E cho-Hawk is chief research officer at the Seattle Indian Health Board and a member of the We Must Count Coalition. The group of health equity leaders calls for better health data tracking to shed light on racial disparities because people of color suffer disproportionate rates of COVID-19 cases, hospitalizations and deaths as a result of longstanding systemic inequities and racism.
A lack of data is further masking vaccination rollout transparency, health equity researchers say, and the data deficit is hurting those most vulnerable. So far, only 16 states are releasing vaccination counts by race and ethnicity, and the data is incomplete. ZIP code-level vaccination data also is not widely available, obscuring which residents of specific neighborhoods are getting the shots. Isolated communities, such as rural and low-income pockets of urban cities, are especially vulnerable.
“If you don’t actually disaggregate the data, see where the people are – you will then have people die who should not be dying,” said Dr. Joia Crear-Perry, a doctor and senior adviser to the coalition who founded the National Birth Equity Collaborative.
The preliminary figures from those 16 states are already raising concerns, according to a recent report by the Kaiser Family Foundation. The analysis shows that the share of vaccinations among Black people in those states is smaller than the number of cases among Black people in all 16 of those states, and smaller than their share of deaths in 15 states. Similarly, Hispanic people accounted for more deaths and cases than vaccinations in most of the states. Data on American Indians, Alaska Natives and Pacific Islanders is missing.
“We are losing our language speakers. We are losing our elders who carry the stories and the songs,” Echo-Hawk said. “The other place where they’re being lost is the data, because they are not being captured by their race and ethnicity correctly within the data, either when they go into the hospital systems, when they are diagnosed with COVID –and then when they die.”
People Over 75 Are First in Line to Be Vaccinated Against COVID-19. The Average Black Person Here Doesn’t Live That Long.
Prioritizing by age might seem like an obvious choice, given the disproportionate impact of the disease on the elderly. Setting the initial threshold at 75, however, ignores the fact that a smaller share of Black people reach that age than white people. It also fails to account for research, released by the nonprofit Brookings Institution in June, showing that Black people who die of COVID-19 are, on average, about 10 years younger than white victims of the disease. (Data for Shelby County, Tennessee, where Memphis is located, bears this out as well.)
“If you [allocate the vaccine] strictly by age, you’re going to vaccinate white people who have lower risks before you vaccinate Black people with higher risks,” said Sarah Reber, co-author of the Brookings research and associate public policy professor at the UCLA Luskin School of Public Affairs.
“If you’re trying to avert deaths, you would want to vaccinate Blacks who are about 10 years younger than whites.”
The pandemic is expected to lower life expectancies nationwide, which will only exacerbate the Black-white life-expectancy gap. Before the pandemic, Black residents of Shelby County, on average, were expected to live to be 73 years and four months old, compared to 78 years and one month for white residents. What that means is that while 54% of the county’s residents are Black, Black people account for only 39% of residents 75 and up.
In Shelby County, the poverty rate is 25% higher than the statewide rate, and the residents who live below the poverty line are concentrated inside Memphis city limits.
Shelby County Residents 75 And Older Are Disproportionately White
Data from around the country — and from cities such as Washington, D.C., and Chicago — reveal vast disparities between where COVID-19 is hitting hardest and where shots are making it into arms. The latest national government data shows that when the race of the person getting the vaccine is known, Black residents are underrepresented; just over 5% of vaccine recipients were Black, compared to just over 60% who were white. By contrast, about 12% of the U.S. population is Black and 60% is white.
The population of Shelby County is 54% Black and 35% white. As of Feb. 6, 22% of Shelby County vaccine recipients are Black, compared to 43% who are white. (Around 16% are categorized as “Other/Multiracial/Asian,” while the remaining 18% or so are unknown).
Experts attribute the vaccination disparity to a number of factors, including poor internet access, lack of transportation and distrust of the medical system caused by racist practices such as the federal government’s Tuskegee syphilis study. The distrust becomes visible in a recent Kaiser Family Foundation survey in which a much higher share of Black people than white say they prefer to wait and see how the vaccine works before receiving it. (An equal share of white and Black respondents — 14% — say they definitely won’t get vaccinated.)
But these disparities aside, strict age cutoffs also play a role. Calculating the impact of those cutoffs is difficult because the age criteria are shifting downward as the rollout plan advances. Last week, the Shelby County Health Department announced that people over 70 are now eligible to be vaccinated. But that is unlikely to fully address the inequity built into the age-based system.
According to the state’s health disparities dashboard, Black residents of Shelby County have higher rates of infections, hospitalizations and mortality than white residents. Among residents between 65 and 74 whose race is known, Black people are notably overrepresented in COVID-19 fatalities, according to the SCHD, making up 67% of deaths in that age range, compared to 28% for white residents, as of Jan. 31.
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