Why updating OMB race and ethnicity data standards matters for health equity

The Office of Management and Budget (OMB) is seeking public comment by April 12 about updates to the federal standards for race and ethnicity data collection. The last time these standards were updated was in 1997. They define five minimum categories for collecting data on race: American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White; and two minimum categories for ethnicity: Hispanic or Latino, Not Hispanic or Latino.

Race is a social construct — but disparities in health outcomes due to race and ethnicity are real. Using data to understand these disparities is an important tool in measuring progress toward health equity — and we’ve learned a lot over the past 25+ years about the different ways data can deepen understanding of communities and populations toward that end.

The central role of OMB’s guidance

For community health planners aiming to advance health equity, access to credible data is key to identifying populations placed at increased risk and harmed by inequities. This includes trends and disparities based on race, ethnicity, sexual orientation, gender identity, age or neighborhood.

The OMB standards are singularly important as the core source of guidance for data collection by federal agencies — such as the Census Bureau, Department of Health and Human Services, Department of Housing and Urban Development, and Department of Education. Data collected by these agencies offers insights into how disparities are distributed among populations across a range of topics. Examples of these metrics include poverty rates, death rates due to specific health conditions, smoking prevalence, and high school graduation rates. All of these are key metrics used to identify priorities and populations at increased risk for poor health as part of community health assessment and planning processes.

OMB standards also serve as a guide for state and local government agencies, academic institutions and researchers aiming to align their work with national standards.

Revisions to the OMB standards will have a far-reaching and lasting impact on understanding communities, and progress toward equity.

Strengthening data’s impact through more granular views

The 2020 Census results, which utilized these standards, showed major shifts in reported racial and ethnic demographics in the United States. For instance, those results showed the number of people identifying with more than one race more than tripled from 9 million to 33.8 million between 2010 and 2020. At the same time, the Census Bureau cautions data users against comparing 2010 and 2020 Census data due to changes in the question design, processing and procedures.

Those working in community health improvement recognize that the current minimum race and ethnicity categories can mask disparities or overlook key populations. In the example below, an analysis of Median Household Income data by race and ethnicity in Hawaii shows the Asian population having higher median income compared to other racial or ethnic groups.

But when race and ethnicity data is disaggregated, it allows for more granular understanding of communities. In Hawaii, where Asian Americans and Pacific Islanders make up a considerable proportion of the population, the State provides disaggregated data for AAPI populations.

The disaggregated data chart below shows that while some Asian communities in the state may have higher incomes, others are at or below the overall state average. The ability to see data in this more granular way helps communities better identify disparities and determine the work needed to advance equity.

Our call to action

The OMB’s initial proposed updates for consideration include collecting more granular data to better understand within-group disparities such as those described above for Asian American populations. Others include combining questions about race and ethnicity, adding detailed categories for Black or African American populations and adding a category for Middle Eastern and North African populations.

OMB’s request for public comment on these and other initial proposals contains some big questions:

• To what extent would a combined race and ethnicity question that allows for the selection of one or more categories impact people's ability to self-report all aspects of their identity?
• Is the term “Middle Eastern or North African (MENA)” likely to continue to be understood and accepted by those in this community?
• What techniques are recommended for collecting or providing detailed race and ethnicity data for categories with smaller population sizes within the U.S.?

It’s unlikely that any one individual, organization or community has the answers to all of these questions. But community-based organizations, health departments, health systems and collaboratives working to advance health equity have important wisdom to offer in responding to the call to comment.

Let’s not miss our chance to contribute our lessons learned with progress toward equity as our guide. The OMB’s Public Comment period ends April 12, 2023.

About Healthy Communities Institute

Conduent Healthy Communities Institute provides an end-to-end solution for community health that links health and social determinants of health with technology and expertise. The HCI platform brings stakeholders together with a centralized dashboard of more than 150 health, social, and economic indicators, high value analytics, and evidence-based practices at the user’s fingertips. HCI’s Consulting Services team provide expert guidance for assessing community needs, developing strategies, and implementing evaluation and monitoring processes. Contact Conduent Healthy Communities Institute at communityhealth@conduent.com.