New Census race category could reveal hidden health disparities

This March, the U.S. Office of Management and Budget (OMB) announced a new race and ethnicity category in the U.S. Census for the first time in decades.

In its updated standards and guidance for reporting and capturing race and ethnicity data across federal agencies, a key change is the introduction of a new “Middle Eastern or North African” (MENA) category. In the past, people with origins in the Middle East or North Africa were grouped into the “white” category. 

The new category is an attempt to better understand the MENA community’s economic well-being, health, education and many other parameters. Before the change, there was “no direct way to numerically count members of this group in official statistics,” the authors of a 2022 PNAS study on the topic wrote. “Therefore, any potential disparities and inequalities faced by MENA Americans remain hidden.” 

Health priorities

Prior to the March announcement, OMB gathered public comments on the need for a MENA category from January to April last year. The majority of comments acknowledged the need for a checkbox, and approximately one-third of them mentioned health as a reason to separate MENA data from white. 

Maternal mortality and mental health were the top two health concerns highlighted in the comments, said epidemiologist Tiffany Kindratt of the University of Texas at Arlington. Differences in maternal health outcomes are well known for Black mothers and American Indian or Alaska Native parents, but not for the MENA community. “We don’t really know much about this population,” Kindratt said. “But the potential difference was known to the people who submitted those comments.” 

Commenters also raised concerns about social determinants of health, such as access to higher education, as reasons to parse MENA data into a separate category. “There were a lot of comments where people would talk about how they were applying to colleges that had a set number of minority students they could accept, but MENA are not considered a minority,” Kindratt said. 

That invisibility makes it near-impossible to know the health of the MENA community. In her research, Kindratt says she’s found the disparity between MENA and white communities is “more similar to other minoritized groups.”

Kindratt’s observation is backed by data from other European and North American countries – nearly all of which separate MENA data into its own category. During the COVID-19 pandemic, for example, data from Toronto suggested that Arab, Middle Eastern, and West Asian communities had higher rates of infection and hospitalization than white communities. 

In various studies in the U.S. and elsewhere, researchers have reported that the MENA community experiences higher rates of heart disease, low infant birth weight, depression, and worse health outcomes than the white population. 

Finding stories

Dive into databases: Although the Census itself does not gather health information, many national surveys of health, such as the American Community Survey, the Medical Expenditure Panel Survey, Child Health Survey and others will now be required to have a MENA checkbox for race and ethnicity information. Race and ethnicity categories from the Census are also used to analyze funding, community needs and trends for Medicaid, community mental health services, housing grants, and the Supplemental Nutrition Assistance Program (SNAP). Groups like the American Medical Association have already begun to update how they gather MENA data. Journalists might find newsworthy trends in disease incidence, rates of vaccination and other preventive care, maternal health outcomes, and other aspects of MENA health. 

Seek out new research: Newly funded research projects offer exciting story fodder for journalists wanting to cover MENA health outcomes. The National Institute of Minority Health and Health Disparities funds research focused on racial and ethnic minority groups, which are defined by the OMB standards. Until recently, researchers wanting to study the health of MENA Americans have been unable to qualify for such funding. “In the past, I’ve emailed them about specific grants and was actually told that MENA was not a priority population,” Kindratt says. In June, the agency announced a call for grants that included MENA. “It’s really exciting to see the awareness and ability to have funds allocated to this population start to trickle in.”

Focus on social factors: MENA individuals have often experienced greater levels of discrimination after socio-political events such as 9/11, the subsequent “war on terror,” and the ongoing Gaza conflict. “Even though not all MENA individuals come from Muslim countries, these types of incidents have really shaped how their health tends to differ from that of white communities,” Kindratt said. Now, MENA data on education, housing, and income will be visible for the first time, making it possible for journalists to connect the dots between these social factors and health outcomes. Go local: States like Michigan have used an “Arab” ethnicity checkbox in past years, Kindratt said, and might be among the first to update how they gather MENA data. Information from such states might offer a glimpse of what journalists might seek out in reporting nationwide trends. MENA community organizations and advocacy groups could also offer valuable story leads.