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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.

The Oregon county with the first confirmed COVID-19 case in the United States began its response in the earliest days of the pandemic. The county’s Emergency Operations Center wanted to center equity in its response and did so by rapidly creating new positions on the team: an Equity Officer, an Equity Technical Advisor, and a Language Access Coordinator. It also established an Equity Team within the center. This allowed responses to quickly identify and respond to population needs, especially those in communities of color experiencing disproportionate impacts of disease spread and burden.

Community health workers, sometimes called health navigators, played a key role in the public health response to COVID-19, especially among communities of color. This report describes how the community health workforce can be developed by public health departments and shares findings from a community health worker training program focused on vaccination, prevention, and contact tracing.

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.

The NYC Department of Health and Mental Hygiene partnered with 45 businesses or faith-based organizations in the Northeast Bronx to increase COVID-19 and flu vaccine knowledge and uptake in predominantly Black and Hispanic areas. The program disseminated health information through trusted community leaders to address vaccine hesitancy. ZIP codes with higher involvement in the program showed greater increases in vaccination rates.

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 article describes the rapid statewide COVID-19 vaccination strategy implemented by the North Carolina Department of Health and Human Services. The strategy focused on equitable distribution and reaching hard to reach populations, including racial and ethnic minority groups and rural communities.

Practice involves using “get out the vote” (GOTV) outreach strategies, conventionally used in political campaigns, along with mobile pop-up vaccine clinics, to encourage vaccination among marginalized communities.

This study compares data from the NYC coronavirus data repository with 2018 American Community Survey 5-year census estimates to examine the distribution of testing sites across New York City by race in May 2020. During this time, the results found that testing sites for primarily Black and Latinx communities increased, but primarily White areas still had the highest number of testing sites. The study team created ZIP-code level maps showing testing site distribution using ArcGIS as a part of this study.

This article covers the efforts of Salud America!, a national Latino-focused organization that uses digital content creation to create stories, tools, and videos to increase people’s self- and collective-efficacy to engage in advocacy for healthy changes. During the early stages of the COVID-19 pandemic, the organization applied its digital content curation model to address how the pandemic affected the U.S. Latino population. They released a series of website blog posts, peer-modeled stories, podcast episodes, tweet chats, action tools for school leaders, action campaigns for individuals, and localized data tools for advocates to educate the Latino community about COVID-19.