Calif. Dept. of Public Health slammed over LGBTQ data collection

Issues impeding SOGI data collection had flown under the radar until COVID

By MATTHEW S. BAJKO

The state’s auditor has faulted the California Department of Public Health for being sclerotic with its eff orts to collect LGBTQ demographics and criticized the agency for having inconsistent policies on how local health officials should be gathering such information.

In a report released Thursday, the auditor suggested lawmakers need to take additional legislative steps to address the ongoing issues with the collection of sexual orientation and gender identity data.

“The lack of consistent SOGI data collection procedures, and ultimately the low number of Public Health forms that currently collect SOGI data, indicate that changes to state law may be warranted to compel more consistent and useful SOGI data collection practices,” concluded California State Auditor Grant Parks in an April 27 letter he submitted to state leaders.

export the SOGI data it collects for over 100 of the 128 reportable disease conditions to an electronic database it oversees.

“Public Health has only made SOGI data available to the public from 17 of the forms we reviewed, and it has not reported directly to the Legislature any SOGI data from the forms we reviewed,” noted Parks.

As the Bay Area Reporter has noted in numerous articles over the years, SOGI data collection remains woefully inadequate and plagued with technical problems at every level of government. Even in San Francisco, where the city’s public health department has been on the forefront of LGBTQ health issues, the local agency has been criticized for its inability to collect the SOGI data of the people it treats and provides services to across its multiple health centers and programs.

San Francisco offi cials and state lawmakers nearly a decade ago had mandated that health offi cials begin collecting SOGI data. But almost immediately the eff orts ran into problems, from how to word the questions asked of patients to needing to update the electronic data record systems health agencies use so the SOGI data could be entered.

Outside of LGBTQ circles, the issues impeding SOGI data collection had largely fl own under the radar until the COVID pandemic hit in 2020. The global health crisis brought to the fore just how blind health offi cials remain about the needs of LGBTQ people.

statement he called the audit fi ndings “extremely concerning” and renewed his demands on health offi cials that they do a better job on SOGI data collection.

“The Department of Public Health continues to use an overly narrow approach to SOGI data collection, which prevents us from understanding the full health needs of the LGBTQ community,” stated Wiener. “The Department needs to institute a centralized, comprehensive approach to collecting this data, update its data collection and analysis systems, and require data collection from third parties. I’m seriously considering legislation to implement the Auditor’s recommendations.”

In a response to Parks dated April 7 and released publicly Thursday, state Public Health Offi cer Dr. Tomás J. Aragón pledged that the statewide health department would address the SOGI data issues raised in the auditor’s report.

“We believe in the importance of collecting SOGI data to identify disparities and acting to change inequities in California’s health systems,” wrote Aragón, who is also director of the state public health department and formerly worked for the San Francisco public health department. “Best practices related to SOGI data collection are evolving. Public Health will continue to strive to achieve and improve compliance in our data collection eff orts and overall use of data to advance health equity in California.”

Titled “The California Department of Public Health: It Has Not Collected and Reported Sexual Orientation and Gender Identity Data as State Law Intended,” the 45-page report detailed myriad problems with the state agency’s SOGI data eff orts. Out of 129 forms used by CADPH, 105 were exempted from collecting SOGI data because a third party, such as a local health jurisdiction, oversees them, found the audit.

“This exemption severely limits the amount of SOGI data the department is required to collect,” Parks noted in a fact sheet accompanying his report.

Even with the 24 forms that are required to collect SOGI data, the auditor found only 17 “do so in a complete manner.” Parks’ report also noted that “because of resource and technical limitations,” CADPH is unable to

Despite a California law signed by former governor Jerry Brown that had mandated the state’s departments of health care services, public health, social services, and aging begin gathering SOGI data in 2016, state health offi cials did not know how many LGBTQ residents of the Golden State were infected with the deadly coronavirus when it began ravaging the state three years ago. To this day, no such data is available.

Nor is it known how many LGBTQ people died from COVID or have gotten vaccinated for it. The lack of such data persists despite state lawmakers adopting a bill in 2020 requiring health offi cials to collect it.

Fed up with the situation, a number of LGBTQ state lawmakers in 2021 had called for an audit of the SOGI data collection eff orts. Among them was gay state Senator Scott Wiener (D-San Francisco), who has been a vocal critic about the lackluster LGBTQ demographic data collection in California for the last three years and authored the 2020 bill requiring SOGI data collection pertaining to communicable diseases.

Wiener could not immediately be reached for comment Thursday regarding the auditor’s report. But in a

Aragón noted that the state health agency had “substantially complied” with the original SOGI legislation Assembly Bill 959, known as The LGBT Disparities Reduction Act. He listed, for example, CADPH adding SOGI questions to its Confi dential Morbidity reports and updating the California Reportable Disease Information Exchange known as CalREDIE so it could receive data from local health jurisdictions.

Nonetheless, he acknowledged that the auditor’s report highlighted other issues that need to be addressed “that go beyond the requirements” of AB 959, which had been authored by San Francisco City Attorney David Chiu when he served in the state Assembly. Aragón committed to reviewing the auditor’s recommendations and to reporting on the state health department’s progress within 60 days as well as in six months and next April.

“We acknowledge and appreciate the insights shared in the audit report. Public Health will both work to improve our own eff orts, as well as support local health jurisdictions and health care providers to collect this data,” he wrote.

(This article was previously published by the Bay Area Reporter and is republished with permission.)