Lawmakers want race breakdown in data
They hope to spot disparities early
Every morning at 10 a.m., the Maryland health department publishes an update to its sobering data about the rapidly spreading coronavirus.
The latest state data showed the number of cases among people ages 10 to 19 more than doubled over three days. It documented how the number of cases among women in Maryland surpassed those among men. And it registered cases as they’ve sprung up in county after county after county.
But absent so far is a breakdown of cases by race. Some lawmakers say publishing this information while the pandemic is ongoing is vital so that state officials can monitor any disparities as they arise.
“We’ve always known that, historically, there’s been health disparities in communities of color. It’s important to get ahead of it,” said state Del. Nick Mosby, a Baltimore Democrat who is running for City Council president.
Mosby started using social media Sunday to push the state to begin publicly tracking cases by race, in addition to age, gender and geographic location. Doctors across the country are making similar calls as some researchers caution black people in America could be hit especially hard by the public health crisis.
Baltimore’s population is more than 60% black.
Asked during a Monday news conference whether the state could report cases by race, deputy state health secretary Fran Phillips said, “I’m not aware that we have looked into that.”
A spokesman for Republican Gov. Larry Hogan, Mike Ricci, said Monday he didn’t have an update on Mosby’s request.
The U.S. Centers for Disease Control and Prevention has not yet made data available by race, either, although high-profile Democratic lawmakers are pushing for more public information.
In a letter to Health and Human Services Secretary Alex Azar, U.S. Sen. Elizabeth Warren and U.S. Rep. Ayanna Pressley said comprehensive demographic data on people who are tested or treated for the virus that causes COVID-19 is not available.
“This lack of information will exacerbate existing health disparities and result in the loss of lives in vulnerable communities,” the Massachusetts lawmakers wrote Friday.
Healthy equity advocates say detailed data is an important tool in the fight against the virus. U.S. cities with large black and brown populations, such as Chicago, Detroit, Milwaukee and New Orleans, have emerged as hot spots of the coronavirus outbreak.
“We need a tangible picture of what is happening, so we can plan better and not, after this is over, look back and see gross disparities in treatment and in outcomes,” said Gail Christopher, executive director of the National Collaborative for Health Equity.
Communities of colors have faced documented disparities that could exacerbate the impact of the new coronavirus. Black people in America suffer higher rates of asthma and diabetes — the kinds of underlying health conditions that could put patients at a greater risk of COVID-19 complications.
Mosby said health care workers’ implicit bias and other barriers to treatment also could “imperil communities already on the front lines of multiple public health threats.”
“Because of the stress that this pandemic will place on hospital capacity, soon residents will not be able to walk into hospital emergency rooms for screening,” he said. “This will have an adverse impact on populations who are less likely to have insurance and primary care physicians.”
Dr. Lisa Cooper, who leads the Johns Hopkins Center for Health Equity, said many people of color have fears about the way they will be treated by hospitals. The story of Henrietta Lacks, a black woman whose cells were collected for research without her permission or knowledge, is ubiquitous in Baltimore.
With better data, Cooper said, Maryland officials could perhaps tailor their public health messaging to specific at-risk communities. Early in the pandemic, some people spouted a myth that black people can’t contract the virus. Some Baltimore community organizers say they must combat such misinformation and apathy as they fight the disease’s spread in their neighborhoods.
Dr. Ebony Hilton, a University of Virginia School of Medicine professor of anesthesiology, said she’s both concerned that there is a disparity in who is getting tested and that there’s a lack of data to prove whether or not her concern is justified.
Hogan said Monday that drivethrough testing sites have opened at Motor Vehicle Administration emissions stations in Bel Air, Glen Burnie and Waldorf, as well as at FedEx Field in Landover. Testing at the sites is limited to people with doctor’s orders and an appointment.
Hilton questioned which patients will be able to get such a doctor’s order, especially when some of the symptoms could be considered subjective. How will implicit and explicit racial bias, she asked, play into a doctor’s decision about who receives a sought-after test?
A handful of other Maryland lawmakers echoed Mosby’s call for racial data on coronavirus cases.
“We know that racial bias in health care exists and only data can help ensure we make any necessary course corrections,” Del. Jheanelle Wilkins tweeted Monday. “Every Marylander benefits from a crisis response that takes an equity approach.”