CDC Found Ways To Use Data To Understand and Address COVID-19 Health Disparities, Despite Challenges With Existing Data

WHY WE DID THIS STUDY

The COVID-19 pandemic has devastated communities across the United States, and socially vulnerable populations have been disproportionately affected. From the beginning, reports indicated that people of color and people from economically disadvantaged communities were at increased risk of becoming sick from COVID-19, needing intensive care due to COVID-19, and dying from COVID-19 compared to members of predominantly White and/or affluent communities. At the same time, reports revealed that demographic data on COVID-19 were incomplete, which could make understanding and addressing disparities more difficult.

HOW WE DID THIS STUDY

In March and April 2021, we conducted structured interviews with CDC staff responsible for collecting and analyzing COVID-19 data, collaborating with State, local, and Territorial entities and with Tribal Epidemiology Centers (TECs), and developing initiatives to address disparities. We also conducted structured interviews with staff from six jurisdictions and two TECs representing a variety of State, local, Territorial, and Tribal entities. We asked CDC staff how they used data to identify and address disparities and about support they provided to jurisdictions and TECs throughout the pandemic. We asked jurisdictions and TECs about their collaboration with CDC and about challenges they faced related to the collection, reporting, and receipt of COVID-19 data and analysis.

WHAT WE FOUND

CDC's racial, ethnic, and socioeconomic data for COVID-19 testing, cases, hospitalizations, and deaths have limitations and provide an incomplete picture of COVID-19 disparities. Racial and ethnic data associated with COVID-19 reporting are sometimes missing, inconsistent, or inaccurate, while socioeconomic data in this reporting are neither clearly defined nor consistently collected.

CDC has taken steps to supplement and improve these data. CDC analyzed disparities using additional data sources, such as emergency department data on COVID-19-like illness and qualitative data from ad hoc surveys on attitudes and beliefs. CDC also developed a methodology to identify disproportionately impacted communities of color using Census Bureau data. Additionally, CDC has worked with the entities that report COVID-19 data to improve the quality of these data at their source.

CDC reported using both these supplemental data and data on COVID-19 testing, cases, hospitalizations, and deaths to address disparities via technical assistance to partners, targeted interventions, and significant funding investments. For example, CDC has helped partners conduct focus group sessions to learn about challenges faced by disproportionately impacted communities and has used data to determine equitable locations for testing sites. CDC also reported that it has elevated health equity throughout its response efforts. For instance, it created a Chief Health Equity Officer unit and published a health equity strategy to guide its COVID-19 response.

The TECs and Territory we interviewed also noted data limitations that could inhibit their ability to identify and address COVID-19 disparities. The TECs we interviewed reported difficulty accessing public health data from CDC and States, while the Territory we interviewed reported that it lacked the technical infrastructure to collect and report COVID-19 data.

WHAT WE RECOMMEND

We recommend that CDC: (1) expand efforts both to improve racial and ethnic data associated with COVID-19 and to supplement them with additional data sources and (2)'ensure that TECs have timely access to all public health data to which they are entitled. CDC concurred with both recommendations.