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More than 57,000 people in the United States have been killed by Covid-19. And though the disease does not discriminate, society is rife with underlying conditions that have led some groups to be more at-risk than others.
“All of these disasters wind up exacerbating what does get discriminated against socially. That’s what these disasters expose both past and present. What we’re seeing in the United States is not surprising. The pandemic is revealing a pattern of inequities and discrimination that existed before,” Josh Garoon, an assistant professor in the Department of Community & Environmental Sociology at University of Wisconsin-Madison, said to Direct Relief.
Over the past several years, Direct Relief has tracked these disparities and generated reports for government agencies, health care centers, and emergency planners to help improve situation awareness and thereby optimize their deployment of resources.
For the Covid-19 pandemic, Direct Relief researchers have opened that window to the public by creating an interactive map that allows users to click on any state or county in the United States and see a graphic detailing pertinent data about the most critical social vulnerability determinants for residents of that area.
“This is a situation where people should be talking to each other about factors related to risk and vulnerability in whatever circumstances they’re in: talking to public health departments, neighbors … the map provides a quick, localized view for those conversations,” said Andrew Schroeder, Direct Relief’s vice president of research and analysis, in discussing why his team chose to create the geographic information system (GIS) map, and open it to the public.
“Some people might say about other disasters in the past, ‘Well, that doesn’t matter to me personally … it’s not happening in my neighborhood, it’s not happening where I live.’ But the coronavirus pandemic is different. It’s everywhere. Now you can point to this map and see how many vulnerable people live near you, and what their risk factors are. Everywhere has some people who have disproportionate risks from this virus,” Schroeder said.
A Centers for Disease Control and Prevention’s report found that about 90% of hospitalized patients had at least one underlying condition, 74.5% of hospitalized patients were older than 50 years old, and 54% of hospitalized patients were male—despite making up 49% of residents in the 14 U.S. states that were studied.
The CDC report said that African-Americans have also been “disproportionately affected” by the virus, as they accounted for 33% of hospitalized patients, while comprising only 18% of the population in the states.
Unlike being male, which appears to be a risk factor in this outbreak, Schroeder explained that racial differences represent a more nuanced situation.
“It’s not true, as far as we know, that being African-American makes you biologically more predisposed to getting coronavirus or being hospitalized. However, social, economic and geographic factors related to race do matter.” Schroeder said. “In New York, for example, you have disproportionate numbers of people in the African American community who are still having to commute for work, who are providing services, in the middle to low ranks of health care, or in gig economy jobs, all of which carry a much higher likelihood of exposure, compared to being able to stay at home,” he said.
Garoon said that mandated government shutdowns also have divergent impacts on people, depending on their circumstances.
“If you’re living paycheck to paycheck, when someone says, ‘stay home,’ you are experiencing a much different state of affairs than someone who continues to get paid when they telecommute and has a stable job with benefits,” he said.
“Someone who’s wondering how they can get through everyday life, and now maybe taking care of family members presents a choice to them as if they have options to choose from: if they don’t go to work, they won’t get paid, and might even get fired. They see the unemployment rates,” Garoon said.
“Social vulnerabilities exacerbated by this pandemic are exactly same lines along which we discriminate against everyday,” he said. “Our normal way of life is responsible for how we experience extraordinary event like this.”
Still, Garoon pointed out that in this pandemic, no one is assured of a pass.
“New York City, by being rich and cosmopolitan doesn’t get exempt,” he said. And older people, no matter how wealthy they are, if they get infected, are really at risk of severe realness and dying.”
In assessing the data, both Schroeder and Garoon cautioned viewers of the map to keep all factors in mind when assessing an area, not just the number of ICU beds, for example.
Each state and county report includes data on the number of people who are uninsured, over 65 years old, have a disability, do not speak English, and who do not have a vehicle. The report also details the number of licensed hospital beds, ICU beds and nursing home beds. Additional demographic information includes the total population, median age, households below the poverty line as well as estimates for the number people who are unemployed and the number of people experiencing homelessness. A side graph shows the number of Federally Qualified Heath Center patients suffering from a range of ailments.
The data was pulled from several sources, including the U.S. Census and Definitive Healthcare, and was plotted onto a map using Esri’s ArcGIS platform.
Schroeder said he chose the aforementioned data since “risk factors versus system capacity is the central issue for Covid-19 response.”
Ultimately, Schroeder said he hopes the GIS map helps users better understand how their actions could affect others in their area.
“It’s not an abstract hypothetical group of people that you’re putting at risk if you don’t do your part for the virus. It’s your neighbors, and people in your communities.”
In the same vein, Garoon said the larger pandemic could end up having a silver lining, of sorts.
“We’re getting a better idea of how interdependent we are,” he said.