Neighborhoods with low incomes or higher rates of social vulnerability suffer the impact of the pandemic more intensely, reveals a study published in the Annals of Internal Medicine . The authors confirm with data something that is easy to intuit, and that is that people in more precarious situations or social exclusion have a greater epidemiological risk : they are more exposed to infection, many times they have more difficulties to comply with isolation or quarantine measures , and there are also delays in the diagnosis or in the identification of contacts.
Scientists analyzed available data on diagnostic tests performed, confirmed cases, and deaths from COVID-19 based on zip code from March to December 2020 in three major American cities: Chicago, New York, and Philadelphia. The team compared these numbers with data from the 2018 Social Vulnerability Index from the Centers for Disease Control and Prevention, including socioeconomic status, household data, minority status, language spoken, type of housing and transportation. The results confirmed that the markers of the impact of the pandemic are grouped into neighborhoods, such that lower-income neighborhoods and minority communities experienced worse outcomes than predominantly wealthy and white neighborhoods.
“We have been documenting the possible existence of these disparities since the early days of the pandemic,” explains Usama Bilal, assistant professor at Drexel’s Dornsife School of Public Health. “We now have comprehensive data on some of the deadly effects of residential segregation, structural and environmental racism, and economic injustice in the ongoing pandemic.”
COVID hot spots
The document highlights where COVID-19 hot spots are located in major cities and shows that social inequalities in COVID-19 outcomes, in positivity, incidence and mortality, are concentrated in specific zip codes and are strongly associated with the social vulnerability.
“The pandemic has highlighted, once again, how the social determinants of health, including social and economic inequalities, as well as structural racism, have profound effects on health,” says Ana V. Diez Roux dean of the Dornsife School of Public Health.
Great inequalities, also in health
“We have seen similar disparities with HIV and other health problems, but the pattern becomes clearer in an international health emergency that would be difficult to control if not controlled everywhere,” Bilal said. ” We need more testing, vaccination, but also better working conditions with expanded access to personal protective equipment, paid sick leave, and more investment in low-income communities .”
The authors note that these inequalities are likely much larger than what was found in the study as a result of the lack of widespread systematic testing in many cities in the United States.
