Patients of color are among those most likely to slip through the public safety net and die as COVID-19 frays the nation's health care system, the Academy and six other medical organizations told HHS in an April 3 letter(5 page PDF) that called on the agency to help physicians by releasing more granular data on those stricken with the disease.
With the pandemic gaining intensity, the organizations wrote, HHS should "collect, analyze and make available to the public explicit, comprehensive, standardized data on race, ethnicity and patients' preferred spoken and written language related to the testing status, hospitalization and mortality" associated with COVID-19.
It's a significant call to action, Academy President Gary LeRoy, M.D., of Dayton, Ohio, told AAFP News.
"This letter challenges HHS to fully illuminate each and every shadowed crevice of statistical inequity in our U.S. health care system," he said. "There, it will find unsettling answers about the lethality of social and racial disparities left unchecked in the U.S. health care system."
The letter, sent to HHS Secretary Alex Azar, was signed by the AAFP in conjunction with the AMA, American Academy of Pediatrics, National Medical Association, National Hispanic Medical Association, Association of American Indian Physicians and National Council of Asian Pacific Islander Physicians.
The Academy and its co-signatories, LeRoy added, have made a "commonsense demand that this nation no longer permit its most vulnerable members of society to be the first to perish during a public health crisis because they are the last to be considered when resources and credible solutions are in short supply."
Evidence is already emerging that racial and ethnic disparities in COVID-19 deaths can be linked to misinformation,(www.usnews.com) the prevalence of preexisting conditions(www.nbcnews.com) in minority populations and the high representation of minorities in occupations(www.kff.org) with an increased risk of exposure to the virus.
Danielle Jones, M.P.H., director of the Academy's Center for Diversity and Health Equity, told AAFP News that the pandemic "has exposed the deeply rooted social, economic and health inequities that create racial and ethnic disparities in the United States."
"Institutional racism embedded in the way our systems are designed and implemented creates the policies, processes and infrastructures that produce racial inequities that result in health disparities," she added.
HHS' release of detailed data, the organizations wrote in their letter, is "essential to understanding the unique challenges and inequities facing communities of color and individuals with limited English proficiency." Making this information known "will help to best prepare our physician members to coordinate medical resources to leverage the greatest and most equitable level of care possible for all patients in a timely manner."
Citing the 2009 influenza A (H1N1) outbreak, the letter reminded HHS that "low-income individuals, those living in impoverished neighborhoods, and people of color and diverse ethnic backgrounds" face higher rates of hospitalization during pandemics. Research on past events, the letter added, underscores "the urgency to adapt our country's COVID-19 response to monitor and act on these inequities via explicit data collection on race, ethnicity and language needs."
The co-signers urged HHS to coordinate its efforts with state and local public health offices and clinical data registries to minimize the burden of data collection for frontline clinicians "and to ensure that data collection efforts prioritize cultural sensitivity and patient privacy."
"I hope we emerge from this crisis with a sober understanding of how best to rid our society of these inequities of care," LeRoy told AAFP News.
Related AAFP News Coverage
AAFP Lends Expertise on Social Determinants to Inform HHS
More From AAFP
EveryONE Project Strategic Priorities