BRATTLEBORO — Spurred on by the Windham County NAACP and the Community Equity Collaborative of the Brattleboro Area (CEC), a consortium is forming to examine the vital role of data collection in eliminating racial and ethnic disparities in health care. In so doing, we hope to improve the health of our entire community and reduce any health disparities going forward.
Brattleboro Memorial Hospital administrators and Vermont Department of Health staff have joined the NAACP and CEC representatives meeting since mid-June to develop a Windham County model response, which could be replicated in other parts of the state.
We are working toward a more accurate and comprehensive picture of how COVID-19 has impacted our Vermont community members of color in Windham County and statewide.
To this end, the committee is reaching out to other county health institutions to participate in our efforts to gather accurate data.
We know that having good data informs policy development and equitable delegation of resources, especially in these times. In this present tumultuous pandemic situation, we want to take advantage of the opportunities for positive change in our health-care system.
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It is time to report a more accurate and comprehensive picture of how COVID-19 has impacted our community members of color.
At present, Black, African American, Asian, and Hispanic Vermonters have the highest rates of COVID-19, and they are growing higher every day.
We are aware that people of color are more likely to be front-line workers, to live in dense or overcrowded housing, to lack health insurance, and to experience chronic diseases, all of which are linked to structural racism.
Race and ethnicity data accountability needs to focus on ensuring the health of the population, ensuring equitable access to care, and ensuring better quality of care.
During this ongoing pandemic, we see every Vermont community experiencing harm. Certain groups are suffering disproportionately, including people of color and workers with low incomes.
Eliminating COVID-19 from disadvantaged groups would ensure that no vestiges of the pandemic will emerge to affect the community just when we believe we are once again safe.
To quote Andrew Young in a recent MSNBC interview, “The rich will not be healthy if the poor are not healthy.”
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State and local leaders are developing response and recovery strategies. Those strategies, to be effective, need to rely on accurate data disaggregated by age, race, ethnicity, gender, disability, and neighborhood characteristics.
In our meetings, we review Vermont Department of Health (VDH) weekly race/ethnicity updates on COVID-19 cases, hospitalizations, and deaths in our county and state. By the end of August, we hope to receive similar VDH data reports on testing.
Continually we ask: Is everyone being counted? For instance, we know our county has a significant number of residents who support our agricultural economy.
During COVID-19, many fear being tested or receiving health care because of problems with ICE. We hope to learn more about their needs and what supports are in place.
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Beyond the COVID-19 situation, we promote a uniform intake form going forward that includes race/ethnicity covering all health care in our state. All ranges of services would comply, including those provided by the state medical examiner, long-term-care facilities, individual health-care practitioners, health clinics, and hospitals.
Toward this effort, we are educating ourselves about how the Vermont Health Information Exchange (operated by Vermont Information Technology Leaders) is assisting health systems to connect effectively, allowing the data to flow between providers and hospitals.
At Governor Scott's request in early April, the Exchange's data became available to the Vermont Department of Health for analysis. Now we have learned that only 7 to 8 percent of COVID-19 cases are missing race or ethnicity information statewide. We are investigating how even that small percentage can be reduced.
We hope to be able to continue similar analyses of health-care-service quality and accessibility based on race and ethnicity on a more permanent basis.
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Separate from the improved data focus, our committee promotes health practitioner and staff education related to the collection of race and ethnicity demographic information.
The Windham County and Rutland County chapters of the NAACP have developed a set of guidelines for staff education to be used in future trainings at Brattleboro Memorial Hospital as part of their equity training curriculum. Comprehensive staff and practitioner education emphasizes the importance of attaining accurate coding of race and ethnicity and helps staff to be more straightforward during intake.
Our committee has a direct link with the newly formed Vermont Racial Equity Task Force. The first of the Task Force's three tasks is to “evaluate structures of support for racially diverse populations, particularly in light of the disparities in health outcomes highlighted by COVID-19.”
Two of our members are also dedicated members of our committee: Steffen Gillom (Windham County NAACP president) and Wichie Artu (Brattleboro Memorial Hospital data and analytics specialist). As we develop our recommendations to the governor, we want our committee to be of service.
Accurate collection of race and ethnicity data related to health and health care does not automatically reduce disparities. But as a guide, it can stimulate development and implementation of strategies to do so effectively.
We hope our committee's efforts will support an equitable response and recovery to help sow the seeds of long-term, transformative change. Race or ethnicity should not determine anyone's opportunity for good health or social well-being but, as COVID-19 has shown, we have a long way to go.