HHS Implementation Guidance on Data Collection Standards for Race, Ethnicity, Sex, Primary Language, and Disability Status

The purpose of this guidance is to promulgate a set of uniform data collection standards for inclusion in health care or public health program, activity, or surveys conducted or sponsored by the US Department of Health and Human Services (HHS) as required by Section 4302 of the Affordable Care Act (ACA). Additionally, this guidance discusses collecting sexual orientation and gender identity (SOGI) data to promote inclusive and responsible data practices as required by Executive Order 14075. This guidance may also be useful for other HHS data collections.

Overview of Section 4302 of the Affordable Care Act

Section 4302 (Understanding health disparities: data collection and analysis) of the ACA focuses on the standardization, collection, analysis, and reporting of health disparities data.

This section of the ACA requires the Secretary of HHS to establish data collection standards for race, ethnicity, sex, primary language, and disability status. The law requires that, once established, these data collection standards be used, to the extent practicable, in health care or public health program, activity or surveys conducted or sponsored by HHS.

Executive Order 14075 Advancing Equality for Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex Individuals

Advancing equity and full inclusion for lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) individuals requires the Federal Government to develop evidence and use data to measure and address the disparities that LGBTQI+ individuals, families, and households face, while safeguarding privacy, security, and civil rights. Section 11 of Executive Order 14075 lays out several actions with an aim to promote inclusive and responsible Federal data collection practices around sexual orientation, gender identity, and sex characteristics data.

In response to the statutory requirements of the ACA this guidance outlines minimum data collection standards for race and ethnicity, sex, primary language, and disability status. This guidance also includes a resource for collecting, reporting, and safeguarding sexual orientation and gender identity data gathered through surveys, developed by the Office of Management and Budget (OMB) in response to Executive Order 14075.

While data collection alone will not reduce disparities, it can be foundational to our efforts to understand the root-causes, design and implement evidence-based responses and evaluate our progress.

Data Collection Standards

The following standards address the collection of data related to Race and Ethnicity; Sexual Orientation, Gender Identity & Sex Characteristics; Primary Language; and Disability Status.

Race and Ethnicity

All HHS race and ethnicity data collections must conform to OMB’s government-wide standard, Statistical Policy Directive No. 15 (SPD 15): Standards for Maintaining, Collecting, and Presenting Federal Data on Race and Ethnicity. OMB released a revised SPD 15 on March 28, 2024, after an extensive review process including public engagement, research, and field testing. For more details on the review process please visit OMB’s official SPD 15 revision information site.

The 2024 revisions replace and supersede OMB's 1997 Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. The revisions are intended to improve the accuracy and usefulness of race and ethnicity data collected by the federal government.

Key Changes to SPD 15 in 2024

  1. One Question for Race and Ethnicity:
2024 Standard1997 Standard
A single question asking about race and ethnicity. Hispanic/Latino is listed co-equal to the other minimum categories. Individuals are encouraged to choose as many categories as describes their identity.Two separate questions. The first question asked about Hispanic/Latino ethnicity followed by a second question about race.
2024 Standard1997 Standard
A new, distinct minimum category for Middle Eastern or North African (MENA).Individuals with origins in these regions were included in the White minimum category.
2024 Standard1997 Standard
Agencies are required to collect detailed race and ethnicity data beyond the minimum categories unless the data collection effort is granted an exception waiver by OMB.Collection of detailed race and ethnicity information was encouraged but not mandatory.