Covid-19 Deaths by County Characteristic — Above Average White, Hispanic, and African American Counties

Acknowledgment

This US County health analysis is dedicated to individuals who are the victims of the Covid-19 virus and to all the people working hard to keep our US Counties safe and nourished.

Takuo Aoyagi, an inventor of the pulse oximeter, an ingenious and indispensable medical device that measures oxygen in the blood and has become a staple of hospitals around the world, emerging in recent months as a key tool in the fight against the novel coronavirus, died April 18. He was 84. Washington Post

Summary

This analysis uses County statistics to report on public health outcomes relating to the covid-19 crisis. The hope is that this information will help support community investment decisions by Federal and County administrators to improve resident health services and public health. This analysis examines covid-19 death rates in Counties with above average White, Hispanic, and Black American populations.

In summary, Counties with above average White American populations (85% or more White American) are faring well in the covid-19 crisis. In fact, among the lowest median income US Counties, death rates are 10 times lower in those with above average White American populations than in all other low-income Counties. Public health expert guidelines would suggest that better diet and exercise coupled with better health services contribute to these positive outcomes.

Counties with above average Hispanic American and African American populations have had much worse outcomes. In mid-size population Counties with above average Hispanic American populations (18% or more Hispanic American) there are 2 times more deaths per 10,000 residents than in other Counties of similar size. Even among America’s highest median income Counties, where they are also above average African American populations (13% or more African American) they also have 3.3 times as many covid-19 deaths per 10,000 residents than other high-income Counties. Most alarmingly, 7 times more deaths per 10,000 residents occur in above average African American population Counties that have the lowest median incomes compared to all other Counties with the lowest incomes — residents of these counties have a 600% higher likelihood to die from a covid-19 infection. Above average Hispanic American and African American Counties require community investment in parks, nutrition services, hospitals, health clinics, and contact tracing if the US wants all Counties to prosper free from the virus. Resources and investments are needed so those that are under-served can take ownership of and sustain a future of more positive outcomes.

The chart illustrates the pattern this analysis focuses on showing States ranked from low-to-high by the population percentage having died from covid-19. On the left, those States with above average percent White American populations tend to have the fewest covid-19 deaths. States on the right, with the highest covid-19 death rates, tend to have lower percentages of White Americans but high percentages of Hispanic and African American populations. The trend lines suggest the tables are tilted in favor of states with large White American populations — the ones on the left with the fewest covid-19 deaths per 10,000 residents.

State Characteristics Percent White, Hispanic, and African American for States Ranked from Low-to-High Covid-19 Death Percent of Population

Prosperity is more complex than just consumption, because we’ve learned from the covid-19 crisis that a healthy and safe workforce is required to sustain consumer economies. A question: can US economists measure our markets and can shareholders value our corporations in ways that account for not just the goods and services they create but also for the value they contribute to sustainable community health and well-being?

Analysis of Covid-19 Deaths — Data as of May 7, 2020

The pandemic has fallen heavily on 6 NY state counties which are part of a group of 44 large US metropolitan “A” Counties with 1 million residents or more. The chart below shows they account for 28% of the US population and 47% of covid-19 deaths to date — 2.2 times more deaths per 10,000 residents occur in “A” Counties than in the rest of the US. When New York state is removed, however, the rate of covid-19 deaths is the same for “A” Counties as for the rest of the US.

However, on removing New York state, another imbalance comes to light. For 228 “B” Counties with between 250,000 to 1 million residents, excluding New York state, then 2.1 times more covid-19 deaths occur for every 10,000 residents than the rest of the US. The spread of covid-19 is predicted by more than population density alone.

US Population and Covid-19 Deaths by County Size Group

To better understand these imbalances, this analysis begins with the US Counties with the fewest covid-19 deaths — the above average White American population Counties. In the graph below, US Counties are split into two groups with the results for above average White American population Counties highlighted (orange). Above average white population Counties experience 70% fewer deaths per 10,000 residents than the remaining US Counties (see Analysis Approach section at end of this report for more on death rate ratios). These covid-19 death rates suggests that above average White American population Counties have made the kinds of public health and health care investments that the rest of US Counties must also now begin to be able to make.

Counties where White Americans are 85% or more of the population (orange)

County median income bands, with roughly 80 million US residents living in each, rank US Counties from high-to-low median income. Currently, 90% fewer deaths per 10,000 residents occur in the lowest median income Counties that have above average White American populations compared to other low median income Counties — these are also more rural Counties where the virus has yet to spread. These have been some of the healthiest Counties in the US during the covid-19 crisis.

Counties where White Americans are 85% or more of the population (orange) — ranked by County Median Income band

If relatively few covid-19 deaths occur in above average White American Counties they must be offset in either above average Hispanic American or African American population Counties.

Above average Hispanic American population Counties account for 39% of the US population and they have 2.1 more deaths for every 10,000 residents than the rest of the US. The previously mentioned imbalance in “B” County covid-19 deaths appears in above average Hispanic American populations where 2 times more deaths per 10,000 residents occur compared to other “B” Counties.

Counties where Hispanic Americans are 18% or more of the population (orange)

When Counties are ranked from high-to-low median income the rate of covid-19 deaths is consistently higher than their population share would suggest. Even among America’s top median income Counties, those with above average Hispanic American populations experience 1.4 times more covid-19 deaths per 10,000 residents compared to other other high-income Counties.

Counties where Hispanic Americans are 18% or more of the population (orange) — ranked by County Median Income band

Counties with above average African American populations account for 37% of US residents. All things being equal, one would expect the same percent of covid-19 deaths, however, 2.6 times more deaths occur per 10,000 residents of above average African American population Counties compare to other US Counties. The chart below is a mirror image of what is illustrated above for above average White American Counties where fewer, not more than expected covid-19 deaths occur.

Counties where African Americans are 13% or more of the population (orange)

Above average African American population Counties with the highest median incomes also suffer. The chart below illustrates they experience 1.8 times more deaths per 10,000 residents compared to the rest of US’s highest median income counties. Most dramatically, in the lowest income Counties, 7 times more deaths occur per 10,000 residents of above average African American population Counties than all other Counties —residents have a 600% higher chance of death than other low-income Counties. These are some of the least safe Counties to live in during the covid-19 crisis.

Counties where African Americans are 13% or more of the population (orange) or not (blue) — ranked by Median Income band

(Race and ethnicity are defined separately on the US Census so that many Hispanic residents can also report their race. As a result, when population and death figures are combined from this analysis they may end up being larger than the national totals.)

Counties with above average White American populations are faring well during the covid-19 crisis. Counties with above average Hispanic American populations, especially “B” Counties, and all above average African American population Counties are not. They require more investment in programs designed to help their communities improve their public health and health care services sustainably in the future.

Analysis Approach

This is one of a series of analyses that relate covid-19 deaths to key County health and demographic characteristics, such as cancer death rate or percent of adults over 60. Each analysis focuses on Counties where the health or demographic characteristic is higher than some “average”. The “average” is defined here as the characteristic’s incidence or percentage — think of average cancer death rates or percentage of adults over 60 — that accounts for roughly 1/3rd of the US population when the Counties that qualify are pooled together. Covid-19 deaths are then totaled for Counties that come in above or below the “average”.

Side-by-side bar charts illustrate how Counties are faring in the covid-19 crises when grouped by size of population and median income and split by those above and below the characteristic’s “average”.

The numbers also tell a story as 1/3 versus 2/3 population comparison is written as an population ratio of 0.5 : 1. Of course, these ratios change as the data and the populations change. Take, for example, the ratio that helps us compare the covid-19 death rates for Counties with above average percent adults over age 60 to those with below average percent adults over 60. All things being equal, the ratio of covid-19 death rates should match the ratio of the County populations. Typically it won’t: “For Counties with 1 million or more residents, the covid-19 death rate ratio of those with above average percent adults over age 60 to that of the remaining Counties with 1 million or more residents is 1.2 : 1. In other words, residents living in Counties with above average percent adults age over 60 have a 20% higher chance of a covid-19 death than residents living in the remaining Counties that have 1 million+ population. They are younger.”

Here’s an example. First, the covid-19 death rate is computed by the covid-19 deaths divided by population. For the entire US, as of today, the covid-19 death rate is 0.02% = 80,140 / 325,719,178, meaning 2 out of 10,000 residents have died. Next, we create the covid-19 death rate ratio by comparing the death rates of the Counties with and without the characteristic. In this example, the 1.2 : 1 ratio reported for “A” Counties with above average percent adults age over 60 is the ratio of covid-19 death rates of the with the characteristic and those without, or, in this case, 1.2 = (3,522 /7,585,831) / (33,043/ 85,069,756). The 1.2 represents the numerator, or counties with the characteristic, and the 1 represents the denominator, or the counties without the characteristic.

Example: “A” Counties where Adult Age 60+ is 23%+ of County population

Update on Past Analyses

Above Average Minority Counties. US counties where populations of African American or Hispanic are 50% or above the US averages — that is, 19%+ for African American or 27%+ for Hispanic — have 43% of the US population and account for 52% of US covid-19 deaths. We note that D Counties with above average Minority populations also have very large covid-19 death rates (bottom orange bar at right), though this is a small number overall. Note this chart will be replaced with the current analysis charts next week.

Counties with 19%+ African American or 27%+ Hispanic (orange) or not (blue) by County Size

Age 60+. 35% of the US population live in older Counties defined as above average Age 60+ populations (orange bars on the left graph). Since 8 of 10 covid-19 deaths are adults 65 years and older Counties with above average Age 60+ populations, especially C and D Counties, are vulnerable in the covid crisis.

Counties where Adult Age 60+ is (orange) or is not (blue) 23%+ of County population by County Size

Heart Disease. It may seem like Heart Disease is a “city problem”, and it is, even when New York state is removed most covid-19 deaths are found in counties with above average Heart Disease deaths. Populations in rural C and D Counties with above average Heart Disease deaths also have relatively more covid-19 deaths. These Counties also have older age populations.

Counties where Heart Disease causes 0.2% or more population deaths (orange) or not (blue)

Cancer. The above average Cancer death Counties (orange bars in the charts) account for 38% of the US population and 27% of covid-19 deaths. The chart shows that above average Cancer deaths trends with covid-19 deaths. When New York state is removed, however, the share of covid-19 deaths exceed the population percentage of above average Cancer death Counties among the 38 remaining “A” counties. These Counties also have older age populations.

Counties where Cancer causes 0.19% or more population deaths (orange) or not (blue) by County Size

More on County Groups, more on the US Excluding NY

3,142 US Counties are geographic and administrative districts for which lots of statistics are gathered, including covid-19 deaths. Each County can be characterized as urban and rural, and they range in population from 10.2 million (LA County, CA) down to 88 (Kalawao County, HI) residents. In these reports, comparisons are made between four groups of counties depending on population size and by median income bands, as indicated in the chart axes.

New York state accounts for 6% of the US population and disproportionately more covid-19 deaths, so it is useful to consider total US results excluding New York state. This is done in the chart below which shows a disproportionate majority of covid-19 deaths occurring suburban B Counties across the US but excluding New York State (second bar on right graph).

US Population and Covid-19 Deaths by County Size Group — Excluding NY State

What Next?

In future reports we’ll continue to examine county health statistics that might help put covid-19 statistics in helpful light.

Some other measures that may tell the developing covid-19 story:

  • How do Covid-19 deaths change when adjusted for the first date one was reported?
  • Do Counties’ previous flu or respiratory deaths tell us about County covid-19 death rates?
  • Do County median income or education tell us about the likelihood of covid-19 deaths?
  • Do results change if we use the exact density of County population instead of County Size?
  • Do average temperatures or levels of particulate matters matter?

If you have any questions about this analysis or the data, or if you have suggestions, please don’t hesitate to contact me.

-Pete

Sources: US Census, USA Facts Covid-19, IHME forecasts, US Cancer Deaths NIH 5 year average, CDC Handbook on Death Reporting, 2003; New York Times; Median Income; CDC Wonder Detailed Mortality; CDC Fine Particulate Matter 2003–2011

Originally published at http://pinpointtargeting.net on May 7, 2020.

Experienced analytic consultant at Epsilon and Time Inc. His mission is to create value and strategic insight from data analytics.