Massachusetts Medical Society: Sign-On Letter Regarding Need for Public Data and Action Plan On Inequities In COVID-19 Impact

Sign-On Letter Regarding Need for Public Data and Action Plan On Inequities In COVID-19 Impact

Governor Charlie Baker
Secretary Marylou Sudders
Commonwealth of Massachusetts
State House
Boston, MA 02133

RE: Need for Public Data and Action Plan On Inequities In COVID-19 Impact

Dear Governor Baker and Secretary Sudders:

We are writing as members of the Task Force on Coronavirus & Equity to ask you to continue the state’s progress on data collection and reporting to understand the equity impacts of the COVID-19 epidemic in Massachusetts, as well as to implore you to prioritize action to address inequities that are becoming ever more clear.

The Task Force on Coronavirus & Equity was convened exactly one month ago to identify and promote policy solutions to prevent and respond to health and economic inequities in the impact of the outbreak. Though no data was available at that time, we strongly suspected that the outbreak would not impact all Massachusetts residents equally. Rather, we anticipated that communities that are already facing marginalization would be hardest hit by the virus and its economic repercussions, starkly exposing inequities across Massachusetts and the nation driven by racism, poverty, and xenophobia. Unfortunately, emerging data from Massachusetts and the nation bear out this expectation.

It is essential that Massachusetts act with urgency to fully understand these inequities, and more importantly, to take bold action to support those communities that are most impacted and to prevent further widening of these gaps.

We appreciate recent action by the Administration to make more data publicly available, including data on race and ethnicity of confirmed cases and deaths, as well as case counts by municipality. We strongly support these measures as important ways to improve our understanding of the outbreak and inform smart approaches to prevention and response that prioritize communities and populations that are being disproportionately affected.

In addition to the actions already taken, we call on you to take these additional actions:

  • Provide regular, detailed reports of the Administration’s actions and plans to prevent and reduce inequities in the health and economic impact of the outbreak. While additional data collection and reporting is needed to fully understand the impacts of the virus, we have clear and compelling data demonstrating that there is an inequitable impact across communities and that unacceptable racial inequities exist. Knowing this information is not the goal; action is imperative. We ask that you provide clear, regular, and detailed information to the public about how the Administration is working to prevent and respond to these inequities.
  • Use all tools available to accelerate accurate and complete collection of race and ethnicity data by labs and medical providers. While race/ethnicity data is now being reported daily by the state, more than 60% of cases and deaths are missing this data, leaving major gaps in our understanding. The Public Health Order of April 8th clarifies that health care providers should make every effort to collect race and ethnicity. It also states that DPH will issue guidance to those entities ordering and providing tests, yet this guidance has not yet been released. The order was issued 8 days ago, yet the percentage of cases with missing race/ethnicity data has not improved significantly. It is essential that the Administration provide more resources and guidance – and most importantly, urgency – to improve these numbers.
  • Include additional demographic factors in data collection and reporting, so that we can understand the full scope of potential inequities. Past experience and anecdotal evidence strongly suggest that inequities are present across other demographic factors, including socioeconomic status, disability, language, and occupation and industry, among others. Without these data, we are in the dark about the nature of these inequities and therefore limited in our ability to take strategic action.
  • Provide testing numbers by municipality, disaggregated by race/ethnicity and other demographic factors. Current reporting only provides insights into confirmed cases and deaths. However, we are concerned about equitable access to testing, particularly in communities of color. We ask that you provide the number of tests conducted by municipality of residence, and we ask that you disaggregate these numbers by race/ethnicity, sex, age, socio-economic status, disability, and occupation, at a minimum.
  • Monitor racial inequities in enforcement of public health orders. It is important that public health officials, with the collaboration of other municipal and state officials, conduct effective educational, outreach, and enforcement measures to ensure the highest level of safety for Massachusetts residents during this crisis. However, given our clear knowledge of inequities in law enforcement actions, we must ensure that communities of color and low-income communities are not targeted by fines, arrests, or other enforcement activities. The Administration should direct municipal and state officials to collect and report data to monitor enforcement activities, and to take corrective action, if needed.

In collecting and releasing these data, it is crucial the state protect fundamental rights and uphold privacy rights by limiting the collection of and protecting personally identifiable information and withholding small numbers.

Thank you for your hard work in the midst of this unprecedented outbreak. We ask for your urgent and attention to these requests, and we stand ready to support your efforts.

Sincerely,


Cheryl Bartlett, RN,
CEO, Greater New Bedford Community Health Center
Co-Chair, Task Force on Coronavirus and Equity

Sandro Galea, MD,
Dean, Boston University School of Public Health
Co-Chair, Task Force on Coronavirus and Equity



Ken McDonnell, 350 Central Mass

Anna Leslie, Allston Brighton Health Collaborative

Sofia Owen, Alternatives for Community & Environment

Carol Rose and Oami Amarasingham, American Civil Liberties Union of Massachusetts

Jane Winn, Berkshire Environmental Action Team

Robert Greenwald, Center for Health Law and Policy Innovation

Etel Haxhiaj, Central Massachusetts Housing Alliance

Charlotte Bruce, Children's HealthWatch

Karen Y. Chen, Chinese Progressive Association

Elecia Miller, City of Lawrence Mayor’s Task Force

Chelsey Patriss, Community Health Network Area 9

Lee Matsueda, Community Labor United

Staci Rubin, Conservation Law Foundation

Magalis Troncoso Lama, Dominican Development Center, Inc.

Debra Falzoi, End Workplace Abuse

Laura Sylvester, The Food Bank of Western Massachusetts

Karen Andrade, The Greater Boston Food Bank

Gail Page, Green Sanctuary, Climate Action Group of Unitarian Universalist Church of Reading

Heather McMann, Groundwork Lawrence

Alex Sheff, Health Care for All

Andrew Cohen, Health Law Advocates

Jennifer Valenzuela, Health Leads

Steven Ridini, Health Resources in Action

Sarah Bayer and Elizabeth Peck, Homes for Families

Helena DaSilva Hughes, Immigrants’ Assistance Center, Inc.

Enid Eckstein, Jamaica Plain Progressives

Mohammed Missouri, Jetpac

Cindy Rowe, Jewish Alliance for Law and Social Action

Jessica Andors, Lawrence Community Works

Chrissy Lynch, Massachusetts AFL-CIO

Elana Brochin, Massachusetts Association of Community Development Corporations

Jamie Berberena and Lissette Blondet, Massachusetts Association of Community Health Workers

Michael Hugo, Massachusetts Association of Health Boards

Kelly Turley, Massachusetts Coalition for the Homeless

Jodi Sugerman-Brozan, Massachusetts Coalition for Occupational Safety and Health

David Stevens, Massachusetts Councils on Aging

Winton Pitcoff, Massachusetts Food System Collaborative

Amy Grunder, Massachusetts Immigrant and Refugee Advocacy Coalition

Maryanne Bombaugh, MD, MSc, MBA, FACOG, Massachusetts Medical Society

Carlene Pavlos, Massachusetts Public Health Assocation

Carolyn Villers, Massachusetts Senior Action Council

Beth Huang, Massachusetts Voter Table

Jessica Wilson, Mill City Grows

Jamie Klufts, National Association of Social Workers - MA Chapter

Andrea Nyamekye, Neighbor to Neighbor Massachusetts

Rosemary Wessel, No Fracked Gas in Mass

Jennifer Lemmerman, Project Bread

Jonathan Cohn, Progressive Massachusetts

Jessica Collins, Public Health Institute of Western MA

James Michel, Resist the Pipeline

Chrystel Murrieta Ruiz, SEIU, 32BJ

Deb Pasternak, Sierra Club Massachusetts

Shelley White, Simmons University Master of Public Health Program

Claire Miller, Toxics Action Center

Pamela Schwartz, Western MA Network to End Homelessness

Jean McMurray, Worcester County Food Bank, Inc.


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