September 26, 2003
The Honorable Tommy G. Thompson
Department of Health and Human Services
200 Independence Avenue, SW
Washington, D.C. 20201
Dear Secretary Thompson:
The National Committee on Vital and Health Statistics (NCVHS) through its Subcommittee on Populations continues to assess the adequacy of federal data to document and monitor the health of racial and ethnic minorities in the United States and its territories. Such data are necessary to monitor the Department’s strategic plan to eliminate health disparities. These data also can be used to determine the extent to which Departmental initiatives are contributing to the health needs of specific racial and ethnic minorities.
The single most compelling and recurrent request that the Subcommittee heard in its four recent hearings is for the collection and analysis of health data on subgroups of specific racial and ethnic minorities, especially those concentrated in geographically distinct areas. These data are urgently needed to adequately monitor the health status and health care quality of the diverse US population. Those who provided testimony (e.g., American Indians and Alaska Natives, Native Hawaiians, Asians and Pacific Islanders) indicated that the lack of quantitative data both hampered their planning and delivery of health care in their communities, and put them at a serious disadvantage in their attempts to compete for State and federal funding. Convincing cases were made at the hearings for periodic health surveys that could be used by specific racial and ethnic minorities in their communities.
Based on what the Subcommittee learned from these hearings, the NCVHS recommends that HHS should:
- Develop a long- term data collection, analysis and dissemination plan to ensure that the nation’s system for monitoring the health status and health care of its subgroups of specific racial and ethnic minorities, especially those concentrated in geographically distinct areas is sufficient in quantity and quality.
- Devise sampling frames for national health surveys that would increase sample sizes for racial and ethnic minority groups that would support appropriate analysis and information dissemination.
- Conduct targeted surveys to collect detailed, timely, and accurate data on specific subgroups of specific racial and ethnic minorities, especially those concentrated in geographically distinct areas. These surveys should use methods similar to the large national surveys so the resulting data can be compared with national data.
- Use of defined, targeted studies to complement and augment the large national studies would, in effect, provide an integrated national data system for a more comprehensive assessment of the health status and health care delivery of the overall population.
- Develop methods and procedures to expand access to data, while assuring confidentiality, to enable monitoring the health status and health care delivery for racial and ethnic minorities.
- Collaborate with States, Territories, Tribal governments, private foundations and other stakeholders to develop methods, procedures and resources to accurately collect health data that ensures that the diversity of the US population is adequately represented. As a specific example, States need financial and technical assistance to complete the development and adoption of an electronic vital registration and statistics system that will include the implementation of revised U.S. Standard Certificates of Birth and Death. Revising this system will ensure that higher quality and more timely data are available for the most basic health events–birth and death.
There are many special considerations for collection of high quality data on racial and ethnic minorities. In additional to statistical sampling issues, these include cultural proficiency (concepts, methods, outreach, selection and training of interviewers); adequacy and availability of translation; and insuring community involvement in outreach, and translation of research into policy and practice. Support for methodological research is essential in order to determine the most effective way to meet these goals.
We recognize that financial resources are limited, but compelling evidence shows that specific racial and ethnic minority populations experience poorer health and inadequate health care. Consequently, we urge the Department to request adequate funding to support the above recommendations. These recommendations are consistent with those made in a recent General Accounting Office report to Congress. The NCVHS believes that these recommendations will make a significant contribution to the important HHS goal of eliminating racial and ethnic disparities in health, as well as disparities based on other factors.
Thank you for your consideration of these recommendations.
John R. Lumpkin, M.D., M.P.H.
Chair, National Committee on Vital and Health Statistics
cc: HHS Data Council Co-Chairs