Correcting the Record: MENA Data Collection in the 2025 American Community Survey
The 2025 American Community Survey is adding a Middle Eastern or North African (MENA) category in line with OMB's 2024 Statistical Policy Directive No. 15, not dropping it. However, broader threats to federal data—including potential reductions in SOGI data collection—remain, impacting health equity for marginalized groups.
This entry corrects an earlier error. The OMB's 2024 Statistical Policy Directive No. 15 explicitly added MENA as a distinct race/ethnicity category, and the 2025 American Community Survey (ACS) is implementing that change. While an informational copy of the ACS published by the Census Bureau does not yet reflect the new combined race/ethnicity question format, the MENA category is being added, not removed. This is a long-overdue improvement for tracking health disparities, economic opportunity, and civil rights enforcement for Middle Eastern and North African populations.
However, the broader federal data landscape remains under threat. The KFF report notes that "there also may be reductions in the availability of SOGI data moving forward," given the administration's actions to suppress or halt sexual orientation and gender identity (SOGI) research. Combined with the politicization of the CDC and NIH, this pattern erodes the statistical foundation needed to identify and address health disparities for LGBTQ+ communities and other underserved groups. Accurate data is infrastructure: without it, we cannot measure or correct inequities. Defending SOGI data collection and ensuring the MENA category is fully implemented are both critical to health equity.
The humanitarian alternative
The legitimate policy goal—reducing unnecessary doctor visits for routine refills—can be achieved without removing physician oversight or creating a regulatory void. Congress and the FDA should create a tiered clearance framework for narrow AI applications like refill authorizations, requiring: 1) real-time integration with the patient's pharmacy and lab records to screen for contraindications, 2) a documented, auditable step where a pharmacist or nurse practitioner—not an algorithm alone—signs off, and 3) a requirement that the patient receives a plain-language explanation of the automated decision with an opt-out mechanism. This preserves the convenience benefit while maintaining a human-in-the-loop safeguard.
Falsifiable predictions
What this entry claims will happen, and what data would prove it wrong. The Reckoner revisits these against current reality.
- Within 12 months, a patient in the Utah pilot will suffer a preventable adverse drug event due to an AI-authorized refill that ignored a new contraindication.
- The FDA will issue a guidance document or an enforcement action targeting state-level AI refill programs within 18 months.
Original source — excerpted
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