The following is a letter addressed to Dr. Stephen Munday, Imperial County Health Officer, regarding advancing equity issues pertaining to the pandemic response. A PDF copy of the letter can be found here.
April 9, 2020
Dr. Stephen Munday
Imperial County Health Officer
Imperial County Public Health Department
935 Broadway Street
El Centro, CA 92243
Sent via e-mail
RE: Advancing equity issues pertaining to the pandemic response
Dear Dr. Munday,
On behalf of the ACLU of San Diego and Imperial Counties and Planned Parenthood Action Fund of the Pacific Southwest we wish you and your family health and wellness as you grapple with the COVID-19 virus firsthand. We write to lift-up key concerns pertaining to issues of equity, which are too often cast aside during emergencies. We believe that under your leadership, Imperial County can lead the state in protecting public health while upholding our shared values throughout the response.
Increasing transparency regarding COVID-19 testing, positive cases and deaths in Imperial County
We request that the County provide additional demographic data (in a way that protects privacy) associated with COVID-19 testing, positive cases, hospitalizations and deaths disaggregated by race, ethnicity, gender identity, disability, primary language, socioeconomic status and whether or not the person was an essential worker (broken down by industry). We were glad to see that the County has a new COVID-19 dashboard which includes breakdowns in categories such as age group, gender, presence of symptoms, and patients’ disposition as a part of the daily updates and believe this additional information we are requesting will help to provide a clearer picture about how COVID-19 is impacting our communities.
This past week we have seen experts from around the Country sound the alarm about how the response to COVID-19 is revealing biases in our healthcare system and the need for agencies to track and share data that will allow for informed responses. As you may have seen, last week Senator Elizabeth Warren and Congresswoman Ayanna Pressley called on the federal Department of Health and Human Services to focus on racial equity in its COVID-19 response by requesting that state and local governments collect data to make it possible to discern whether there are racial disparities in access to COVID-19 testing in communities nationwide. Recent reporting from the New York Times also highlights the need to understand the impact of COVID-19 on communities of color before it is too late. UN human rights experts in a statement urged governments to commit to racial equity and racial equality because of the threat posed by structural racial discrimination and the potential for it to exacerbate inequality in access to health care and treatment.
While we know that anyone can contract the virus, we also know that the impacts on communities of color and other vulnerable populations could be severe. We’ve already begun to learn about these disparities in other parts of the country for example, Milwaukee’s African American community has been hit particularly hard, leading the numbers of deaths in the state. People with disabilities are among those at the greatest risk during this crisis because of several factors including: being more likely to have underlying health conditions, being economically disadvantaged, being dependent on others for care, or simply because people with disabilities are disproportionally placed in institutions, incarcerated, or homeless. Understanding the impact of COVID-19 on essential workers can also help to inform responses. This includes our hardworking first responders, healthcare workers, restaurant and grocery store workers, farmworkers, and all other essential workers. The COVID-19 pandemic has placed a spotlight on the important role that essential workers have in our day-to-day lives and the fact that they are at greater risk of becoming infected with the virus. But without data, we won't be able to take the necessary steps to protect their health. It's our responsibility to not leave our frontline behind.
It’s also crucial that our county government do everything in its power to ensure equitable access to testing and treatment during this pandemic. We cannot manage what we do not measure.
Ensuring an equitable response to COVID-19 in Imperial County
Another key equity issue pertains to the distribution of personal protective equipment and ventilators across the county. Given the potential for a lack of adequate resources, it is important for the County to focus on equity when determining which health clinics, communities, or people obtain personal protective equipment and ventilators. Distributions must be based on need determined by a consistent, fair, and transparent process, not economic or any other social status. To the extent that need will be determined by testing, the county must ensure that test kits are equitably distributed, taking into account the ability of people with limited English proficiency to advocate for themselves.
In order to promote just and fair inclusion for everyone in society, including access to health care and equitable health outcomes, we call on you to take immediate steps to expand your dashboard data to include additional demographic data mentioned above. Thank you for your tireless work to respond to this crisis and for your assistance in helping us and the public better understand the County’s response to this crisis. We look forward to your response.
ACLU of San Diego & Imperial Counties
Darrah DiGiorgio Johnson
President and CEO
Planned Parenthood Action Fund of Pacific Southwest
Board Chair Luis A. Plancarte
Supervisor Jesus E. Escobar
Supervisor Michael W. Kelley
Supervisor Ryan E. Kelley
Supervisor Ray Castillo