How States Collect Data, Report, and Act on COVID-19 Racial and Ethnic Disparities
Updated October 12, 2020
The racial inequities exposed by COVID-19’s case* and death rate data gives states opportunities to target their responses and address inequities in communities most impacted. This chart details which states are reporting case, mortality, and testing data by race and ethnicity on a state, zip code, or community level, and what initiatives they are taking to address race and health inequities. Read this NASHP blog, States Launch Initiatives to Address Racial Inequities Highlighted by COVID-19, to learn what their approaches have in common.
For more information, contact Elinor Higgins at EHiggins@nashp.org.
| State | Actions |
| Alabama | Not found |
| Alaska | Not found |
| Arkansas | Not found |
| Arizona | Not found |
| California | Gov. Gavin Newsom’s Task Force on Business and Jobs Recovery has recommended that racial justice principles and a focus on equity become part of the economic reopening plan for the state. |
| Colorado | The Office of Health Equity created the COVID-19 Health Equity Response Team, which promotes transparency by publishing summaries of weekly team meetings. It also conducted a survey to inform the team’s actions.
The Equity Response Team released their recommendations on June 10, 2020 and released equitable testing guidance for COVID-19 testing sites soon after. |
| Connecticut | Not found |
| Delaware | Not found |
| District of Columbia | Washington, DC’s Equity, Disparity Reduction and Vulnerable Populations Committee is part of Reopen DC’s advisory group. The committee assembled a set of recommendations describing how to ensure equity during reopening. |
| Florida | Not found |
| Georgia | Not found |
| Hawaii | Not found |
| Idaho | Not found |
| Illinois | The Illinois Department of Public Health created a COVID-19 Health Equity Task Force involving other departments that will work to address health disparities.
The task force has launched a COVID-19 text messaging system (which includes an option for Spanish-speakers). Illinois residents can opt-in to receive text messages and obtain the most accurate information about coronavirus and how to protect themselves. |
| Indiana | The legislative Racial Disparity Task Force on COVID-19 was created after the Legislative Black Caucus urged the Governor to do so. Its letter to the governor included several other concrete suggestions for action. A report was released in July, 2020, which included findings of the Task Force and recommendations for future action. |
| Iowa | Not found |
| Kansas | Not found |
| Kentucky | Not found |
| Louisiana | Gov. John Bel Edwards announced he is making $500,000 from the Governor’s COVID-19 Response Fund available to the Louisiana COVID-19 Health Equity Taskforce to examine the causes and possible solutions to the high rate of deaths from the coronavirus within Louisiana’s African American community and other impacted populations. The task force has a set of short term and intermediate goals to provide data driven information, ensure testing is available for all communities, and provide the medical community with best practices. |
| Maine | On July 30, Gov. Janet Mills announced that $1 million from the Coronavirus Relief Fund would be dedicated to significantly and quickly expand services to help reduce the disproportionately large racial and ethnic disparities in COVID-19 in Maine. |
| Maryland | Not found |
| Massachusetts | Gov. Charlie Baker signed a bill into law that requires the collection of vital public health data and establishes a COVID-19 Equity Task force.
The Department of Public Health’s COVID-19 Health Equity Advisory Group released its recommendations that include: · Continuing to disaggregate COVID-19 data across populations and sectors, such as transit usage. · Increasing equitable distribution of personal protective equipment (PPE) for essential workers and residents in professions most at risk. · Implement policies that increase housing stability for populations disproportionally impacted by COVID-19. · Prioritizing investment in multilingual outreach to communities to increase access to testing, home and workplace protections, and access to state assistance programs. · Planning and implementing a strategy for the active engagement and representation of existing community-based organizations in the most impacted communities as part of decision-making processes related to COVID-19 response and recovery. |
| Michigan | Gov. Gretchen Whitmer issued an executive order that created the Michigan Coronavirus Task Force on Racial Disparities. The task force will suggest ways to:
· Increase transparency in reporting data regarding the racial and ethnic impact of COVID-19. · Remove barriers to accessing physical and mental health care. · Reduce the impact of medical bias in testing and treatment. · Mitigate environmental and infrastructure factors contributing to increased exposure during pandemics resulting in mortality. · Develop and improve systems for supporting long-term economic recovery and physical and mental health care following a pandemic. The task force helped distribute large quantities of masks to the public, launched efforts targeted to communities of color, collaborated with regional racial disparity task forces, and increased access to coronavirus testing in communities of color. The state has seen disparities decrease, possibly as a result of these actions. The state made $20 million dollars available for the Task Force to respond to community needs associated with the disparate impacts the virus has had on communities of color. Applications for funding through the Rapid Response Initiative closed in August 2020, with funds available for a wide range of needs. |
| Minnesota | Gov. Tim Walz established a community resilience and recovery work group to work with communities experiencing the worst disparities in COVID-19 outcomes. Items of business include policymaking, executive actions and executive orders, communication and outreach, and other processes for amplifying the voices in impacted communities.
The Minnesota Department of Health (MDH) holds regular conference calls with local public health community and faith leaders and other diverse communities across the state during which they share COVID-19 updates and questions and concerns from partners about their needs, other issues, and the barriers they face. MDH has also created multilingual COVID-19 resources and now provide access to translators on their COVID-19 hotline. The MDH media strategy for providing information about COVID-19 includes contracts with diverse media partners who can more effectively reach residents from communities of color, Native American residents, LGBTQ residents, and residents with limited English proficiency. |
| Mississippi | Not found |
| Missouri | Not found |
| Montana | Not found |
| Nebraska | Not found |
| Nevada | Not found |
| New Hampshire | Gov. Chris Sununu established the COVID-19 Equity Response Team. The group is charged with:
· The collection and ongoing release of demographic data; · Conducting a thorough analysis of all available data using a cross-cultural research method to examine the social, cultural, and systemic factors contributing to differences and disparities in COVID-19 related outcomes; · Identifying and recommending specific resources that could be allocated to address these disparities; and · Within 30 days (as of May 28), identifying and recommending achievable steps for the state and other stakeholders to consider undertaking to remedy the disparate impact of COVID-19, which is likely to be a public health concern for months, if not years to come. The response team released its initial Report and Recommendations in July, 2020, which includes recommendations across several topics, including the following: · COVID-19-specific recommendations; · Permanence of Equity Response Team; · Equitable data practices; · Equitable resource allocation; · Community engagement; and · Policies. |
| New Jersey | Gov. Phil Murphy signed legislation that requires hospitals to report COVID-19 demographic data to the Department of Health.
The state legislature introduced a bill to establish the Racial Equity Rapid Response team. It was referred to the Assembly Community Development and Affairs Committee in June of 2020. |
| New Mexico | Gov. Michelle Lujan Grisham created the Council for Racial Justice. The group is tasked with counseling the administration and monitoring state institutions, holding them accountable for taking action to end systemic racism and ensuring that all persons receive fair and equal treatment and opportunities. |
| New York | Not found |
| North Carolina | Gov. Roy Cooper issued an executive order to address the disproportionate impact of COVID-19 on communities of color. The order:
· Establishes the Andrea Harris Social, Economic, Environmental, and Health Equity Task Force to focus on economic stability, health disparities, and environmental justice in North Carolina; · Tasks the North Carolina Pandemic Recovery Office to ensure the equitable distribution of pandemic relief funds; · Directs the Historically Underutilized Business Office to provide small historically underutilized businesses with access to opportunities, tools, and resources that promote equitable economic recovery and procurement of state contracts; · Directs the North Carolina Department of Health and Human Services to ensure all communities have access to COVID-19 testing and related health care; · Tasks the Office of Public Engagement to increase awareness about COVID-19, COVID-19 relief services and resources, and provide education on eliminating disparities; · Directs the Division of Emergency Management to continue coordinating efforts to protect the food supply chain and support feeding operations at food banks and school systems; · Directs the North Carolina National Guard to provide planning and logistical support and personnel where feasible to support mass testing of food processing plant workers in impacted communities and migrant farm workers; and · Tasks the Department of Environmental Quality to create a common discourse on environmental justice and coordinate with state executive agencies on the integration of environmental justice considerations into current and future policies, programs, and procedures. Gov. Cooper followed that executive order with another that established a task force to address racial inequity in the state criminal justice system. The North Carolina Department of Health and Human Services also awarded grants to five North Carolina organizations to help address the disparate impact that COVID-19 is having among the state’s Latinx communities. |
| North Dakota | Not found |
| Ohio | Gov. Mike DeWine created a Minority Health Strike Force and its official recommendations were released in June. The recommendations go beyond the scope of COVID-19 to address broader racial disparities. Examples include:
· Establishing culturally appropriate and accessible COVID-19 exposure notification services for communities of color; · Acknowledging racism as a public health crisis and commiting to swift action to dismantle racism, which is a driving force of the social determinants of health; · Using data to prioritize resources in the communities that have the highest need; · Developing community understanding, health literacy, and trust; · Considering the implementation of one or more of the poverty-reduction strategies from the 2020-2022 State Health Improvement Plan (SHIP); · Enhancing job connections and workplace protections for essential workers by linking people of color to job training and other employment supports; · Collecting and reporting consistent, disaggregated police and court data; · Exploring options to expand broadband funding to ensure that Ohioans of color have sufficient internet access and bandwidth for education and telehealth activities; and · Strengthening cross-agency implementation of SHIP and monitoring its success. In response to the Strike Force’s recommendations, Gov. DeWine released a Plan of Action to Advance Equity. He previously had announced other activities that the state has undertaken to address disparities: · A $1 million federal grant will be used to address mental health issues among difficult-to-reach populations, especially among people of color; · A new “Stay in the Fight” messaging campaign aims to keep minority communities informed, involved and inspired in the effort to combat COVID-19; and · A new position will be created within the Ohio Department of Health dedicated to social determinants of health and opportunity |
| Oklahoma | Not found |
| Oregon | Gov. Kate Brown released the State of Oregon Equity Framework in COVID-19 Response and Recovery. The core elements of the framework include a commitment to:
· Use inclusive communications, including translated materials that are accessible, timely, trauma-informed, shared by trusted messengers, and involve the intended community. · Form community-informed policy and partnerships. Work with community leaders who are an essential part of the decision-making process. · Ensure safety for our communities. Protect civil rights for all Oregonians and take active measures against discrimination, racism, xenophobia, stigmatization, violence, and hate crimes. · Collect, analyze, and report data in culturally and linguistically responsive communications. Allot resources for the most-impacted communities across the state and collect qualitative data to provide context to quantitative data. · Ensure a safe, inclusive, and accessible workplace for all. Recruit, hire, retain, and promote diverse staff, create leadership pipeline opportunities, and ensure every level of state government’s workforce reflects the population of Oregon. · Make investments in community resilience. Target investments to historically and currently marginalized populations and organizations that serve them, to improve economic welfare. · Ensure contract equity. Provide state economic opportunities for all Oregon businesses, in particular those who are owned by people who are minorities, women, disabled, and/or veterans. · Ask – and answer – the tough questions. The Equity Framework outlines more than a dozen guiding questions to ensure you are applying equity. Gov. Kate Brown created the Racial Justice Council to address systemic racism. The council will have five subgroups; criminal justice reform and police accountability, health equity, economic opportunity, housing and homelessness, and environmental justice/natural resources. The council will provide recommendations for the 2021-2023 governor’s budget. |
| Pennsylvania | The governor and lieutenant governor established a COVID-19 Response Task Force for Health Disparity to help communicate and address issues about how the pandemic is affecting the state’s minority and vulnerable population. In August, the task force published its first policy recommendation report. It includes six recommendations focused on policy topics relating to health disparities, ranked in order of urgency: housing, criminal justice, food insecurity, health disparity, education and economic opportunities.
Office of Health Equity has a Covid-19 Health Equity Response Team with six core strategies: · Clinical Care Considerations for Vulnerable Populations at Risk for COVID-19; · Predictive Modeling; · Strategic Communications; · Coordination of Strategic Partnerships; · Mass Fatality Management; and · Economic Stability and Revitalization |
| Rhode Island | The Executive Office of Health and Human Services Equity Council was created to advance and embed race equity into all areas within the state’s government, with a current focus on incorporating equity measures into the reopening plan. |
| South Carolina | Not found |
| South Dakota | Not found |
| Tennessee | The Tennessee Department of Health and the Office of Minority Health created the COVID-19 Health Disparity Task Force. The group meets weekly. |
| Texas | The Texas Health and Human Services Commission will study “COVID-19′s impact on vulnerable populations and will include data in many sectors including race, ethnicity, age, geographic location, socioeconomic status, chronic illness, a presence of a disability and employment status.” |
| Utah | The Utah COVID-19 Community Task Force created a multicultural subcommittee that aims to prioritize racial equity. The subcommittee also oversees the COVID-19 Racial Equity & Inclusion Grant Fund. The fund provides grants up to $5,000 to community-based organizations that provide emergency assistance to multicultural communities. |
| Vermont | Gov. Phil Scott signed an executive order to form the Racial Equity Task Force as a component of a broader state effort to promote racial, ethnic, and cultural equity, including in its response to COVID-19. The task force will undertake three major projects:
· Evaluate structures of support for racially diverse populations, including a focus on the racial disparities in health outcomes highlighted by COVID-19; · Review current state and federal law on hate speech and freedom of speech, and consider changes to state laws to clarify the path for prosecuting harassment, hate speech, and other bias-motivated crimes; and · Study and present options to encourage Vermonters from diverse, marginalized, or underrepresented racial and ethnic groups to run and serve in public office at all levels. |
| Virginia | · The Office of Health Equity created a Health Equity Leadership Task Force to address COVID-19.
· Gov. Ralph Northam announced a pilot program in Richmond to increase equitable access to personal protective equipment (PPE) in underserved communities that may be more adversely impacted by the virus. The task force is leveraging data to prioritize areas experiencing disproportionate impacts and working with the City of Richmond to establish policies and programs that include an equity lens. |
| Washington | New proposed recommendations from the Governor’s Interagency Council on Health Disparities for discussion only include:
· Adequately fund the Office of Equity and statutory commissions to conduct community outreach and engagement; · Provide opportunities for communities to take the lead in creating information about and for themselves, including through contracts and grants; · In partnership with the statutory commissions, build connectivity with communities that are isolated (socially, technologically, geographically, linguistically); and · Prioritize issues that are most important to communities and work with them on emerging issues. Lessons from the COVID-19 pandemic and response. · The impacts of COVID-19 highlight systemic barriers and institutional oppression. There is disproportionate burden on communities of color, immigrant communities, low-income communities, the LGBTQ community, the disability community, and vulnerable labor forces. · ‘Hitting pause’ on services is not neutral — it is harmful. Agencies must be prepared to continue serving all populations (e.g., students with disabilities, isolated communities). · Do not revert to inequitable systems and behaviors; do not replicate and reinforce inequities. · What will be different this time? We have the responsibility to ensure communities are not left behind, and a unique opportunity to rebuild systems to be more just and equitable. · The door is open even wider than before for an Office of Equity — it is needed now more than ever. If approved, these lessons would replace the current Office of Equity Task Force Preliminary Report (2019). |
| West Virginia | A task force focusing on the impact of COVID-19 on African American residents was established by the Department of Health and Human Resources (DHHR) and Office of Minority Affairs. Gov. Jim Justice and the DHHR also announced a plan to increase COVID-19 testing opportunities for minority populations and other vulnerable populations in counties that have both a large minority population and evidence of COVID-19 transmission.
Since May, the task force has met weekly to review COVID-19 data on racial and ethnic disparities. |
| Wisconsin | Wisconsin State Assembly Speaker Robin Vos created a task force to examine “racial disparities, educational opportunities, public safety, and police policies and standards.” |
| Wyoming | Not found |
Support for this work was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the foundation.
For more information, read the NASHP blogs, States Use Race and Ethnicity Data to Identify Disparities and Inform their COVID-19 Responses. Learn more about what the data conveys about health inequities from The COVID Tracking Project and Boston University Center for Antiracist Research.
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
