Iowa's race, ethnicity data on COVID-19 and vaccines shows huge gaps, leading to blind spots in equitable response
Iowa has massive gaps in the data it reports on the race and ethnicity of the people who have tested positive for the coronavirus and those who have received the vaccine, Iowa Department of Public Health data shows.
For weeks state health department data, as reported on coronavirus.iowa.gov, has reported double-digit percentages of race and ethnicity data as unknown or pending investigation. Public health experts warn the lack of information creates a blind spot in understanding and addressing whom the pandemic is affecting and the equity of the response.
As of noon Tuesday, 35% of positive cases were reported as an unknown race and, separately, 38% of people who have tested positive have their ethnicity recorded as pending investigation, the Iowa Department of Public Health coronavirus website shows.
The state's website also shows 19.7% of vaccine recipients are of an unknown race and, separately, 25% are of unknown ethnicity. Ethnicity and race are separate demographic categories.
Iowa Department of Public Health spokesperson Sarah Ekstrand wrote in an email that “we are working with testing partners to ensure they are capturing data during testing so that we have a clear picture of how COVID-19 is impacting the state's population.”
She did not respond to follow-up questions about how the reporting gaps happened or what steps the state is taking to address the knowledge gaps.
What we do know about the race, ethnicity coronavirus data
The Iowa-Nebraska chapter of the NAACP began requesting COVID-19 data by race and ethnicity soon after Iowa Gov. Kim Reynolds started holding regular news conferences on the pandemic in the spring, said the chapter’s health chair, Jacquie Easley McGhee.
In April, Black Iowans accounted for 8.7% of all confirmed coronavirus cases, despite making up about 4% of the state’s population.
Hispanic Iowans accounted for 16.4% of positive tests, despite making up about 6.2% of the state’s population. That is also when the coronavirus ripped through Iowa’s meatpacking plants, whose workforce is more diverse than the state at large.
But those disproportionate rates eased as time progressed, according to available data. The state now reports 3% of Iowans who have tested positive are Black and 6% are Hispanic.
Many medical providers don’t want to assume a person’s race or ethnicity, she said, and instead rely on self-reporting.
Easley McGhee, who is also the director of health equity at MercyOne Medical Center, suspects some people may not want to identify their race or ethnicity in medical settings. But, she said, there must be other factors with data collection pushing Iowa’s unknown figures so much higher than those in other states.
“… If we don’t know the accurate numbers, we don’t really know how to address it," she said.
In Polk County, which has the largest number of Black residents in Iowa, the health department is working specifically to track race and ethnicity of people being vaccinated, Polk County Health Department spokesperson Nola Aigner Davis said.
In Scott County, which has Iowa's second-highest Black population, officials turned contact tracing over to the state in November due to surging daily coronavirus cases. As a result, local officials didn't have county-level race and ethnicity data, spokesperson Brooke Barnes said in an email.
History with medical research exploitation creates hesitance
Black Americans have a long history of being subjected to medical experiments against their will, from medical experimentation during slavery to Henrietta Lacks having her cells harvested without consent in 1951 for cancer research to the decades-long, federally funded syphilis study that relied on lies to Black men and left them untreated for the disease. The Tuskegee Syphilis Study ran from 1932 until 1972, when it was exposed by the Associated Press.
“It's the lack of permission and treating people of color like they are medical guinea pigs that has really instilled this hesitancy,” Easley McGhee said, adding that the worry is compounded by misinformation online.
To help ease those concerns, the annual African American festival I’ll Make Me A World In Iowa will feature a panel Feb. 27 on the pandemic.
It will include a Black man who participated in a clinical vaccine trial, Polk County Health Department officials to address vaccine accessibility, and a Los Angeles-area doctor who has focused on helping communities of color there, Easley McGhee said.
Black Americans in particular have faced worse health outcomes related to the coronavirus, Iowa Public Health Association Executive Director Lina Tucker Reinders said.
"There's historical reasons that some communities are hesitant to take the vaccine,” she said. “So what we're looking at as a public health community is how do we engage with trusted community members in those communities to get those influencers to say this is OK, this is safe, you can trust this, the harm of not vaccinating our community is greater than the risk of vaccination."
Nick Coltrain is a politics and data reporter for the Register. Reach him at firstname.lastname@example.org or at 515-284-8361.