Background
The Massachusetts Department of Public Health (DPH) envisions an equitable and just public health system that supports optimal health and well-being for all people in Massachusetts, centering those with systemically and culturally oppressed identities and circumstances. According to the United Health Foundation America’s Health Rankings, Massachusetts is consistently one of the healthiest states in the nation. However, that achievement belies the existence of health inequities, particularly racial inequities. DPH is dedicated to understanding the root causes of inequities seen in communities across Massachusetts and taking action to eliminate them. We have prepared this Racial Equity Data Roadmap to outline ideas, suggestions, and best practices for using data to help close gaps in health outcomes by race and ethnicity.
To achieve this goal, DPH is addressing structural and institutional racism and the ways in which systems and policies advantage certain groups and disadvantage others. DPH acknowledges racism is a public health threat. Hence, an explicit focus on racism allows for the development of frameworks, tools, and resources that can be applied to racial inequities impacting health outcomes. This also provides the opportunity to better understand how racism influences public health so actionable strategies and solutions can be identified.
Importance
On March 25, 1966, in Chicago at the 2nd National Convention of the Medical Committee for Human Rights, Dr. Martin Luther King, Jr. said the following (in part):
"We are concerned about the constant use of federal funds to support this most notorious expression of segregation. Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death. I see no alternative to direct action and creative nonviolence to raise the conscience of the nation."
It has been more than half a century since Dr. Martin Luther King Jr. spoke about the unacceptable racial inequities in health outcomes perpetuated by a system of segregated health care. While progress has been made to integrate the healthcare system, the gap in health outcomes between people of color and white people remains. In some cases, the gap has even widened as new technologies increase the overall potential for health. At the same time, too little has been done to address the history of structural racism that endures in the lives of people and communities of color. By examining the role that data play in perpetuating and failing to address health inequities, we are performing an act of what Dr. King calls “creative nonviolence.” We are explicitly using data to disrupt the status quo, face racial inequities head-on, and inform data-to-action approaches that can be used to test new ideas that may finally lead to all people having the opportunity to reach their full potential for health and well-being.
While the Road Map is intended to improve programs’ use of data to promote racial equity, the concepts and frameworks provided are not limited in their application. The Road Map values and acknowledges intersectionality, and users are encouraged to consider the ways in which health inequities are influenced by interconnected systems of privilege and oppression.
Improving the use of data to inform racial equity work includes collecting and analyzing relevant data, collaborating with communities, framing program data in the context of historical and current policies, and identifying system factors impacting the health of communities. Additionally, it includes asking questions and using tools to aid in root cause analyses, identifying and designing solutions, and developing strategies to address inequities.
The Road Map provides a suggested methodology for programs to assess their progress in addressing racial inequities in service delivery and health outcomes. This is not a rigid process that must be followed step by step. Rather, it is a collection of guiding questions, tools, and resources that can be customized to best suit the needs of programs with different levels of capacity in data analysis, quality improvement, and racial equity reframing techniques. There are multiple entry points to the Road Map so programs may start at different places.
Overview of sections
The Road Map is organized into eight sections. The purpose of each section is outlined below.
For more information on the above infographic, contact REDataRoadMap@mass.gov.
| Road map section | Purpose |
|---|---|
| 1. Applying a racial equity reframe | Describes the importance of centering racial equity when examining health issues and introduces a tool for programs to use in their work. |
| 2. Assessing readiness to use data for racial equity | Encourages programs to use the Racial Equity Program Data Readiness Assessment to better understand which systems are in place that support racial equity work using data. |
| 3. Centering racial equity in data collection | Outlines steps to ensure racial equity is the focus throughout the data collection process. |
| 4. Disaggregating data and assessing inequities | Describes why it is important to look at data in smaller units such as race, ethnicity, or zip code and gives suggestions on how to do this. Provides guidance on comparing data across sub-groups to see whether there are inequities. |
| 5. Contextualizing Data | Provides suggestions on how to describe data with historical and structural context, focusing on engaging the community by sharing best practices on how to meaningfully and authentically engage community members. |
| 6. Prioritizing strategies | Introduces tools to support the process of identifying the most striking inequities and creating a plan to address them. |
| 7. Communicating data | Outlines important questions and things to consider in designing materials used to communicate data to key partners. |
| 8. Moving from data to action | Describes how to plan, put in place, and monitor the impact of interventions to address inequities. |
Foundational terms/phrases
A detailed Racial Equity Glossary is made available online. We strongly recommend you visit the terms on the racial equity glossary as they are important to understand as you move through the Road Map.
Key takeaways
We hope that the collection of guiding questions, tools, and resources offered in this Road Map will help you to take concrete steps to better identify, understand, and act to address racial inequities in program implementation and health outcomes. Using this Road Map will support programs and initiatives to authentically engage the community; frame data in the broader historical and structural contexts that impact health; communicate that inequities are unfair, unjust, and preventable; and design solutions that address the root causes of these issues.
The Road Map is intended to be used in a flexible way that best meets the needs of programs based on their unique goals, structures, and capacity in data analysis and quality improvement. Given that there is much work to be done before racial equity can be fully realized, we acknowledge that the Road Map is a living document that will be updated based on feedback from its users and refined as the practice of using data to inform our racial equity efforts evolves. If there are mistakes, corrections, or new knowledge that can improve this Road Map, please let us know by emailing us at REDataRoadMap@mass.gov.
Thank you for your commitment to eliminating institutional and structural racism to ensure the optimal health of all people.
Acknowledgments
The Racial Equity Data Road Map was initially released in December 2020. This version serves to update and replace the previous version. This update was made possible by Title V interns Nautica Farrell and Orlando Gonzalez-Merino and members of the Racial Equity Strategic Pathway Implementation Team (RESPIT): Oanh Bui, Cheryl Cromwell, Melanie Jetter, Simona Lang, Susan Manning, Paul Oppedisano, Samatha Riley, Christine Silva, Amy Sorensen-Alawad, Sarah L. Stone, Shioban Torres, Mahsa Yazdy, and Megan Young, with support from DPH leadership.
Special thanks to Manwai Leung for her expertise in helping us transition the Road Map to a more accessible, user-friendly web-based format.
Suggested citation: Massachusetts Department of Public Health. Racial Equity Data Road Map. Boston, MA; March 17, 2025.
To obtain additional copies of this report, please contact:
Massachusetts Department of Public Health
Bureau of Family Health and Nutrition
250 Washington Street, 5th Floor,
Boston, MA 02108
Email:REDataRoadMap@mass.gov