Report publication date: 12-16-2020
Data as of: [date]
This report was written on 12-16-2020. The data and visuals on this page are updated on a regular basis.
Despite the hope the COVID-19 vaccine rollout represents, these are among the bleakest days of the pandemic. As attention turns toward vaccinations, we must not lose focus on controlling the virus’ spread within California’s most vulnerable communities. In mid-December, the United States reached a grim marker – more COVID-19 deaths in one day than 9/11 deaths. And just this month, we reached another grim milestone – 400,000 total deaths due to the disease. That total is fast approaching the 405,000 U.S. fatalities from World War II.
We know the threat and what to do. California remains at a critical juncture in the COVID-19 pandemic. Roughly one out of every 13 Californians have tested positive for coronavirus at some point during the pandemic, and case numbers have been surging in the past months. Hospitals, funeral homes, and crematoriums are currently pushed to their limits. As this catastrophe plays out, disparate impact on Latinx, Black, Native Hawaiian, Pacific Islander (NHPI), American Indian, and Alaskan Native (AIAN) Californians persists. Every COVID-19 death is senseless and tragic because it could have been prevented by following public health guidance.
Elected officials are locked in a dangerous dance between their public health experts and powerful private interests pushing to reopen businesses and fighting to keep new restrictions from being imposed. It is essential to understand that we cannot begin an economic recovery until the pandemic is contained and under control. Policymakers must re-embrace the expert advice provided by public health officials. Such action will decrease the loss of life between now and widescale vaccine availability.
At the start of the pandemic, acting on sound public health advice, many elected officials in California quickly enacted non-essential business closures and social distance restrictions to reduce the virus’ spread. With time, business interests pushed back against, and in some cases, defied these orders. Unfortunately, too many elected officials have bowed to the pressure and moved to reopen before the public health threat was sufficiently contained. Up until recently, elected officials have navigated the terrain between their embattled public health official’s expert guidance and aggressive business interests with moderate political success.
But the most important measure of success must not be about the impact on the political careers of these officials. Californians of color are paying the cost with their health and lives. Californians of color, compared to white Californians, are more likely to work in low-wage jobs, have an income below the poverty level, and experience food insecurity.i Moreover, Californians of color are less likely to own their homes, have less money left after paying rent, and occupy low-quality housing.ii Black and Latinx low-wage workers have larger gaps between their wages and housing cost than white workers.iii In addition to the economic and housing instability that Californians of color face, they also face healthcare access vulnerabilities as they are less likely to have health insurance, a usual health care source iv, and paid sick leave.v These pre-existing vulnerabilities place Californians of color in the difficult position of having to work in the middle of the pandemic and place them at greater risk for exposure and economic hardship.
Using data from the California Department of Public Health, we show case and death rates by race and ethnicity as they stand now and as they have changed over time. The data reveal how our Native Hawaiian and Pacific Islander (NHPI), Black, and Latinx populations have most consistently borne the brunt of high case and death rates. The consistently high and, at times rising, racial disparities should demonstrate the importance of tracking data by race to determine how our state and local officials can begin reopening our economies while prioritizing all people’s health and safety.
The most recent data show how COVID-19 is having a disproportionate impact on communities of color. Our Native Hawaiian and Pacific Islander, and Latinx populations, have the highest case rates, while these two groups and our Black population have the highest death rates.
Methods: Using case and death counts from the state, we calculate cumulative case and death rates as the number of cases or deaths per 100,000 people of each race and ethnicity. We then compare each race’s case and death rates against the racial group with the lowest rates to determine racial disparities. We include the state’s overall case and death rates for comparison.
This bar chart shows statewide racial disparities in COVID-19 cases and deaths based on the most current data (12-06-2020). Hover over each bar to see how each group’s total case and death rate compares to the lowest rate of the day. Click between the case and death rates to compare the prevalence of COVID-19 cases to disease mortality.
Plotting case and death rates over time reveals a consistency in racial disparities that have also risen to even higher levels throughout the pandemic. When the state first began reporting data by race/ethnicity in April, disparities in cases and deaths were apparent but have only grown over time. Our Black population, followed closely by our NHPI and Latinx populations, has consistently experienced the highest death rates. All the while, case rates for Latinx and NHPI populations have increased rapidly compared to other groups, with dramatic increases during statewide surges.
When we examine average daily rates, we see the disproportionate impact of statewide surges on certain groups. Average daily case rates for our NHPI, Latinx, Black, and AIAN populations have frequently exceeded one of the criteria the state set on August 28th in its Blueprint for a Safer Economy to move counties toward reopening. California’s Blueprint for a Safer Economy established criteria for loosening and tightening restrictions on activities. Counties were assigned to tiers based on their positivity rates, adjusted case rates, and a health equity metric. Reopening case rate thresholds were set at a past 7-day average of 7 new daily cases per 100,000 to move from the most restrictive purple tier to the second most restrictive red tier. This threshold and other criteria indicated that counties could allow certain businesses to reopen with a focus on indoor non-essential businesses.
Our data show that 7-day average case rates for Latinx and NHPI populations rarely dipped below the 7 per 100K threshold and were often far above this threshold even as county economies reopened. Rates for NHPI and Latinx populations have reached levels over three times this threshold throughout the pandemic. This threshold was set after the summer surge and reopenings and applied to county reopenings. However, it serves as a useful reference point to highlight the disproportionate impact on communities of color and how these communities rarely fell to what is currently considered “safer” transmission levels. Additionally, alarming case rates among these communities of color did little to slow the reopening of county economies preceding the fall surge. For many of these communities, policymakers’ best attempts to keep at-risk communities safe have fallen short.
Methods: Pulling data from the state, we calculate cumulative case and death rates by race and ethnicity and the rolling 7-day average of new daily cases per 100,000. We compare rates between groups by taking each racial group’s case or death rate and comparing it to the group currently with the lowest rate. We include the state’s overall case and death rates for comparison.
These line charts show the progression of statewide racial disparities in total case and death rates and 7-day average rates. Click between tabs to see the change in case and death rates over time. Hover over a line to see how each group’s rate compares to the lowest rate of the day.
The charts show fluctuations in our NHPI and AIAN communities’ rates due to corrections in their data reporting that have visible effects on their rates given their relatively smaller populations. Dramatic increases or decreases in case or death rates for these groups should be interpreted with caution.
Consumer spending declined after the state’s first stay-at-home order. Many Californians lost their jobs when businesses halted operations. Despite federal relief, not all Californians who lost jobs due to closures were eligible for unemployment insurance or federal stimulus payments. Many people have fallen behind on rent and struggled to meet their basic needs. Community-driven mutual aid efforts led by long-established community-based nonprofits and emergent organizations had to step in to fill gaps in the government’s social safety net.
Throughout the pandemic, the ability of some to safely shelter at home has been possible only because workers are risking infection to deliver our mail, groceries, and online purchases, provide care for the elderly and perform other essential work. Nationally over 50% of Black, Latinx, and AIAN workers are essential workers or non-essential workers that must work in-person.vi Black and Latinx workers in California have the highest rate of employment in essential jobs.vii Asian, Black, and Latinx workers are disproportionately likely to work in jobs that involve close physical proximity.viii Given these conditions, it is easy to see how the reopening of the economy, along with existing vulnerabilities, put Californians of color at greater risk and lead to disproportionate impact.
We compare 7-day average case rates against holidays, reopenings, and closures to evaluate the impact of reopening businesses on case rates. We focus on reopenings to see how returning people to work, opening more businesses, and overall creating greater movement between people coincided with increased rates among certain groups. We compare periods where just a holiday occurred, or fewer sectors reopened and a holiday occurred to periods with expanded reopenings to try disentangling the effect of reopening larger sectors of the economy. The analysis suggests that the rapid movement to reopen sectors in close succession had a disparate impact on case rates for Latinx, NHPI, and Black populations during the summer surge.
While our analysis demonstrates the impact of reopenings on increasing case rates, other factors have contributed to surges. The current surge that has eclipsed case rates seen over the summer suggests a unique effect from significant fall and winter holidays along with other factors, like mass gatherings. After Thanksgiving and Christmas, there was an explosion in case rates that likely built off the impact of reopenings in September and October. Our analysis provides evidence for the disproportionate impact of surges and specifically reopenings on people of color in the state. The disproportionate impact of reopenings is unsurprising given the role people of color play in essential and non-essential areas of our economy. By occupation, Latinx workers are overrepresented as cooks, food preparation workers, cashiers, stockers, and order fillers, among other occupationsix. Black workers are likewise overrepresented as food preparation workers, customer service representatives, and office clerks. These are some of the positions directly affected by retail and foodservice reopenings in May and June.
Limitations: This analysis does not include the individual reopening decisions made by each county. While the state makes decisions about which sectors counties may consider reopening, counties can impose stricter local guidelines. However, many counties, including the state’s largest (Los Angeles), reopened quickly throughout the summer rather than opting for a stricter approach. Given that LA County is the state’s most populous county and a significant share of total COVID-19 cases, we include key reopening dates for LA County as a reference.
The summer and fall surges were preceded by the reopening of sectors as well as holidays. While holidays occurred throughout the pandemic, holidays alone do not appear to correlate with the fall surge in case rates. Mother’s Day on May 8th and Labor Day on September 7th did not coincide with an increase in 7-day average case rates. Instead, surges seem to follow times where a cluster of reopenings occur in combination with holidays. Using the summer surge as an example, we see that 7-day average case rates by race and ethnicity began to diverge following state reopenings in May and June that occurred before and after Memorial Day, Father’s Day, and the Fourth of July. The growth in 7-day average case rates for the Latinx and NHPI communities outpaced the growth rates for other groups. Wider restrictions that began in August coincided with a downward trend in case rates for all groups, though to a lesser degree for the Latinx community.
The 7-day average case rate for the Latinx and NHPI populations exceeded the state’s current threshold for the most restrictive purple tier before any other group in the July summer surge, and before the state took the more dramatic measure to close the indoor operations of several businesses, including restaurants and gyms, and indoor and outdoor operations of bars and breweries across the state. While the state did not adopt its current tiered system and thresholds until the end of August, these comparisons demonstrate the importance of disaggregating rates by race/ethnicity in determining reopenings as some groups could provide an earlier indication of a changing course in the pandemic. The state’s efforts to account for health equity and require counties to create targeted investment plans have reduced but not eliminated disproportionate COVID impacts on NHPI, Latinx, and AIAN communities during the fall surge.
Methods: We plot 7-day average case rates against holidays and key reopening and closure dates throughout the pandemic. The majority of reopening and closure dates focus on statewide actions, but we include important dates from LA County, given its size. To track reopening and closure dates, we reviewed the Governor’s and State Public Health Officer’s orders and their social media accounts that the state often uses to post updates on reopenings. We also referenced the LA County Department of Public Health press releases to identify dates where LA County opened faster or slower than the state.
Click on and off holiday, reopening, and closure dates to see how dates compare to lows and highs in case rates. Hover over a dateline to learn more about what reopened or closed on that day, or hover over a case rate line for a racial group to see how each group’s rate compares to the group with the lowest rate of the day.
We focus on three reopening periods preceding the summer surge to explore the changes in case rates by race and ethnicity. We use May 8th as a baseline, which marked the state’s limited reopening of low-risk businesses and retail, mainly for curbside pickup, and it includes one holiday—Mother’s Day. We show how changes in case rates for this period compare to changes in case rates following two periods of expanded reopenings: May 25th and June 12th. On May 25th, Memorial Day, the state announced the reopening of in-store retail shopping and in-person religious services, and a day later, the reopening of barbershops and hair salons. Four days later, LA County reopened indoor dining. On June 12th, the state allowed counties with attestations to overall epidemiological preparedness to reopen bars, restaurants, wineries, gyms, museums, cardrooms, and several other sectors.
The data show greater case rate increases, particularly for Latinx and NHPI populations followed by Black and, sometimes, AIAN populations 2 and 3 weeks after periods of expanded reopenings.
Methods: We calculate the 7-day average case rates by race/ethnicity at the start of each reopening, two weeks after, and three weeks after. We then calculate the difference in case rates by subtracting each week’s case rate from the beginning rate.
The charts below show the beginning 7-day average case rate for each period and the rate two weeks and three weeks after. The blue dot represents the rate at the start of the period. The orange dot represents the rate each week after. Toggle between the weeks to see how rates change by race and ethnicity. Hover over a racial group to see the difference between the rates.
Our limited analysis demonstrates the state’s reopenings correlated with increases in case rates for people of color.
These findings demonstrate the mismanagement of the state’s reopening, where private and public interests in spurring economic activity came at the expense of communities of color. The data point to the need for a better collective path forward for reopening that provides for our economy’s health without putting our vulnerable communities squarely in harm’s way.
Vaccine distribution has created hope and confusion. Californians 65 and over are scrambling to access vaccines, worried they will miss out on a possible lifeline, and essential workers are anxious for their turn. The vaccine cannot distract us from meeting the needs of Californians in hard-hit communities. These residents, unable to work from home, risk infection as they board public transportation to get to their workplaces and return to segregated neighborhoods with overcrowded housing conditions. Protecting Californians must include using available public health levers to restrict aspects of our economy.
Although it runs counter to what some may intuit, across the country, state-ordered reopenings have led to only modest increases in economic activity because many consumers have reduced their spending on in-person services and are not likely to resume spending until the COVID-19 public health threat is resolved or effectively controlled.x The best approach to spur economic activity is to invest in addressing the COVID-19 public health threat.x Only then will consumers resume their spending and spur the type of economic activity that businesses are clamoring to generate. Some elected official’s pursuit of balance between public health guidance and business interests is no longer a viable path – if it ever was. This path has resulted in Black, Latinx, NHPI, and AIAN Californians’ disparate infection and death. Elected officials must rise above the false choice between Californians’ lives and livelihoods by providing broad governmental support. Protecting public health must prevail. In the end, it is the only right thing to do, and it is also best for business.
Further hampering the state’s ability to manage the COVID-19 public health threat is the chronic underfunding of public health infrastructure. Less than 3 percent of the United States’ estimated $3.6 trillion in annual health care spending is directed toward public health and prevention.xi Investing in robust public health infrastructure is essential to meet current and future public health threats.
The COVID-19 pandemic has preyed on those left vulnerable by structural and systemic racism. Policy solutions must center these impacted communities. LA County’s COVID-19 Community Equity Fund is a promising partnership between County departments and community-based organizations (CBOs). CBOs will assist with outreach, education, case investigation, and contact tracing in hard-hit communities. This community-based response is promising because it leverages trusted messengers to counter historically rooted government distrust.
The COVID-19 pandemic will leave an indelible mark on future generations. While our immediate focus must be on containing the public health threat and protecting those most at risk of exposure, we cannot lose sight of the need to invest in the long-term health and well-being of the hardest-hit communities. We need an immediate equitable COVID-19 response and a future equitable economic recovery.
Given ongoing conditions, controlling the spread of COVID-19 must take precedent over economic recovery. That does not mean that businesses are left to fail. Our government, at all levels, must act immediately. We need more than mandates — we need action. Californians need financial support to weather the remainder of the pandemic. Aid for small businesses, low-income entrepreneurs, and sole proprietors is needed today. We must do more to prioritize workers’ health and safety.
The following recommendations are directed to local, state, and national policymakers to provide guidance to address the economic and health impacts of the COVID-19 pandemic and what is needed to strengthen our public health infrastructure.
COVID-19 Cases and Deaths:
California Department of Public Health, California Open Data Portal, COVID-19 Cases-Ethnicity Demographics. Retrieved from https://data.ca.gov/dataset/covid-19-cases.
L.A. Times Data Desk, California Coronavirus Data, County Totals, Retrieved from https://github.com/datadesk/california-coronavirus-data.
U.S. Census Bureau, American Community Survey 5-Year Estimates (2014-2018), Table DP05.
Reopening and Closure Dates:
California Department of Public Health, Office of Public Affairs, CDPH News Releases 2020, Retrieved from: https://www.cdph.ca.gov/Programs/OPA/Pages/New-Release-2020.aspx.
Office of Governor Gavin Newsom, Newsroom, Retrieved from: https://www.gov.ca.gov/newsroom/.
County of Los Angeles Department of Public Health, Communications & Public Affairs, 2020 Press Releases, Retrieved from: http://publichealth.lacounty.gov/phcommon/public/media/mediapubdisplay.cfm?unit=media&ou=ph&prog=media.
Los Angeles Times, Tracking California’s Coronavirus Closures and Reopenings, Retrieved from: https://www.latimes.com/projects/california-coronavirus-cases-tracking-outbreak/reopening-across-counties/.
Case and Death Rate Calculations: We join case and death counts from the California Department of Public Health and Los Angeles Times to population estimates from the 2014-18 American Community Survey. We calculate case and deaths rates per 100,000 people of each race and ethnicity as well as per 100,000 in the total population. Total case and death rates are calculated by adding case and death counts across counties. We calculate the rolling 7-day average of new cases by subtracting the total number of cases and deaths for each day from the number of cases and deaths reported 6 days before, and then divide by 7. We then calculate rates per 100,000 of each race and ethnicity. In cases where the 7-day average rate is less than zero, we convert these estimates to null or missing estimates. This only happens in the case of small population groups (AIAN and NHPI) where there are corrections in their data. Seven-day average rates for these small population groups should be interpreted with caution.
Race and Ethnicity Designations: We follow the race and ethnicity categories available in COVID-19 data from the California Department of Public Health. These categories include American Indian or Alaska Native, Asian, Black, Latino, Multi-Race, Native Hawaiian or other Pacific Islander, Other, and White. While the state reports data for “Other” and “Multi-Race,” we do not publish rates for these groups given our uncertainty in their population estimates, since it is unclear from state data who is grouped into these categories. Estimates for the racial groups American Indian or Alaska Native, Asian, Black, Native Hawaiian or other Pacific Islander, and White do not include Latinx individuals.
Comparison Ratios: To make comparisons between groups, we divide each group’s case and death rate per day by the lowest rate for each day. In other words, if the lowest case rate of the day is among the Asian population, we divide all other groups by the rate among Asians. We exclude American Indians or Alaska Natives as well as Native Hawaiians or Pacific Islanders from having the lowest 7-day average case or death rate given ongoing fluctuations in their data reported by the state. While there may be a single day where they have the lowest rate, their counts are often adjusted upwards in following days following misclassification events and corrections in the data.
To examine the impact of reopenings on case rates by race and ethnicity, we reviewed the Governor’s and State Public Health Officer’s press releases as well as their social media accounts, which the state often uses to post updates on reopenings. We focus on statewide actions, but also include major reopenings from LA County given the size of the county and its total share of cases. To evaluate how case rates changed after reopenings, we chose a baseline period where few reopenings, or lower risk reopenings, occurred. This allowed us to see how case rate changed 1 to 3 weeks after reopenings compared to a period where few businesses had reopened.
Our analysis is limited by its statewide focus and it does not include the individual reopening decisions made by each county, outside of Los Angeles. Some counties could have chosen a stricter approach than the guidance provided by the state before each surge. Additionally, while our analysis shows correlation between case rate increases and reopenings, we cannot say definitively that reopenings alone increased case rates. There are several other factors in addition to reopenings that affect transmissions, including holidays and gatherings. However, we do believe our analysis provides evidence about the disproportionate impact of surges and reopenings on people of color in the state.
Recommendations developed in partnership with the RACE COUNTS Steering Committee.
Research and data analysis by Elycia Mulholland Graves, Rob Graham, Chris Ringewald, Leila Forouzan, and Laura Daly.
Written by Maria Cabildo, Elycia Mulholland Graves, and Matt Trujillo.
Conceptualization support from John Kim and Chris Ringewald.
Editing support from Mike Russo, Amy Sausser, Ron Simms Jr., Katie Smith and Chris Ringewald.
Messaging and communications support from Ron Simms Jr. and Katie Smith.
Design and page development by Rob Graham and Katie Smith.
i Artiga, Samantha, Rachel Garfield, and Kendal Orgera. “Communities of Color at Higher Risk for Health and Economic Challenges Due to COVID-19.” KFF, April 8, 2020. https://www.kff.org/coronavirus-COVID-19/issue-brief/communities-of-color-at-higher-risk-for-health-and-economic-challenges-due-to-COVID-19/.; Advancement Project California. “Economic Opportunity.” Race Counts. Accessed December 10, 2020. https://www.racecounts.org/issue/economic/.
ii Advancement Project California. “Housing.” Race Counts. Accessed December 10, 2020. https://www.racecounts.org/issue/housing.
iii Leifheit, Kathryn M, Sabriya L Linton, Julia Raifman, Gabriel Schwartz, Emily A Benfer, Frederick J Zimmerman, and Craig Pollack. “Expiring Eviction Moratoriums and COVID-19 Incidence and Mortality.” SSRN, November 30, 2020. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3739576.
iv Advancement Project California. “Health Care Access.” Race Counts. Accessed December 10, 2020. https://www.racecounts.org/issue/health.
v Bogardus Drew, Rachel, and Ahmad Abu-Khalaf. “Linking Housing Challenges and Racial Disparities in COVID-19.” Enterprise Community Partners, April 15, 2020. https://www.enterprisecommunity.org/blog/04/20/housing-challenges-racial-disparities-in-COVID-19.
vi Dubay, Lisa, Joshua Aarons, Steven Brown, and Genevieve M. Kenney. “How Risk of Exposure to the Coronavirus at Work Varies by Race and Ethnicity and How to Protect the Health and Well-Being of Workers and Their Families.” Urban Institute, December 2, 2020. https://www.urban.org/research/publication/how-risk-exposure-coronavirus-work-varies-race-and-ethnicity-and-how-protect-health-and-well-being-workers-and-their-families.
vii Thomason, Sarah, and Annette Bernhardt. “Front-Line Essential Jobs in California: A Profile of Job and Worker Characteristics.” UC Berkeley Labor Center, July 1, 2020. https://laborcenter.berkeley.edu/front-line-essential-jobs-in-california-a-profile-of-job-and-worker-characteristics/.
viii Huang, Kuochih, Tom Lindman, and Annette Bernhardt. “Physical Proximity to Others in California’s Workplaces: Occupational Estimates and Demographic and Job Characteristics.” UC Berkeley Labor Center, December 7, 2020. https://laborcenter.berkeley.edu/physical-proximity-to-others-in-californias-workplaces/.
ix Thomason, Sarah, and Annette Bernhardt. “Front-Line Essential Jobs in California: A Profile of Job and Worker Characteristics.” UC Berkeley Labor Center, July 1, 2020. https://laborcenter.berkeley.edu/front-line-essential-jobs-in-california-a-profile-of-job-and-worker-characteristics/.
x Raj Chetty, John N. Friedman, Nathaniel Hendren, Michael Stepner, and the Opportunity Insights Team. “The Economic Impacts of COVID-19: Evidence from a New Public Database Built Using Private Sector Data.” Opportunity Insights, November 2020. https://opportunityinsights.org/wp-content/uploads/2020/05/tracker_paper.pdf.
xi Leana S. Wen and Nakisa B. Sadeghi. “Addressing Racial Health Disparities In The COVID-19 Pandemic: Immediate and Long-Term Policy Solutions.” Health Affairs, July 20, 2020. https://www.healthaffairs.org/do/10.1377/hblog20200716.620294/full/.
We are working on a tailored place-based index to identify local hotspots within counties and guide public education and investments. The index will assess each area’s risk factors for COVID-19 infection and severity, as well as its ability to recover from the pandemic’s health, economic, and social impacts. We have reviewed existing research and related indexes from sources such as the Centers for Disease Control and Prevention, the Public Health Alliance of Southern California, New York University, the California Health Interview Survey, and others to identify potential indicators. We are currently testing these indicators for their reliability at sub-county geographies and correlations with COVID-19 case rates. The indicators fall across three categories: infection, severity, and resiliency. Check back here in January 2021 to see which communities across the state have the most immediate health risks from COVID-19 and potential for long-term social and economic impacts.
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In February 2021, we will release a series of county-level reports that explore how race, place, and class have affected the spread of COVID-19 in individual counties. Check back here in 2021 to see if your county is featured.