What is the current landscape?
The COVID-19 infection rate in the US at one of the highest it has been since the pandemic hit, surpassing what was seen in the early months of lockdown. According to data compiled by The New York Times, the number of daily cases is rising in 8 out of 51 states and in the District of Columbia and Puerto Rico with sustained increases in case rates in Western, Midwestern, and Southern states such as North Dakota, Kansas, California, and South Dakota.
https://www.nationalgeographic.com/science/2020/05/graphic-tracking-coronavirus-infections-us/
As of: 8/17/2020
Growing data availability has confirmed what many frontline workers, residents, and city leaders already knew and were seeing: that Black, Latinx and American Indian and Alaskan Native (AIAN) people are facing the disproportionate brunt of both cases and deaths.
https://www.apmresearchlab.org/covid/deaths-by-race#data
As of: 8/4/2020
These trends are exacerbated when adjusted by age difference. Adjusted for age differences in deaths across racial groups, Black Americans have a death rate that is 3.7 times as high compared to White Americans; Indigenous 3.5 times higher; Pacific Islander 3.1 times higher; Latino 2.8 times higher; and Asian at 1.4 times higher.
Emerging hotspots show that these trends will likely sustain as the virus spreads. States in the South and West are home to a higher share of the country’s Black, Indigenous, and People of Color (BIPOC). While just over half (51%) of the U.S.’s population lives in the 23 southern and western hotspot states, these states are home to 71% of the country’s Hispanic population, 59% of the country’s Asian population, 57% of the country’s American Indian and Alaskan Native population (AIAN) and 51% of the country’s Black population. As the virus continues to spread, BIPOC, particularly Black, Latinx, and AIAN populations, will continue to be put at heightened risk.
Data is Missing
There has been a growing demand among public health officials, city leaders, and policymakers for accurate, detailed, and real-time reporting of COVID-19 data disaggregated by race. On June 4th, the U.S. Department of Health and Human Services (HHS) announced new guidance that requires laboratories to report to state and local public health departments data disaggregated by race, ethnicity, and gender. While many states have begun to report case and death rates disaggregated by data, these numbers are far from comprehensive as not all states and local health departments have followed through.
Lags in testing and a lack of comprehensive, real-time reporting means that cities are being forced to be reactive to growing hotspots, rather than be proactive with targeted testing and other resources. Forty-nine states have released disaggregated data by race on confirmed cases and forty-seven states on deaths. North Dakota has not yet published cases or deaths; New York on cases; and Montana and New Mexico on deaths. Currently, only 73% of total cases and 89% of total deaths have been reported by race (e.g., White, Black). Fewer cases and deaths have been reported by ethnicity. Only 67% of total cases and 85% of cases have been reported by ethnicity (e.g., Hispanic vs non-Hispanic).
Why the data matters
Data is crucial for cities’ crisis responses to target resources and testing towards Black and Latinx communities proactively. Austin, TX rolled out three new and free testing sites in early July, chosen based on the accessibility to the community in areas where data has shown to be the most impacted by COVID-19. Austin Public Health has also addressed the barriers vocalized by their community members, making these testing sites open to those arriving on foot, bicycle, motorcycle, or in a vehicle, unlike the typical drive-thru testing sites which require an enclosed vehicle. Targeted testing and reducing barriers to access (transportation; language; misinformation) are key to addressing the disparate impact of the pandemic on communities of color. Baltimore, MD has launched a testing site at Iglesia de la Resurrección en Baltimore church—located in a ZIP code with the highest rates for positive tests at 19.8%–and a new partnership to bring more mobile testing sites to growing hotspots. Under partnership with the University of Maryland Medical Center, John Hopkins Medicine, and a community group the city will deploy more mobile testing sites where the data shows case rates are high. Orange County, CA has partnered with nonprofit officials to provide mobile COVID-19 testing clinics in zip codes where COVID-19 cases are far higher than the county average. The initiative, spearheaded by the Latino Health Access, is also leveraging trained community members called promotoras and student health ambassadors to dispel misinformation and increase the number of residents who get tested.
Going forward
COVID-19 has shed light on racial disparities in American health outcomes and is widening that gap in the absence of policies that protect the most affected communities. It is important for states to provide accurate, real-time data so that policymakers—on the local, state, and federal levels—can effectively target dollars, testing and medical resources towards those that are impacted most by COVID-19. Cities must push their state and local health departments and governors for disaggregated data around race, ethnicity, and gender. In doing so, cities will be able to target resources and personnel in a proactive rather than a reactive way.
About the Authors
Tina Lee is a Senior Coordinator within NLC’s Center for City Solutions. She supports the Center for City Solutions and Senior Executive and Director. Additionally, her areas of research include urban innovation, mobility, and housing.
Brooks Rainwater is the Senior Executive and Director of the Center for City Solutions at the National League of Cities. Follow Brooks on Twitter at @BrooksRainwater.
David Park is Program Director of NLC’s Center for Municipal Data & Analytics.