Report Shows How Social Factors Affect COVID-19

A new report look at how race, income and other factors have influenced who is more likely to get  COVID-19 and shows that the picture is far more complicated than first thought. Indeed, at this point it is white people in the county who are suffering the highest case levels.

The report comes from faculty at the Medical College of Wisconsin, UW-Milwaukee, and public health employees from various health departments throughout the county. This group includes people that develop the county’s weekly local COVID-19 data report. The report breaks down the data by race and ethnicity, income and social vulnerability and whether someone is an essential worker. In all categories the incidence of diseases has changed greatly since the early days of the pandemic.

Social Vulnerability

The researchers mapped data at the level of census tracts onto the measures in the CDC’s Social Vulnerability Index (SVI). This index uses 15 “social factors” to determine the social vulnerability of a population. These factors include the level of poverty, crowded living quarters and car ownership.

Social vulnerability was measured out in the report among four quartiles, from lowest to low-medium, high-medium, then highest.

Early in the pandemic, it was people with the highest levels of social vulnerability who were experiencing the most cases of COVID-19, but as the pandemic went on, that changed. When the July surge hit, it was no longer the people with the highest social vulnerability experiencing the most cases of COVID-19, but rather people with the second lowest social vulnerability — the low medium group. All four groups are now seeing a spike in cases but the low medium group still ranks first, followed by the lowest or least vulnerable group. Both groups now have rates higher than for the more socially vulnerable. 

Household Income

Household income is one indicator that has, mostly, not changed throughout the pandemic. Through every surge, those in Milwaukee with the lowest median household income have had the highest number of cases, and hospitalizations. In the beginning this group had the most deaths by a long-shot, but recently, the income group with the highest number of deaths has fluctuated and all income quartiles have seen a spike in death. 

However, when looking at the rate of deaths per 100,000 people, it is people in the highest median-household quartile that are currently experiencing the highest rate of death. Something that also occurred during the surge in May.

Essential Workers

Another population the report looked at was essential workers. The report measured what percentage of a census tract worked in jobs classified as essential.

When the pandemic first hit, areas with the highest percentage of essential workers had the highest cases, hospitalizations and deaths.

The surge in May hit essential workers hard, as areas with the highest percentage of essential workers had the most deaths and the highest rate of death compared to areas with fewer essential workers.

But a shift occurred during the July surge, when areas with the least essential workers began to spike and by September passed the case level for census tracts with the most essential workers. Since then the two groups have traded the lead for most cases. But again, all four groups have seen the rate spike in the last month or two.  

Race and Ethnicity

Early on, the county’s Black population was very hard hit, with the highest case numbers and hospitalizations and deaths. As the pandemic went on this changed. The county’s Hispanic population started to show a rate of disease much higher than other groups. More recently the county’s white population began to see the most cases, hospitalizations and deaths. But Black people are still experiencing the highest rate of hospitalization.

Surges Show Changing Dynamics

Mid-summer is when a lot of things changed. It’s when the county’s white population passed the Hispanic population in case numbers and those with the highest social vulnerability were no longer experiencing the highest case rates and deaths.

Looking at the data, it becomes clear that no one surge is the same. In this latest surge, the populations experiencing the highest rates of death are areas with the least number of essential workers, people with the highest median household income, people with the lowest social vulnerability and the county’s white population — quite the opposite of what was happening in March when the virus first hit.

But one thing that is the same is that the burden of disease is going up during this latest surge: everyone is seeing a spike in cases. In that sense we are all equal, even though the case rates have varied over time depending on who we are and what neighborhood we live in. 

You can read the full report here.