From PhiladelphiaNeighborhoods.com:

Aug. 12, 2020

Statistically speaking, Old City residents are less likely to catch COVID-19.

In zip code 19106, Old City, where median household income is $109,393 and 77% of the population is non-Hispanic white, according to the U.S. Census Bureau, a little more than 100 residents tested positive for the virus since the start of the pandemic, according to city data. Thirteen residents were hospitalized and none have died, according to the data.

Further northwest, in the West and East Oak Lane neighborhoods that comprise the 19126 zip code, median household income is $41,266 and 95% of the population is nonwhite or Hispanic. Here, infection rates are significantly higher. In Oak Lane, nearly 600 residents have tested positive for COVID-19, approximately 374 cases per 10,000 residents, compared to Old City’s rate of about 87 cases per 10,000 residents. In Oak Lane, 26% of those infected were hospitalized, and 93 have died.

The stark contrast between Old City and Oak Lane shows how disparities between neighborhoods amplify the coronavirus’ uneven toll. Data from the Philadelphia Department of Public Health (PDPH) and U.S. Census Bureau, analyzed by Philadelphia Neighborhoods, shows Philadelphia’s poorer, browner, and more densely populated zip codes have borne the brunt of the virus.

The findings are consistent with city data showing higher infection rates among African-Americans and Hispanics.

Last week, the PDPH outlined a racial equity plan that expands testing sites in minority and low-income communities, and targets public health messaging in those communities. The plan also includes provisions for protecting essential workers, who are disproportionately people of color.

What the data shows

At the individual level, demographics do not make someone more susceptible to becoming infected, Michael LeVasseur, an epidemiology and biostatistics professor at Drexel University, said. But, “certain social conditions,” he said, can increase the probability of encountering someone else who is.

Residents in Philadelphia’s poorer zip codes are more likely to test positive for COVID-19 and be hospitalized as a result than those in wealthier neighborhoods. Those residents also mostly lived in larger households. Epidemiologists generally agree infectious diseases like COVID-19 spread most rapidly between members of the same household, which might explain why the virus has moved so rapidly in poorer neighborhoods.

The positive test rate generally corresponds with larger average household sizes in Philadelphia, as the maps below illustrate.

“It’s not necessarily that having a low income makes you more likely to have an infectious disease,” Krys Johnson, a professor of epidemiology and biostatistics at Temple University, said. “It’s that the low income dictates where you live, how you’re able to eat and exercise, and those things make you more at risk for infectious diseases.”

Experts knew well before COVID-19 racial and ethnic minorities have less capacity to withstand pandemics due to structural inequality and health disparities. COVID-19 has infected and hospitalized African Americans more than twice as often as whites in Philadelphia, according to data from the PDPH. The data also show Hispanics are more likely to be infected and hospitalized from COVD-19 than whites.

Residents in zip codes with higher percentages of Black residents also experienced higher infection rates and were hospitalized more often from COVID-19. In a city with 16 majority-Black zip codes, nearly every one of them had a higher rate of cases per 10,000 residents than the citywide average of 200.

Tracking rates of infection among the Hispanic community, by zip code, is less clear. The community is dispersed across the city, and there is only one majority-Hispanic zip code, 19133, which includes parts of Fairhill, Glenwood and West Kensington.

Separated by age, case data from the PDPH show Hispanics 75 or older experience the highest rate of infections of any group in the city, followed by African Americans 75 or older and Asians 75 or older ranking third.

Hispanic and Black communities are more likely than white communities to have higher rates of major chronic diseases, which explains why minority communities also have more COVID-19 hospitalizations, Usama Bilal, an epidemiology and biostatistics professor at Drexel, said.

“All of those things are interconnected,” Bilal said. “The same neighborhood where there is a higher likelihood of spread is also the neighborhood where people that are more vulnerable to COVID-19 have severe consequences.”

The higher amount of stress racial minorities experience in their daily lives can make them more susceptible to severe outcomes, like hospitalization and death, when they contract COVID-19, Johnson said.

“People who are persistently stressed because they are in survival mode financially, because they are systematically discriminated against, are going to have more negative consequences of an infection and be more likely or less likely to be able to fight off an infection before it becomes a dire situation,” she said.

Public health officials were originally concerned about the availability of COVID-19 tests in minority and low-income communities in the early days of the pandemic.

In March, testing availability was more limited in poorer zip codes than wealthier ones in Philadelphia, a study Bilal co-authored found. However, the gap closed almost entirely by mid-May, according to the study, and recent data show little disparity from neighborhood to neighborhood.

The PDPH’s racial equity plan set a benchmark of growing testing sites from 56 to 75, though its timeline is unclear. The city has also hired a diverse group of contact tracers who speak multiple languages to alert those infected with COVID-19 or exposed to someone with the virus, according to the plan.

City officials and members from Philadelphia-based nonprofit, academic and healthcare organizations comprise the team that oversees the Racial Equity Plan, wrote James Garrow, a PDPH spokesperson, in an email. The group meets every month to review the plan’s progress, said Cheryl Bettigole, the director of the division of chronic disease and injury prevention in the PDPH.

“We don’t have the luxury of waiting,” Bettigole said. “We need to act to do the things we can do in the short term to mitigate risk and also really elevate the work that needs to be done in the longer term.”

Methodology: Case, test, hospitalization and death data by zip code retrieved from opendataphilly.com. U.S. Census data retrieved from censusreporter.com.

Case per population data may differ from the Philadelphia Department of Public Health due to differing sourcing of U.S. Census data.

Data is current as of 8/11/20.

Please email any questions or concerns about this story to: editor@philadelphianeighbors.com.

This story was originally published by PhiladelphiaNeighborhoods.com.

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