May 13th, 2021

By Kristen Honey, Chief Data Scientist and COVID-19 Diagnostics Informatics Lead, COVID-19 Testing and Diagnostics Working Group (TDWG); Joshua Prasad, Director of Health Equity Innovation, Office of the Chief Data Officer (OCDO); Jack Bastian, Data Engineer, HHS Protect, Office of the Chief Data Officer (OCDO)

The federal government is moving forward on its goal of delivering an equitable pandemic response, and is specifically eager to do this by addressing the social determinants of health, or the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

The COVID-19 Pandemic has exacerbated disparities driven by these conditions in many ways. Black, Indigenous, Latinx groups have been hit harder by the virus, in addition to a plethora of rural communities across the country. These come from social factors that stem from historic and contemporary inequities that result in them living in more crowded conditions or might include working service jobs that they make isolation impossible. They are working jobs that they can’t afford to miss, are perhaps more reliant on public transportation, or living in areas that have higher levels of air pollution or effects of climate (another area HHS is committed to solving) – the list goes on.

Despite knowing these factors, public health needs the tools to be able to better prepare and respond in both the short term and long-term inequity. HHS has taken a long-standing approach to help empower communities, but also researchers, scientists, governments with data-driven methods to be able to build better public health and social determinant solutions. To achieve this, government must better understand who the most impacted communities are in the country from a broader social perspective.

The pandemic has made it clear that a good high-speed internet connection is a crucial part of life. Virtual school. Telework. Telemedicine. In a time when the best clinical advice is to not meet in person, the internet has become a staple of healthcare delivery. Over the past year, CMS has expanded permissibility of types of services and platforms that are reimbursable for telehealth. However, if there isn’t reliable internet available, these reimbursable services remain inaccessible. Fortunately, Coronavirus relief funding has directed several key stakeholders like the Federal Communications Commission (FCC), the U.S. Department of Agriculture (USDA) and the Health Resources and Services Administration (HRSA) to work collaboratively to expand access to broadband internet.

The HHS COVID-19 Diagnostics Informatics team worked with FCC and the HHS Office of the Chief Data Officer (OCDO) to organize, synthesize, and crosswalk geospatial information into indices for community vulnerability based on several key open datasets that were defined in some of this grantmaking. The resulting open data is a machine-readable dataset, called the COVID-19 Community Vulnerability Crosswalk on HealthData.gov, which creates a snapshot of several key factors related to geography, demographics and socioeconomics:

These areas are weighed based on the parameters and overlap, to better illuminate the most under-resourced parts of the country, down to the census tract. Taking a page out of healthcare’s book for hot spotting that helped identify “super-utilizer” patients, this dataset can help public health and cross-sectoral designers and problem-solvers to better allocate resources, attention and solutions for both the pandemic response as well as long term public health planning and sustainability.

This goes well beyond healthcare: the ability to remote work, virtually attend school, or even mitigate the effects of social isolation is reliant on a strong internet connection. These all impact individuals, families and communities’ lifestyles, health and well-being as much as, or even more, than healthcare access. By some estimates, social & non-clinical factors impact something like 80% of an individual’s health status. Fortunately, the FCC and other federal partners have taken steps to expand funding for these types of connectivity into schools, libraries and other key areas, and this is just a first start to chipping away at all the social impacts on our health and wellbeing. It is imperative that the federal government look upstream by equipping communities to build solutions that work for them and stay committed to ensuring that as all Americans emerge from their isolation, so too do equitable social and economic solutions.