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COVID-19 More Prevalent, Deadlier in U.S. Counties with Higher Black Populations

Black man wearing mask in the Bronx during the COVID-19 pandemic
Authors
  • Laurie Zephyrin, M.D.
    Laurie Zephyrin

    Senior Vice President, Advancing Health Equity, The Commonwealth Fund

  • David Radley
    David C. Radley

    Senior Scientist, Tracking Health System Performance, The Commonwealth Fund

  • Yaphet Getachew
    Yaphet Getachew

    Former Program Associate, Health System Equity, The Commonwealth Fund

  • Jesse Baumgartner
    Jesse C. Baumgartner

    Senior Research Associate, Health Care Coverage and Access & Tracking Health System Performance, The Commonwealth Fund

  • Eric C. Schneider, M.D.
    Eric C. Schneider

    Executive Vice President, Quality Measurement and Research Group, National Committee for Quality Assurance

Authors
  • Laurie Zephyrin, M.D.
    Laurie Zephyrin

    Senior Vice President, Advancing Health Equity, The Commonwealth Fund

  • David Radley
    David C. Radley

    Senior Scientist, Tracking Health System Performance, The Commonwealth Fund

  • Yaphet Getachew
    Yaphet Getachew

    Former Program Associate, Health System Equity, The Commonwealth Fund

  • Jesse Baumgartner
    Jesse C. Baumgartner

    Senior Research Associate, Health Care Coverage and Access & Tracking Health System Performance, The Commonwealth Fund

  • Eric C. Schneider, M.D.
    Eric C. Schneider

    Executive Vice President, Quality Measurement and Research Group, National Committee for Quality Assurance

Toplines
  • Counties with a higher-than-average share of black residents have been disproportionally burdened by COVID-19

  • A new analysis shows there are more COVID-19 cases and related deaths in counties with higher-than-average black populations

Troubling racial inequities have emerged in the COVID-19 pandemic; city and state health departments have raised alarms about the impact on communities of color. In Chicago, African Americans make up 30 percent of the population but 68 percent COVID-19 deaths. Similar trends exist in Milwaukee, Michigan, New Orleans, and other locations.

We analyzed county-level COVID-19 case and mortality data, and paired it with county-level population demographic information. This allowed us to compare the COVID-19 experience in counties with either a higher- or lower-than-average African American population.

The results are stunning. More people are sick with COVID-19 — and death rates are higher — in counties with a relatively larger black population. From the time COVID-19 took hold in the United States and community spread of the virus became evident, communities of color have been disproportionally burdened by the disease. The exhibits show this clearly: diverging trend lines highlight a widening disparity between counties with higher and lower shares of black people.

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. 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 U.S. 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 CDC began releasing national data on race/ethnicity. But as of this week 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. 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.

The authors acknowledge the research and editorial assistance of Sara Collins.

Publication Details

Date

Citation

Laurie Zephyrin, et. al., "COVID-19 More Prevalent, Deadlier in U.S. Counties with Higher Black Populations," To the Point (blog), Commonwealth Fund, Apr. 23, 2020. https://doi.org/10.26099/y3xs-qr19