Using Available Data to Understand the Health of Racialized Groups of People

What is the relationship between race and health? 

Measuring differences in health between groups of racialized people helps to highlight unfair policy, practice and norms that produce differences in how long and how well people live. In the United States and many other countries, racial and ethnic groups are created to establish and maintain social hierarchies and divisions. The use of power to systematically value and devalue groups of racialized people is called racism. Measures of race and ethnicity can help communities monitor where racism may lead to differential access to societal resources, like high quality education, affordable housing in places where people feel safe and welcome, and economic wealth. Racism shapes community conditions necessary for health and is a fundamental cause of differences in health between racialized groups. People and communities can build power to structure our society so historical and current injustices are addressed and resources are allocated according to need, so that differences between racialized groups can be reduced. 

Race is a construct and the meaning of race categories changes over time. 

In racialized societies, individuals are socially assigned to a racialized group to define a hierarchy of human value and determine resource allocation. Categories of racialized people change over time, and have been based on varying criteria, including nationality, ethnicity, and observable physical traits. As such, racial and ethnic groupings are constructed by society. Because race and ethnicity are social constructs, they reflect the fluidity of societal beliefs, perceptions, and norms. There is no genetic basis for the racial categories currently in use. 

What is the difference between race and ethnicity? 

Race and ethnicity are different forms of identity but are sometimes categorized in non-exclusive ways. Race is a form of identity constructed by our society to give meaning to different groupings of observable physical traits. An individual may identify with more than one race group. Ethnicity is used to group individuals according to shared cultural elements

How is race represented in the 2024 Annual Data Release? 

Determination of race categories happens before data reach County Health Rankings & Roadmaps (CHR&R). Methods for defining and combining race and ethnicity categories can differ between data sources and within data sources over time. To retain as much specificity as possible in our summaries, the race and ethnicity categories presented in the Annual Data Release vary by data source. With a few exceptions, CHR&R adheres to the nomenclature defined by The Office of Management and Budget (OMB): 

  • American Indian or Alaskan Native (AI/AN): includes people who identify as having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment and do not identify as Hispanic. 
  • Asian: includes people who identify as having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam, and do not identify as Hispanic. 
  • Black or African American: includes people who identify as having origins in any of the Black racial groups of Africa and do not identify as Hispanic. 
  • Hispanic or Latino: includes people of Cuban, Mexican, Puerto Rican, Cuban, South or Central American, or other Spanish culture or origin, regardless of race. 
  • Native Hawaiian or Other Pacific Islander: includes people who identify as having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands and do not identify as Hispanic 
  • Two or more races: includes people who identify with more than one of the race categories and do not identify as Hispanic. 
  • White: includes people who identify as having origins in any of the original peoples of Europe, the Middle East, or North Africa and do not identify as Hispanic. 
Limitations:
  • As with all racial categorization systems, OMB categories have limitations and have changed over time, reflecting the importance of attending to contemporary racialization as a principle for examining approaches to measurement.
  • Racial and ethnic categorization masks variation within groups. For example, the Hispanic ethnicity category combines individuals of all race categories; the Black race category combines individuals who are descendants of enslaved persons, immigrants and descendants of immigrants; the white race category includes individuals with origins in Middle Eastern and North African populations who experience racial discrimination in the U.S. in ways that individuals with origins in European populations do not.
  • Individuals may identify with multiple races, indicating that none of the offered categories reflect their identity; where possible, these individuals are included in our summaries as Two or more races.

Race categories in the 2024 Annual Data Release by data source:

Data source: National Center for Health Statistics (NCHS) 

CHR&R measures: Premature Death; Low Birthweight; Teen Births; Injury Deaths; Infant Mortality; Child Mortality; Premature Age-Adjusted Mortality; Life Expectancy; Suicides; Homicides; Firearm Fatalities; Motor; Vehicle Crash Deaths; Drug Overdose Deaths 

This data source provides exclusive race/ethnicity categories; this means that each individual is counted in only one category. 

 

Data source: American Community Survey (ACS) 

CHR&R measures: Children in Poverty; Driving Alone to Work; Median Household Income 

This data source only provides an exclusive race and ethnicity category for people who identify as non-Hispanic white. Race categories other than white also include people who identify as Hispanic and people who identify as non-Hispanic. This means, for example, an individual who identifies as Hispanic and as Black would be included in both the Hispanic and Black race/ethnicity categories. 

In contrast with OMB categories, ACS data may combine race categories for people who identify as Asian and people who identify as Hawaiian & Other Pacific Islander. For measures of Children in Poverty and Driving Alone to Work, CHR&R reports a combined estimate for the Asian and Other Pacific Islander categories; for the measure of Median Household Income, only the Asian category is reported. 

 

Data source: Center for Medicare and Medicaid Services

CHR&S measures: Mammography, Preventable Hospital Stays, Flu Vaccinations 

This data source follows ACS categories and combines the Asian and Other Pacific Islander categories. For this data source, race and ethnicity are not self-reported. 

 

Data source: Stanford Education Data Archive 

CHR&R measures: Reading Scores; Math Scores 

This data source follows the National Center for Education Statistics (NCES) categories which align with OMB definitions. This data source excludes U.S. nonresidents from inclusion in any race or ethnicity category; people who are in the U.S. on a visa or temporary legal status are reported as “unknown race” in this data source.