County-Level Data Shows Racial, Ethnic Disparities in COVID-19 Cases

April 27, 2020 - County-level data collected during the COVID-19 pandemic has revealed staggering racial and ethnic disparities in care, with the virus disproportionately impacting black and Hispanic populations.  

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A new report from the Commonwealth Fund shows that COVID-19 is more prevalent and deadly in US counties with higher black populations. While African Americans make up about 30 percent of the population in Chicago, they account for 68 percent of the city’s COVID-19 deaths. The team found similar patterns in Milwaukee, New Orleans, Michigan, and other places.

“Troubling racial inequalities have emerged in the COVID-19 pandemic; city and state health departments have raised alarms about the impact on communities of color,” Laurie Zephyrin, MD, David C. Radley, Yaphet Getachew, Jesse C. Baumgartner, and Eric C. Schneider, MD wrote.

“Not long after the virus started spreading, counties with relatively larger black populations faced higher case counts, higher COVID-19-related mortality, and a faster pace of progression compared to counties with a lower share of black people.”

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Researchers analyzed county-level COVID-19 case and mortality data, and paired it with county-level population demographic information. Using this data, they were able to compare the COVID-19 experience in counties with either a higher- or lower-than-average African American population.

The group found that in counties with a relatively larger black population, more people are sick with COVID-19 and mortality rates are higher.

By April 21, high-concentration black communities saw 422,184 confirmed COVID-19 cases and 27,354 deaths, compared to 378,667 cases and 16,203 deaths in low-concentration black counties.

The 681 high-concentration black counties account for only about a third of the US population, but 53 percent of the cases and 63 percent of the deaths nationally.

“These trends — especially the diverging mortality between these groups of counties — should raise alarm bells. To address them, we need more consistent data collection and transparency on the impact of COVID-19 among communities of color,” the authors stated.

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The group noted that although the CDC has started releasing national data on race and ethnicity, recently two-thirds of the reported cases failed to specify the race of the individual.

“Going forward, the United States needs to mandate standardized collection and reporting of COVID data by race and ethnicity to provide a clear national picture of the disproportionate impact of the pandemic on communities of color,” the researchers concluded.

“Only then will federal and local leaders be able to ensure resources for testing, treatment, and recovery are targeted to communities and people most affected by this pandemic.”

Hispanic populations have also been disproportionately affected by coronavirus. Researchers in Texas recently found that the Hispanic population in Travis County has been contracting COVID-19 at a growing rate since April 8.

The data was collected by a team from Central Health, a public organization that connects low-income and uninsured individuals to healthcare services.

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On April 8, 33 percent of all coronavirus cases in Travis County were Hispanic patients. By April 20, that percentage had risen to 41 percent, and by April 23, to 46 percent.

Travis County’s estimated doubling time, or the number of days for the number of cases to increase by a factor of two, has risen for two straight weeks.

“Doubling time gives us an indication of continuous growth or stagnation. The growth has slowed considerably,” said Sarita Clark-Leach, the Central Health director of analytics and reporting.

However, researchers found that some of the county’s poorer ZIP codes and neighborhoods are experiencing the most dramatic percentage increases in rates. According to documents from Central Health, the St. John’s neighborhood saw a 187.5 percent increase in confirmed COVID-19 cases from April 13-20, a doubling time of 4.59 days.

A nearby ZIP code experienced a 64.9 percent increase in cases from April 13-20, with an estimated doubling time of 9.7 days.

In comparison, ZIP codes that contain downtown Austin and North University neighborhoods either experienced no increase in cases, or saw declines in the number of confirmed COVID-19 cases per capita.

These county-level findings reveal that states and communities should prioritize the collection of race and ethnicity data throughout the pandemic.

In a recent report from the American Association of Nurse Practitioners (AANP), researchers argued that capturing race data about COVID-19 cases and outcomes will be essential to overcoming health equity issues highlighted during the outbreak.

“Sadly, the health disparities making the news today aren’t new or specific to COVID-19,” said AANP President Sophia L. Thomas, DNP, APRN, FNP-BC, PPCNP, FNAP, FAANP.

“The time for waiting is over. We need immediate solutions to the disparities ravaging the health of at-risk populations.”