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Variation in Reporting of the Race and Ethnicity of COVID-19 Cases and Deaths Across US States: April 12, 2020, and November 9, 2020

Megan D. Douglas, JD, Ebony Respress, MSPH, Anne H. Gaglioti, MD, MS, Chaohua Li, MPH, Mitchell A. Blount, MPH, Jammie
Hopkins, DrPH, MS, Peter T. Baltrus, PhD, Robina Josiah Willock, PhD, MPH, Lee S. Caplan, MD, PhD, MPH, Daniel E. Dawes, JD,
and Dominic Mack, MD, MBA

COVID-19 has infected more than 114 million people worldwide, killing more than 2.5 million.1 Every US state has COVID-19 infections, with more than 28.6 million cases and more than 513 000 deaths in the United States.2 In early April 2020, data from several large US cities showed that COVID-19 was disproportionately affecting racial/ ethnic minority populations.3–5 The magnitude of the reported disproportionate COVID-19 impact on communities of color was and continues to be staggering.

Many studies have confirmed that Black, Hispanic, Native American, Native Hawaiian, and Pacific Islander Americans are more likely to contract, be hospitalized for, and die from COVID-19 than are White Americans.6–11 Several studies and reports have highlighted the large number of cases and deaths being reported with unknown race/ethnicity, suggesting that the observed disparities are larger than reported and demonstrating an urgent need to improve the completeness and consistency of COVID-19 race/ethnicity data.12

Our goal in this study was to describe the evolution, granularity, and quality of COVID-19 data reported by race/ ethnicity at the state level. We analyzed changes in state reporting of COVID-19 data between April 12 and November 9, 2020, highlighting observed gaps in available data that preclude a true accounting of the COVID-19 impact on racial/ethnic minority communities. Based on these gaps, we discuss interventions to improve data quality, recognize challenges to improvement, and propose strategies to mitigate the impact of COVID-19 on racial/ethnic minorities.

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