Understanding the Impact of COVID-19 on Communities of Color

The past decade of disaster preparedness has focused heavily on individual and family readiness, focusing on improving the preparedness of households instead of communities and networks. Despite significant efforts, research has shown that these methods are not effective to creating broader community resilience, and the majority of individuals – and communities – are still unprepared.

Recognizing the disproportionate risk and impact on communities of color from the COVID-19 pandemic and seeing the critical opportunity to save lives and address existing disparities in the response (and outcomes) of the pandemic, Healthcare Ready, with support from the Walmart Foundation, sought to characterize communities that are most vulnerable to catastrophic outcomes from the COVID-19 pandemic, and to create an opportunity to shed light on the concerns and needs of communities in greatest need, one year after the start of the pandemic. 

Throughout the pandemic, many Americans found themselves in dire straits as sources of income shuttered, social safety nets became more necessary (but harder to access), and medical care became more complicated to seek and acquire. Economic insecurity led to issues with consistent housing, the ability to procure and pay for medicines or medical treatment, or even just the purchase of necessities. Mental and emotional health needs became pervasive due to the threat of the pandemic itself and the many challenges described above.

Due largely to historical, systemic health and socioeconomic inequities, communities of color and poor communities were much more likely to experience these challenges – on top of greater rates of COVID-19 infection and death. These inequities include higher rates of chronic disease and structural disparities such as lower transportation and healthcare access. These inequities not only directly contributed to COVID-19 infection and death, but also made communities of color and poorer communities more vulnerable to devastating economic and mental health impacts of the pandemic.

Healthcare Ready’s Impact of COVID on Communities of Color (IC3) project aims to identify communities of color most vulnerable to catastrophic impacts of COVID-19.  In partnership with researchers from the University of Maryland and the University of Southern Alabama, we used participatory research practices, coupled with a traditional disaster risk assessment analysis, to assess existing vulnerabilities in the areas of food security, access to medications and health, childcare, employment support, and more.

Read on to learn our approach and see what we found. 

Assessing Vulnerability – Identifying Communities of Focus 

At the start of the project, we set out to determine geographic areas on which to center outreach with the aim of generating deeper, location-specific insights for those areas. To do this, we created an index to illuminate areas of the country that were relatively more vulnerable to negative impacts from disasters and had been disproportionately impacted by COVID-19. The index, which was calculated for all US counties, was comprised of: 

  1. CDC’s Social Vulnerability Index (SVI), which accounts for “potential negative effects on communities caused by external stresses on human health. Such stresses include natural or human-caused disasters, or disease outbreaks” (Agency for Toxic Substances and Disease Registry (ATSDR), 2020). 
  2. Composite Health and Healthcare Index we created for the project, which accounts for the number of pharmacies and hospitals per capita per county and the incidence of chronic conditions (based on Medicaid and Medicare data). 
  3. COVID-19 data from the JHU COVID-19 Dashboard, comprised of COVID case counts, COVID deaths, and deaths per case count per county.

Based on the sum of these indices, we were able to narrow down areas of country for outreach. Finally, these rankings were filtered for counties with a majority nonwhite population. Using this filtered calculation, we chose to focus on East Baton Rouge County, Louisiana, and Hidalgo County, Texas for further outreach. 

Pandemic Polling – Understanding Needs and Challenges 

While working to identify areas of focus, we also developed a reoccurring set of polls at a representative level of the nation and 15 different states with the goal of characterizing the past and expected needs related to COVID-19 of communities and vulnerable populations across the country. The 15 states we chose to poll were chosen based on two purposes – to reflect the geographic diversity of the country and to reflect those states that had been particularly impacted by COVID-19. 

The polls were designed to highlight the challenges faced by respondents through the COVID-19 pandemic, as well as to understand how these challenges were handled by individuals, whether or not they went looking for assistance, if they were successful in receiving assistance, and if the respondents believed these issues would persist. We also asked respondents what barriers they faced that stopped them from getting help during the pandemic.

Demographic breakdowns of all poll results were also collected. Demographics included Race, Income, Gender, and Education.

For a detailed methodology of our polling approach and a full list our poll questions and answers, click here.

Participatory Research – Interviews in Communities of Focus 

Alongside polling, we conducted interviews with representatives from 30 community-based organizations (CBOs) in Baton Rouge, Louisiana and Hidalgo County, Texas. Both regions were selected for this exercise due to being highly ranked on all three indices described above: CDC’s Social Vulnerability Index, Composite Health and Healthcare Index, and COVID-19 case and death rates. In addition to being highly ranked, these areas were selected due to their high exposure to natural hazards, such as hurricanes and flooding.

In total, 17 and 13 CBOs responded to interview requests from Baton Rouge and Hidalgo, respectively, that provide services, such as: Healthcare for low-income populations, housing support, food relief, and 

more. These organizations were identified through a basic Google search of CBOs in the area and through recommendations from the National Voluntary Organizations Active in Disasters (NVOAD). The full list of mission areas represented by CBOs for this project are listed in Table 1, below.  

Table 1: CBO Mission Areas for IC3 Interviews

*This organization also offer services as a homeless shelter.

Several themes on common needs in both regions emerged from the interviews, including the following most prevalent needs for community members: 

  • Widespread food insecurity, including the loss of regular meals through schools for children; 
  • Paying for housing and utilities; 
  • Unemployment / Uncertainty around employment and needs associated with long-term employment;
  • Mental/behavioral health needs;
  • Healthcare;
  • And equitable access to COVID19 healthcare resources 

CBOs also identified areas of need that should be addressed in order to better serve their mission and help their communities recover from the pandemic. They identified increased, sustainable funding, specifically unrestricted funds, and enhanced partnerships as critical organizational needs in recovery from COVID-19. 

The Findings – Data and Analysis

View National or State level breakdowns of the findings by clicking on the drop-down menu below. 

1 Services that provide assistance with basic necessities to low-income individuals

2 Organizations that advocate for various issues in underserved communities

3 Services supporting survivors of sexual trauma, improve systems response, and create social change to end sexual violence

4 Low-cost healthcare services and efforts expanding availability of healthcare[1] Services that support adult education and work skills development

If you are interested in downloading complete data for your own analysis, please contact us at contactus@healthcareready.org.

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