Apr 4, 2020 - Health

Coronavirus hits poor, minority communities harder

Illustration: Sarah Grillo/Axios

The coronavirus doesn't discriminate, but minorities and low-income families are bearing the brunt.

Why it matters: The impact of the coronavirus is reflecting the racial and socioeconomic disparities of the cities where it’s spreading and the health care system that’s struggling to contain it.

The big picture: New York Gov. Andrew Cuomo last week called the virus “the great equalizer,” because anyone can get it. And while it’s true everyone’s at risk, New York itself is a stark illustration of just how unequal the virus’ toll really is.

  • The highest concentration of cases in New York City are in neighborhoods in Queens with large immigrant populations and low average incomes, according to city data analyzed by the Wall Street Journal.
  • And New York is not alone.

By the numbers: Nationwide demographic data aren’t available, and the quality of state and local recordkeeping varies widely. But the clear trend in preliminary data from multiple metro areas is hard to ignore.

  • The county that contains Charlotte, N.C. is about 33% black, but black residents make up roughly 44% of its coronavirus cases, according to the Charlotte Observer.
  • In Michigan, the highest concentrations of cases are in largely black, largely poor counties around Detroit. African-Americans make up a plurality of both cases (35%) and deaths (40%) in the state.
  • Milwaukee County, Wisconsin is just 26% black, yet African-Americans account for almost half of the coronavirus cases and 80% of the deaths, according to ProPublica.
  • In Illinois, African Americans make up 14.6% of the population, but 28% of confirmed cases.

The catch: Researchers would need better data to fully confirm this trend, but these initial signals from multiple cities align with almost everything we know about who’s most at risk.

  • “Even though we can’t necessarily perfectly understand the racial disparities in COVID risk and death once infected, we know all the other risk factors that increase the risk of getting covid and increase the risk of complications are higher for these groups,” said Hedwig Lee, a researcher at Washington University in St. Louis.

A slew of pre-existing disparities are contributing to this coronavirus disparity.

  • African-Americans are more likely to have several underlying health conditions, including heart disease, diabetes, hypertension and some cancers that can make COVID-19 infections more severe.
  • Lower-income areas — which tend to have larger non-white populations — have less access to health care services and the quality of that care is often worse than what wealthier parts of the countries receive.
  • Lower-income workers are less likely to have health insurance. They’re also less likely to be able to work from home, and therefore more likely to have to keep going to work and putting themselves at risk.
  • Substandard housing, multiple families living together, and homelessness all facilitate the virus’ spread.

What’s next: “In terms of who is at risk, who gets sick — it is too late. But there are things we can do to mitigate the impact,” said Lehigh University’s Sirry Alang, who studies health disparities and inequities.

  • She says they include incorporating voices of people of color in shaping a response of justice and equity, forming alliances with organizations in communities to communicate messages about prevention and treatment from trusted messengers and a commitment to “small things” — providing transportation to people who might be sick, public housing.

The bottom line: “It's a precarious time for people who are already vulnerable,” Alang said.

Go deeper

U.S. coronavirus updates

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Andrew Witherspoon/Axios. This graphic includes "probable deaths" that New York City began reporting on April 14.

More than 100,000 Americans have died of the coronavirus, according to data from Johns Hopkins — a milestone that puts the death toll far beyond some of the most tragic events in U.S. history.

By the numbers: Over 1.6 million have tested positive in the U.S. Nearly 354,000 Americans have recovered and over 15.1 million tests have been conducted. California became the fourth state with at least 100,000 reported cases of the coronavirus on Wednesday, along with Illinois, New Jersey and New York.

The pandemic’s health side effects are growing

Illustration: Sarah Grillo/Axios

Nearly half of Americans said that either they or someone in their household has skipped or delayed needed medical care because of the coronavirus, according to new polling by the Kaiser Family Foundation.

Why it matters: Shutting down elective medical care may have been necessary, particularly in coronavirus hotspots, but will have lasting effects on some patients.

Fauci: Data is "really quite evident" against hydroxychloroquine for coronavirus

Anthony Fauci told CNN Wednesday that the scientific data "is really quite evident now about the lack of efficacy" of hydroxychloroquine as a coronavirus treatment.

Driving the news: The comments came in response to news that France on Wednesday banned the use of hydroxychloroquine to treat the virus, after a large retrospective study in The Lancet found an increased risk of heart problems and death among coronavirus patients who took the anti-malarial drug.