COVID-19 has illuminated racial and ethnic disparities across the country and simultaneously created new momentum for state leaders to address the root causes of racial inequity. COVID-19 case data has made the disparities — driven by systemic racism and inequitable economic and social conditions — increasingly blatant. In response to the dual crises of racism and COVID-19, many state leaders are working to address the inequities leading to disproportionate outcomes for communities of color.

A new section of the National Academy for State Health Policy’s (NASHP) interactive map, How States Collect Data, Report, and Act on COVID-19 Racial and Ethnic Disparities, highlights how states are approaching this issue. Eighteen states have activated task forces to address the high rates of COVID-19 cases and deaths in communities of color and their recommendations include:

• Additional protections and compensation for employees who are put at increased risk of COVID-19 due to the nature of their jobs;
• Additional collection, analysis, and transparent release of COVID-19 demographic data;
• Targeted distribution of personal protective equipment (PPE), testing, and treatment resources to communities most impacted by COVID-19;
• Formal methods for the incorporation of community-based organizations and community voices into state and local decision-making processes;
• Increased efforts to make COVID-19 informational materials multi-lingual and accessible;
• Increased focus on affordable and stable housing for those most impacted by COVID-19; and
• Increased public health funding and the continuation of services that support and prioritize communities of color.

NASHP will continue to monitor state task forces to identify recommendations that are incorporated into state policy. States are also using new funding streams, implementing innovative technology solutions, and targeting resources to where they are most needed:

• North Carolina: The North Carolina Department of Health and Human Services (NCDHHS) awarded grants to five local organizations to help address the disparate impact that COVID-19 is having among the state’s Latinx communities. Additionally, Gov. Roy Cooper issued an executive order to address the disproportionate impact of COVID-19 on communities of color. The order:

• • Tasks the North Carolina Pandemic Recovery Office with ensuring the equitable distribution of pandemic relief funds;
  • Prioritizes historically underutilized businesses for state contracts and resources for recovery;
  • Directs NCDHHS to ensure all communities have access to COVID-19 testing and related health care; and
  • 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, and the North Carolina National Guard to assist with mass testing of food processing and migrant farm workers.

• Virginia: Gov. Ralph Northam announced a pilot program in Richmond to increase access to PPE in underserved communities . The new Health Equity Leadership Task Force is leveraging data to prioritize areas experiencing disproportionate impacts of COVID-19 and working with the City of Richmond to establish policies and programs that include an equity lens.
• Ohio: A new position will be created within the Ohio Department of Health dedicated to social determinants of health and opportunity. This position will build on existing efforts and work directly with local communities on their specific long-term health needs and Ohio’s response to COVID-19. This position will also collect data to inform best practices and assist in implementation of the Minority Health Strike Force’s recommendations.
• Illinois: The Illinois Department of Public Health created a multi-departmental COVID-19 equity team to address health disparities. The equity team 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 the coronavirus and how to protect themselves.
• 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 Task Force to examine the causes and possible solutions to the high rate of deaths within Louisiana’s African American community and other impacted populations.
• Massachusetts: Gov. Charlie Baker signed a bill into law that requires the collection of vital public health data — information that would provide additional detail about the impact of COVID-19 on minority communities — and establishes a COVID-19 Equity Task Force.
• Washington, DC: The 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.
• West Virginia: Gov. Jim Justice and the Department of Health and Human Resources 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.

The disproportionate impact of COVID-19 makes it more clear than ever that racism is a public health issue with implications for state health policy. As states continue to grapple with COVID-19, many, like those in the examples above, are focusing on how to address immediate disparities related to the pandemic.

States are beginning the process of setting in place strategies to address the preexisting racial and ethnic disparities that worsen outcomes for people of color. New positions dedicated to addressing social determinants of health and opportunity; multi-departmental equity teams; enhanced collection and reporting of data; and public health services that support and prioritize communities of color are key strategies to ensure equity issues remain part of states’ agendas. NASHP will continue to track how states approach this work and how they measure change and success over time.

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. Thanks to NASHP’s Population Health Team for their contributions to this analysis.