New figures released Thursday show black Pennsylvanians make up a disproportionate amount of coronavirus cases across the commonwealth. But public health officials who released the numbers amid pressure to share more demographic information about COVID-19 cases cautioned that the data represent only a quarter of confirmed cases.
While other states and municipalities have publicized data on the race of COVID-19 patients for weeks, Pennsylvania has struggled to collect comprehensive demographics, which experts and some lawmakers say are vital to public health officials’ ability to target resources and begin to scale back social distancing.
Though the state’s data on race is incomplete, the virus’ spread in minority communities can be tracked in other ways. Sharrelle Barber, an assistant research professor of epidemiology and biostatistics at Drexel University, said geographic data on cases down to the zip code or neighborhood can be linked with census indicators to help fill the gaps.
But the state Department of Health, which has addresses for the majority of those tested and those who have died, has resisted calls to publish case and death counts that are more granular than county-level.
Still, an outsize impact on African Americans can be gleaned from what information is available. Of the 26% of patients the Department of Health released race data on, about a third are black, though black Pennsylvanians make up just 12% of the population, according to 2019 census estimates.
Conversely, the department’s data show that 63% of those patients are white — and whites make up about 80% of the population. But the state does not have reliable data on ethnicity, so that category could include some Hispanics and people of Middle Eastern descent, a Department of Health spokesperson said.
The trend is consistent with numbers released by other states across the country and municipalities in Pennsylvania showing the pandemic has had a disproportionate impact on black and brown people, who have higher rates of chronic disease and represent an outsize portion of workers deemed “essential” who are still interacting in person.
The publication of the data on race came amid mounting pressure from public health experts and days after The Inquirer filed requests for the information under Pennsylvania’s Right-to-Know Law.
Public health experts say officials and providers can’t wait until the pandemic recedes to better report, collect, and publish demographic information.
“We’re not wanting data for the sake of data,” Barber said. “We’re wanting data so we can mitigate this disproportionate impact in certain communities and come up with short- and long-term policy solutions to save lives.”
The Wolf administration has published the number of confirmed COVID-19 cases and deaths for every county in Pennsylvania and created a public dashboard of hospital preparedness data. It also this week began releasing county-by-county data on cases and deaths in elder-care facilities, as well as a breakdown of cases by sex.
Department of Health spokesperson Nate Wardle said Thursday officials are working to provide more data to the public, and Gov. Tom Wolf on Wednesday announced a task force to be led by Lt. Gov. John Fetterman that will study health disparities in Pennsylvania’s vulnerable communities.
House Minority Leader Frank Dermody said reliable information is “one of the best weapons” for mitigating the spread of COVID-19 and acknowledged the racial disparities already emerging, though data are limited.
“Having more information helps us determine where to put resources and, eventually, decide when some restrictions can be lifted,” Dermody (D., Allegheny) said. “The state’s working hard to get more information from all the private labs doing much of the testing.”
Counties without health departments rely on the state to be forthcoming with the data it has. Sen. Tim Kearney (D., Delaware) has pushed for more data concerning Delaware County, which doesn’t have its own health department. Instead, officials there partnered with nearby Chester County, which does have a health department, to collect and share information.
“This is not a long-term fix,” Kearney said, “but it is providing enough information right now to guide our local response to prioritize antibody testing, protect long-term care facilities, and more.”
County-level figures without information on case numbers by zip code or municipality can be problematic, said Shiriki Kumanyika, emeritus professor of biostatistics and epidemiology at the University of Pennsylvania and chair of the Council on Black Health at Drexel. This is particularly true, she said, in counties that are primarily rural but have an urban area, like Lackawanna County, home to thousands of acres of farm and rural land and also the city of Scranton.
Kumanyika said that without more granular geographic information, “it would totally dilute the sense of what’s going on.”
Wolf’s administration said the state has provided necessary information to local emergency management and other officials.
Pennsylvania Health Secretary Rachel Levine said this week efforts to collect data on patients has been stymied by an outdated system that allows health-care workers to skip some fields when sending specimens to the state’s public health lab in Exton.
The process starts with medical professionals, who in some cases don’t ask patients for demographic information. In other cases, private laboratories have the information but don’t report it to the state, even though the form submitted along with the sample includes fields for the patient’s address, date of birth, sex, ethnicity, and race.
This week, Levine put new pressure on doctors and laboratories to report such information. It will be difficult to enforce, she said, so “we’re going to rely on health-care providers and laboratories to do the right thing.”
Some counties with their own health departments have been more forthcoming. Philadelphia city officials earlier this month publicized some data on race, though it represented less than a third of confirmed cases in the city. Those figures showed while most early cases were among white patients, new cases overwhelmingly affected black residents. As of this week, the city health department now has data on race for two-thirds of its more than 7,000 cases.
It has also published graphics showing cases and deaths by age, gender and zip code.
Amie Downs, a spokesperson for Allegheny County’s health department — which has begun releasing data on race and ethnicity — said the department is monitoring cases by race because “communities of color already have poorer health outcomes in Allegheny County, and it is critical to know if COVID-19 is affecting those communities to a greater degree.”
Last week, New Jersey released available data on race, noting it represented 21% of confirmed COVID-19 patients in the state. As of last Friday, the data showed the disease had an outsize presence among black New Jerseyans, who make up 13.6% of the population but 25% of the confirmed cases.
Other states and municipalities have more comprehensive data and information-sharing capabilities. Consider New York City, the epicenter of the outbreak in America, which has publicized data points like testing and cases by zip code; case and death rates by race; and cases, hospitalizations, and deaths broken down by neighborhood, age, and gender.
Advocacy organizations that work in minority communities need the information, too. Jennifer Clarke, executive director of the Philadelphia-based Public Interest Law Center, said the organization uses federal survey information to develop its programming “all the time.”
For example, the law center started work on housing and evictions about five years ago, responding to data showing people evicted in Philadelphia were disproportionately women of color with children. That information allowed the group to lobby for targeted policy solutions.
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“We know there are these inequalities,” she said, “and we can’t even begin to address them if we can’t see who is sick and where they’re sick.”
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