By Whitney Hodges
A lot remains unknown about the novel coronavirus that created the current pandemic. One thing stands out, however. COVID-19 has managed to cross all boundaries, infecting all age groups, celebrities, socialites, and the highest ranking government officials in addition to traditionally vulnerable communities here and abroad.
While infection rates have varied both regionally and internationally, the severity of the disease has also varied from one person to another. Typical of many common viral diseases, more adverse COVID-19 outcomes have been associated with the presence of pre‐existing noncommunicable diseases, such as high blood pressure or chronic illness. While the virus may appear to be indiscriminate, the evidence continues to demonstrate that socioeconomic and racial disparities are exacerbating the impacts and spread of COVID-19.
Socioeconomic status is calculated based on a number of factors including education, social class, and income. Historically, lower socioeconomic status can have a considerable impact upon health in various ways, particularly comorbidity and recovery. Additionally, substandard housing conditions and smaller living spaces associated with lower-income individuals and families are common factors that lead to increased exposure rates. With regard to respiratory infections, studies have shown people from impoverished backgrounds experience a higher incidence of disease as well as more severe levels of infection.
While not distinguishing rates on a micro-socioeconomic level, the County of San Diego has nevertheless been tracking the impact of the virus according to race and region. By mid- October, the County reported approximately 50,000 confirmed cases of COVID-19 with a little over 800 COVID-19 fatalities. Although residents who self-identify as Hispanic or Latinx represent 34.5% of the County’s population, this community has been disproportionately impacted by COVID-19, representing 62% of all confirmed County cases. This equates to a COVID-19 infection rate of approximately 2,312 individuals for every 100,000 Hispanic/Latinx people, or 2.3%. Blacks or African Americans, who represent 4.4% of the County’s population, are reporting an infection rate of 1,066 per 100,000 Black individuals, or 1%. Conversely, residents who identify as white comprise the largest ethnic group in the County, at 45.7% of the population, but represent only 25.1% of confirmed County cases, slightly less than a 0.7% infection rate.
Moreover, the two regions reporting the largest number of COVID-related deaths — South and East County with 246 and 194 deaths, respectively — are also home to the County’s lowest per capita personal incomes. On the other hand, the coastal regions, which are typically enclaves for the County’s wealthiest communities, report the lowest number of COVID-related deaths, with 62 deaths in North Central County and 53 deaths in North Coastal County.
In addition to the imbalances related to infection and recovery, stark inequities in access to the resources required to navigate the pandemic persist for those in communities with lower socioeconomic indicators. Historically, in the United States, communities disproportionately affected by poor health outcomes include non-white communities, as well as undocumented populations, front-line low-wage workers, people experiencing homelessness, and justice-involved populations. This disproportionality is primarily the result of longstanding inequities in an array of health determinants, including limited access to health care — especially primary care — and limited access to affordable housing and nutritious foods. Additionally, the United States Centers for Disease Control and Prevention (CDC) has reported that racial and ethnic disparities in the COVID-19 pandemic may in part be due to socioeconomic disadvantages that require individuals to continue to work outside their home and a lack of paid sick leave. Globally, the United Nations also confirms this pattern, finding the impacts of COVID-19 disproportionately affect the poor and vulnerable.
This pandemic has already proven to be incredibly disruptive to the global economy, unfortunately, also further exacerbating the disparities between economic sectors, countries, and regions, hence driving down socioeconomic indicators. Social distancing, self-isolation, and travel restrictions have led to a reduced workforce across all economic sectors and caused many jobs to be lost. Schools have closed down, and the demand for commodities and manufactured products has decreased. In contrast, the need for medical supplies has significantly increased, and agricultural sectors have faced increased demand due to panic-buying and stockpiling of food products. In response to this global outbreak, COVID-19 will likely have socioeconomic effects on most, if not all, individual sectors of the world economy.
Whitney Hodges (whodges@sheppardmullin.com) is a partner in the Real Estate, Land Use and Natural Resources Practice Group in Sheppard, Mullin, Richter & Hampton LLP’s San Diego office.