From National Policy to Local Practice: A County Health Department's Experience With Race and Ethnicity Data...

Area of Science:

• Public Health
• Health Equity
• Survey Methodology

Background:

• Federal reporting standards for race and ethnicity have been updated under the US Office of Management and Budget's Statistical Policy Directive Number 15 (SPD 15).
• A community-engaged health department implemented COVID-19 health education programs, incorporating a race and ethnicity questionnaire aligned with new federal standards.

Purpose of the Study:

• To examine survey attributes and attendee characteristics associated with disaggregated race and ethnicity responses.
• To inform the design of data instruments compliant with revised SPD 15 requirements.

Main Methods:

• A race and ethnicity questionnaire was developed, consolidating questions, adding a Middle Eastern or North African category, and including disaggregated options based on local ancestries.
• Surveys were administered to attendees of virtual and in-person health information sessions in the New York City metropolitan area between March 2022 and March 2023.
• Primary outcomes included disaggregated race and ethnicity response rates analyzed by race, ethnicity, age, education, gender, and language.

Main Results:

• A total of 984 paper and 335 online surveys were collected in English and Spanish.
• Black or African American respondents were least likely to provide granular racial or ethnic identification.
• Younger adults and Spanish speakers showed higher likelihoods of selecting disaggregated race and ethnicity options, with variations between paper and online formats.

Conclusions:

• Inclusive survey designs are crucial for obtaining precise health data.
• Findings support the development of SPD 15-compliant data instruments for use in communities with medical and government mistrust.