Collecting and analyzing race and ethnicity data in highly diverse communities: Challenges and strategies for healthcare systems

It is well established that disparities in healthcare access, utilization, and health outcomes exist among racial and ethnic minorities in the United States. In order to identify and address such disparities, healthcare systems must collect race and ethnicity (RE) information from patients. The Office of Management and Budget (OMB) provides standards for RE data collection, but the standards use broad categories that mask the cultural diversity within racial/ethnic groups. Furthermore, some populations do not identify with any of the standard RE categories. To address these limitations, the Cambridge Health Alliance (CHA), a Massachusetts safety-net network of three hospitals and 15 primary care clinics, institutionalized a policy of collecting detailed ethnicity information from patients in addition to the OMB standard RE items. Comprehensive collection of this information has enabled CHA to analyze data at a granular level and gain a detailed understanding of disparities within its highly diverse patient population. This presentation will discuss CHA’s approach to RE data collection and analysis, including challenges and strategies. Selected examples will be used to illustrate the limitations of the OMB categories for CHA’s patient population, and the presentation will highlight health disparities that have been identified through the use of detailed ethnicity data. Collection of RE data beyond the OMB standard categories will become essential as the United States population grows increasingly diverse, and CHA’s approach to RE data collection and analysis can be replicated by other healthcare systems seeking to better understand the populations they serve and provide culturally appropriate, equitable services.