The coronavirus pandemic has disproportionately affected communities of color, LGBTQ+ and unhoused communities, the elderly and those of lower socioeconomic status.
La Plata County has been no exception.
Disparities in which certain community members face a higher burden of disease and more severe economic consequences exist in La Plata County. They reflect national trends that increasingly show the most vulnerable are the most impacted by COVID-19.
The data available to rural communities does not reveal these disparities, but public health officials say they have seen it on the ground as they have sought to address these inequities.
“We know that these struggles exist in our community,” said Liane Jollon, executive director of San Juan Basin Public Health. “We hear again and again about families that are afraid to get tested, even though everyone’s sick, because they’re afraid of loss of income. We hear about families where there are individuals who have tested positive through exposures at work, or at school, and due to the multi-generational nature of their housing, disease has been passed on to an elder in the family.”
Nationwide, the racial disparities are stark.
COVID-19 infection rates are 3½ times higher for Native Americans than whites, according to a study released in August 2020 by the Centers for Disease Control and Prevention.
Another CDC study released in December 2020 found that younger Indigenous people died from COVID-19 at higher rates than whites. About 35% of Indigenous people who died were younger than 60. For whites, those younger than 60 made up just 6.3% of deaths.
Black people have died from COVID-19 at almost double the rate of white people and are 2½ times more likely to be hospitalized.
Latinos die and are hospitalized from COVID-19 at double and 2½ times the rate of white people, respectively, according to CDC data.
A study by researchers with the National Cancer Institute, National Institute on Minority Health and Health Disparities, and Pacific Institute for Research and Evolution published in Annals of Internal Medicine in October found that excess deaths, a measure of how many additional deaths COVID-19 has contributed, were three to four times higher than whites among Black and Indigenous Americans and about two times higher among Latinos.
“A lot of these trends apply to our community,” said Chandler Griffin, spokesman for SJBPH. “Those groups are a focus of our outreach and equity strategies.”
But in La Plata County, a relatively homogeneous county in which more than 88% of residents are white, according to the U.S. Census Bureau, those racial disparities are less pronounced.
While racial disparities certainly exist, local public health officials have focused more on inequity among other community members.
“What we’ve learned over two years of this pandemic is that many people who have higher income(s) and have more resources available to them were able to really protect themselves and protect their families well from the ravages of COVID,” Jollon said.
Those of lower socioeconomic status, including the unhoused community, who lack the financial security and the flexibility it affords, often bear the brunt of both the health and the economic consequences of the pandemic.
“Right from the very beginning, there has always been more exposure for people with less resources than people with more resources,” Jollon said. “There is not only more opportunity to be exposed to COVID in your work that doesn’t allow for working from home, but also more opportunity to spread it to family members within a smaller footprint household.”
Closely quartered living spaces and limited access to regular testing or hygiene facilities have led to disproportionate impacts on the unhoused community.
A 2020 study of homeless shelters in Chicago by the CDC and the Chicago Department of Public Health found that almost a third of residents tested positive for COVID-19, a higher rate than staff members who worked at the shelter.
Another study by the Coalition for the Homeless in New York using data from New York City found that the sheltered homeless died from COVID-19 at a roughly 50% greater rate than the general public.
SJBPH documented an outbreak of five positive cases at Purple Cliffs in January and February 2021, Griffin said.
Without intervention from SJBPH and other local homelessness groups, in which they offered testing and housing support, the outbreak likely would have been worse, he said in an email.
“We use a lot of resources to reach harder-to-reach populations because if we don’t do that there is tremendous evidence that our less resourced friends and neighbors carry a higher burden of disease,” Jollon said.
While local public health officials say the pandemic has highlighted the same COVID-19 inequities in La Plata County that are happening in the rest of the country, they are relying on anecdotal evidence rather than quantitative data to identify the disparities and the effects they are having on community members.
The problem is that rural communities have fewer ZIP codes than urban areas, Jollon said.
Public health officials use ZIP codes and their demographic data, such as income, education and race, to identify inequity with infectious diseases.
In urban communities with many ZIP codes, they can isolate and compare areas with high deaths or transmission rates.
“In rural communities with our small numbers, it is much harder to break that down,” Jollon said. “We don’t have geographic areas that are so clearly defined by socioeconomic status, or race or ethnicity.”
Lacking concrete data, they have to turn to community organizations to find out how the pandemic has disproportionately affected certain members of the community.
“We hear every day the stories of the struggles that community members who are less resourced are dealing with in this pandemic and it’s absolutely heartbreaking,” Jollon said.
Anecdotal evidence from community groups that the same national inequities are appearing in La Plata County spurred SJBPH to spend significant resources to help those who are disproportionately impacted.
SJBPH worked with the La Plata Family Centers Coalition and Compañeros, an immigrants rights nonprofit, to reach out to the county’s Spanish speaking population for vaccine clinics and education.
The local public health agency offered about 50 vaccine clinics for underserved populations and unhoused people at places such as Purple Cliffs, Manna soup kitchen and Volunteers of America shelters.
They also worked with senior centers, schools, jails and parole organizations, and disability groups to mitigate the disproportionate impact of the pandemic on the vulnerable.
Even with those efforts, the pandemic continues to affect community members in La Plata County unequally.
“We’re certainly not immune in our smaller community to some of those inequitable impacts that are being tracked and reported on at either the state or national level,” Griffin said.
ahannon@durangoherald.com
