Khazanchi is a medical student and health disparities researcher at the University of Nebraska Medical Center. Marcelin, M.D., is an infectious diseases physician and health disparities researcher. This essay expresses their personal viewpoint rather than that of their affiliated employer or institution.
Nebraska is in the national spotlight again, but this time, we can’t be proud of the reason. Recent COVID-19 outbreaks at meatpacking plants in Hall and Dakota Counties have highlighted Nebraska to have some of the highest per capita COVID-19 infection rates in the country. Despite the documented impact of these two outbreaks on Latino, Somali, Sudanese, and Burmese workers, no demographic breakdowns of cases and deaths have been reported, and recently, at least one health district declined to report cases associated with meatpacking plants. In fact, the American Medical Association recently reported that Nebraska is the only state in the country not reporting COVID-19 cases by age and gender, and one of only five states not reporting race and ethnicity. As health care professionals, health disparities researchers, and people who proudly call Nebraska our home, we are deeply concerned by this lack of transparency.
National data from the ongoing pandemic has revealed a clear story: COVID-19 is disproportionately affecting minority communities around the country. These inequities are driven by differences in “essential worker” employment, chronic disease risk factors, language and health literacy barriers, and the longstanding impacts of structural racism on black and brown communities.
Nebraska’s experience has been no different. As of May 11, data from the Douglas County Health Department shows that 43% of people diagnosed with COVID-19 are Hispanic. (Hispanic people make up only 13% of the Douglas County population.) Asian and black people each represent 15% and 14% of COVID-19 diagnoses while only making up 4% and 11% of the population, respectively.
It is imperative that Nebraska starts reporting statewide COVID-19 demographic data. The Douglas County Health Department has been able to collect and report this information by incorporating questions about race/ethnicity into their contact tracing process. This method is time-consuming and may not be feasible on the state level. However, given that 45 states are currently reporting race and ethnicity, there are both precedents and expert recommendations to pragmatically achieve this. To address incomplete source data, the state could implement a required short digital form incorporating demographic information. Additionally, state-level resources should be leveraged to patch holes in chronically underfunded public health systems.
Data collection and reporting is just the first step. Our public health response must continue to include culturally appropriate messaging and education. Targeted testing, contact tracing strategies, and economic relief efforts should be prioritized in vulnerable, high-risk communities. These evidence-based approaches can be implemented by local, state and federal agencies only if adequate information is collected and reported first.
The Omaha World-Herald previously reported that 23 organizations, including blue collar workers advocacy groups, sent a letter to Gov. Pete Ricketts on April 21 calling for the release of case and death rates by race and ethnicity. As our state enters the early stages of reopening, we sincerely urge the governor and state health officials to heed these requests. Without a data-driven path toward equity, the negative consequences of COVID-19 will quietly continue to amplify among marginalized communities.
While remaining resilient in the face of a formidable foe, we must remind ourselves that our community’s greatness is determined by how we care for our most vulnerable neighbors. Health care professionals and researchers have made it clear that we intend to maintain this focus, and we are counting on our elected officials to do the same, because we must keep #NebraskaStrong for everyone.