and nurturing local and regional trust; and trust regionally; and decisive and aggressive quarantine practices.

This review of state data collection and reporting practices during the COVID-19 pandemic found inconsistencies and gaps in data collected by race and ethnicity. Improved standardization across the U.S.–which may come in the form of a federally-operated centralized database–would address some of the concerns in data representation of all Americans.

This brief lists interventions to support state public health efforts to address rural disparities and racial discrimination. It emphasizes the importance of localized data on social determinants of health and improving systemic and structural underpinnings of racial disparities. Suggested interventions address data collection and workforce issues, including representativeness and paid family leave.

This study discusses how a team of public health researchers and legal scholars with expertise in racial equity used systematic policy surveillance methods to develop a comprehensive database of state laws that are explicitly or implicitly related to structural racism, with the goal of evaluating their effects on health outcomes among marginalized racial and ethnic groups.

This is an assessment of the association between hospitalization for illness from COVID-19 infection and chronic conditions among Medicare beneficiaries (MBs) with fee-for-service (FFS) claims by race and ethnicity for January 1–September 30, 2020. Racial/ethnic disparities in hospitalization rates persist among MBs with COVID-19, and associations of COVID-19 hospitalization with chronic conditions differ among racial/ethnic groups in the U.S.

This story is part of a series, “Race Matters.” It highlights the problems with inconsistent data collection and reporting for Native Hawaiians and Pacific Islanders. Native Hawaiians and Pacific Islanders are often grouped with Asians or not tracked at all.

This blog highlights how the Pennsylvania Department of Human Services is addressing algorithm bias as part of a larger strategy to improve equity across all of the agency’s programs and activities, which were recently detailed in the state’s comprehensive Racial Equity Report.

This study uses data from the COVID Tracking Project’s Racial Data Tracker, which aggregates state-level COVID-19 reporting and tracking databases to determine racial/ethnic trends of COVID-19 incidence and evaluate the racial/ethnic distribution of COVID-19 related mortality in the US. Results found that disparities are more apparent at the county and city level, and discusses the importance of transparent, local data in order to allow for greater precision in resource allocation and effective policy changes aimed at reducing disparities. The study includes choropleth maps of the results by state.

In northwest Arkansas, the Marshallese community has experienced a disproportionate COVID-19 burden. This response plan, funded by the CARES act, hired English/Marshallese bilingual staff to provide contact tracing, navigation, and other types of response. Staff that were not bilingual participated in cultural humility training.