EDITORIAL
Proposition 54 and public health
The San Francisco Chronicle
August 18, 2003
STATE HEALTH leaders, angered and confused by Proposition 54, are concerned that the so-called Racial Privacy Initiative will impair their ability to accurately assess public health and target services to communities with specific health needs.
The measure, authored by UC Regent Ward Connerly, will be on the Oct. 7 recall ballot. It would prohibit state and local governments, schools and universities – or any agency that receives public funding – from collecting and using data about race, ethnicity or national origin to chart its students, contractors or employees.
"There are all kinds of reasons why one might decide that we don't want a color-blind government. But . . . the medical issue is the most bogus," Connerly recently told The Chronicle. He contends the measure excludes "all things medical" and, at any rate, allows the Legislature, by a two-thirds vote, to remedy any "unintended consequences" by making more exemptions if they serve "a compelling state interest."
Opponents fear the measure will impede efforts to end racial imbalances in housing, education, law enforcement and more. But it's especially harmful to public health, according to medical experts statewide who say its exemption for "medical research subjects and patients" is too narrow and vague.
Indeed, all top health officials in the nine-county Bay Area maintain that it is difficult to gauge its ultimate impact because it doesn't clearly delineate what types of information gathering would be permitted.
They're certain, however, that it would be impossible to get an accurate picture of public health and craft prevention strategies or prescribe treatments without the racial data compiled on basic government records – particularly birth and death certificates. For example:
-- Sickle-cell anemia is more prevalent among African Americans. Without racial data on birth records, health officials would have a much harder time detecting, tracking or treating certain diseases in the future. Today, for instance, if sickle-cell anemia shows up in a screening of a white child, doctors immediately suspect it's a "false positive," and test again rather than begin costly and probably unneeded treatment.
-- Similarly, birth and death records have revealed persistently higher rates of infant mortality among African Americans, especially with women in lower income groups. Alameda County has responded to this crisis -- which became clear through government records -- with a variety of services, including help with unemployment, transportation and substance abuse problems. As a result, there hasn't been an infant death within the group for more than three years. Los Angeles has a similar program.
"I'm sure these are unintended consequences," said Dr. Tony Iton, Alameda County's health officer. "But there are several thousand types of uses for the information and it's virtually impossible to bring them all to the Legislature.  Besides, what position would the Legislature be in to determine if they violated the intent of Proposition 54?"
Then there's the unduly onerous prospect of getting two-thirds of the Legislature to agree.
The data ban could also threaten the ability of counties to get federal funding to target race-specific health problems. Counties need the demographic data to support their requests for grants. Alameda County, for example, gets about $25 million, a fourth of its $100 million health budget, from such grants.
Health issues are not color-blind – and government records often provide essential warnings and clues about how and when diseases are afflicting various demographic groups. Public-health experts present a compelling case that Proposition 54 would block the collection of this vital information. Ignorance is not bliss.