A new Oregon Health Authority report on COVID-19 Race, Ethnicity, Language and Disability (REALD) data highlights the inequitable impact of the disease on specific racial and ethnic groups, and challenges faced by those with language, disability and health access barriers. REALD data provide additional details on the race, ethnicity, language and disability of reported COVID-19 cases and health care encounters. REALD data must be collected during a COVID-19 case interview or encounter with a health provider. A COVID-19 encounter is any interaction between a provider and patient for health care services related to COVID-19 and includes ordering a COVID-19 test. In 2020, the Oregon Legislature passed a law (House Bill 4212) that requires health care providers to collect REALD information at health care visits related to COVID-19, and to share this information with Oregon Health Authority (OHA). The new data collection system started in October 2020. “What we are seeing in this report is the importance of rigorous data collection through REALD, and its necessity as a tool to help OHA reach its goal to end health inequities by 2030 because it lets us collect more precise racial, ethnic, language and disability data in Oregon,” said Rachael Banks, OHA’s Public Health Director. “These granular data allow us to understand the health inequities facing Oregonians and the intersection of conditions and unfair experiences that lead to differing health outcomes. REALD allows us to understand which Oregonians face the greatest burden of COVID-19 infections and which groups statewide can access health care for COVID-19-specific care.” The report, published today, calls out several findings: More cases than health care encounters identified as Hispanic and Latino/a/x, possibly indicating insufficient access to testing. Cases and health care encounters preferred more than 100 non-English languages, posing a potential challenge for effectively interviewing people in their own language. More information is needed on English proficiency, interpreter need and disability. With the currently available data, the report shows: Among people who prefer a non-English language, 29.4% of cases and 25.7% of health care encounters either did not speak English well or did not speak English at all. A spoken language interpreter was requested by 12.9% of cases and 54.9% of health care encounters who preferred a non-English language. Most people reported no functional limitations (31.1% of cases, 31.6% of health care encounters). More health care encounters than cases report a disability acquired either before age 19 or at 50 or older, which may reflect coordinated testing efforts in congregate living settings. Future iterations of this report will examine REALD data at the county level; include race, ethnicity and language information from other data sources for a more complete picture; and compare findings to adjunct data sources. The racial or ethnic identity categories in the REALD report differ from the previously published COVID-19 race and ethnicity data, which follow the U.S. Office of Management and Budget (OMB) guidelines used by the Census Bureau. In addition, the disability data collected by REALD provide more detailed information than currently available in OHA’s Weekly Data Reports. The data will be used to 1) identify populations where health inequities are prevalent and affect the ability to access necessary COVID-19 testing and education, 2) quantify the health inequities that many already know from lived experience, and 3) guide the development of culturally specific and accessible services. Collecting REALD data will continue supporting OHA’s strategic goal to eliminate health inequities in Oregon by 2030 and achieve health for all people living in Oregon.
