A four-page document from the Department of Health & Human Services (HHS) and Centers for Disease Control & Prevention (CDC) outlining racial health disparities and equity issues is “woefully inadequate and completely unacceptable,” according to Frank Pallone Jr (D-NJ), the chairman of the House Energy and Commerce Committee.
Pallone was joined by Patty Murray (D-WA), the leading Democrat on the Senate Health, Education, Labor, and Pensions (HELP) committee, in lambasting the document that was meant to provide data on health equity issues brought to light during the COVID-19 pandemic.
Through anecdotal evidence and state and local data, it quickly became clear that black patients were suffering from COVID-19 at higher rates than their white peers. In New York, Latinx patients were also more likely to experience more severe coronavirus symptoms than their white peers.
That prompted federal lawmakers to ask HHS, in coordination with relevant other agencies, to disclose data about COVID-19 testing, outcomes, and mortality. The Paycheck Protection Program and Health Care Enhancement Act asked HHS to stratify data by race, ethnicity, age, sex, and geographic region.
Data was to be deidentified and disaggregated and sent to Congress in a full report.
That report came on Friday, May 15, in the form of a four-page document outlining the sources HHS consulted to find COVID-19 testing, hospitalization, and mortality data as well as the demographic data outlined above.
“CDC is leveraging our available surveillance systems to monitor the COVID-19 epidemic and proactively protect vulnerable populations,” the document reads. “The goal is to get as timely and accurate a picture as possible of the overall situation in the U.S. and share findings with the American public; as data continue to evolve and are validated these findings are subject to daily change.”
HHS and CDC leaned on state and local health agencies to collect demographic data and supplemented gaps in that data with other sources. Those sources included COVID-Net, which gives hospitalization data for about 10 percent of the US population. Additionally, HHS and CDC also tapped mortality data from the National Vital Statistics, which grants access to death certificates.
On the whole, HHS acknowledged that the COVID-19 situation is changing daily, but that most of the data indicate that racial minority groups are affected by the virus at a higher rate than their white peers.
On the following page, the agencies give a list of six different resources offering data on COVID-19 testing, hospitalizations, and outcomes or mortality, with links included.
These resources are simply not enough, Pallone and Murray said in a joint statement.
“Congress mandated this report in order to better understand how the coronavirus impacts different demographic groups with the intention of using that information to provide resources and support to help close gaps in COVID-19 health outcomes,” Pallone said.
“Unfortunately, instead of compiling a comprehensive report, the Trump Administration chose to provide Congress with a few website links to already existing and incomplete demographic data sets.”
This data set is limited, Pallone added, and doesn’t give enough commentary to meet legislative standards.
“There is no context or explanation regarding missing elements required by the Paycheck Protection Program and Health Care Enhancement Act,” Pallone explained. “This report fails to meet the basic requirements of the law and leaves both Congress and the American people in the dark. Furthermore, it underscores the urgent need for Congress to require the comprehensive demographic data reporting included in The Heroes Act.”
Murray minced no words, calling the HHS effort lazy and not in whole appreciation for the health equity crisis at hand.
“What Congress required was a comprehensive report on health disparities related to the COVID-19 pandemic,” Murray said.
“What we got from President Trump was a lazy, four page copy and paste project that links to a handful of limited, previously available data sets. This wholly inadequate response tells us nothing except what we already knew: the Trump Administration would prefer to ignore the disproportionate impact this crisis is having on communities of color. We are not done pushing for answers and action here, not by a long shot.”
The question of health equity has been critical since the COVID-19 outbreak. Through anecdotal data, it quickly became clear that people of color were suffering more severe forms of the disease and dying at higher rates than their white peers.
In early April, the CDC confirmed that by publishing its first round of COVID-19 data stratified by certain demographics, including race.
This data is essential to crafting the healthcare response, stakeholders from across the continuum have contended. The American Medical Association (AMA), for example, noted that access to race data would help providers better treat individual COVID-19 cases.
Easily accessible race data would also be helpful for public health leaders working to frame their outreach and education efforts.