Author:
Spangler Keith R.,Levy Jonathan I.,Fabian M. Patricia,Haley Beth M.,Carnes Fei,Patil Prasad,Tieskens Koen,Klevens R. Monina,Erdman Elizabeth A.,Troppy T. Scott,Leibler Jessica H.,Lane Kevin J.
Abstract
Abstract
Infectious disease surveillance frequently lacks complete information on race and ethnicity, making it difficult to identify health inequities. Greater awareness of this issue has occurred due to the COVID-19 pandemic, during which inequities in cases, hospitalizations, and deaths were reported but with evidence of substantial missing demographic details. Although the problem of missing race and ethnicity data in COVID-19 cases has been well documented, neither its spatiotemporal variation nor its particular drivers have been characterized. Using individual-level data on confirmed COVID-19 cases in Massachusetts from March 2020 to February 2021, we show how missing race and ethnicity data: (1) varied over time, appearing to increase sharply during two different periods of rapid case growth; (2) differed substantially between towns, indicating a nonrandom distribution; and (3) was associated significantly with several individual- and town-level characteristics in a mixed-effects regression model, suggesting a combination of personal and infrastructural drivers of missing data that persisted despite state and federal data-collection mandates. We discuss how a variety of factors may contribute to persistent missing data but could potentially be mitigated in future contexts.
Funder
National Institute on Minority Health and Health Disparities
Google
National Institute of Environmental Health Sciences
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health,Health Policy,Sociology and Political Science,Anthropology,Health (social science)
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