COVID-19: Prioritizing an Equitable Recovery for our Highest-Need Communities

COVID-19 AND THE TRUE COST OF REOPENING

Report publication date:  12-16-2020, Updated 01-25-2021
Data as of:  [date]

The data and visuals in this section are updated on a regular basis.

A year after reporting the first cases of COVID-19 in California, the state once again stands at a crossroads. On one hand, California suffered one of the harshest winter surges of any state in the nation and saw the racial disparities – that have been a hallmark of this entire crisis – explode to new, tragic levels that dwarf the disparities seen in prior surges. On the other hand, we have the chaotic yet hope-filled rollout of the vaccine starting to ramp up throughout the state. The appalling racial disparities we see from the winter surge were fueled by the same, structural dynamics that drove them in prior surges – the disproportionate number of low-income people of color in the in-person, essential workforce, overcrowded and multi-generational housing, and generations of systemic racism that have made communities of color fertile ground for the virus. Now, as our collective attention turns towards the massive undertaking of vaccinations, we must never lose focus on controlling the virus’ spread within California’s most vulnerable communities and never forget the dear cost we as a state have extracted from them over this past year. 

With roughly one out of every 13 Californians having tested positive for coronavirus at some point during the pandemic – we continue to see a dis-spiriting level of deaths as a lagging indicator from the surge. Different regions in the state were hit at dramatically different levels from one another. Regions like Southern California (with LA County at a time being the global epicenter of the pandemic) and San Joaquin Valley took the brunt of the impact. And underneath the swirling numbers, there lies the threat of MULTIPLE, more transmissible COVID-19 variants that can burst through any modeling and projections of where this virus will go next. As has been the case through much of the pandemic – surges take a tragically high toll on Latinx, Black, Native Hawaiian and Pacific Islander (NHPI), and American Indian and Alaskan Native (AIAN) Californians.

As the case counts start to come down, it’s important to remember that the actions of state and local leaders to institute much more restrictive measures in late November and early December helped blunt the catastrophic rise in cases and why we are now seeing numbers move in the right direction. We know what works. However, even after a precipitous decline in cases the past couple of weeks – the case numbers are still nearly three times the level we saw at the height of the winter surge. And given this extraordinary level of community transmission and without a full handle on these new variants – we must not simply return to the pre-surge, pre-variant balancing act between the public’s health and powerful private interests’ push to reopen businesses. Instead, it is incumbent on both state and local elected officials to immediately modify their reopening plans, augment support for the in-person workforce and their families, and produce an at-scale and transparent equity plan for vaccine distribution. If not, we will likely see another surge and the continuation of high infection rates in California’s most vulnerable communities.

The Human Cost of Reopening

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.i Black and Latinx workers in California have the highest rate of employment in essential jobs.ii Asian, Black, and Latinx workers are disproportionately likely to work in jobs that involve close physical proximity.iii Given these conditions, it is easy to see how reopening the economy, along with existing vulnerabilities, put Californians of color at greater risk and lead to disproportionate impact.

Tracking the Impact of Reopenings and Closures by Race

Tracking 7-day average case rates by race and ethnicity lays bare the roller coaster of rising and falling case rates our state and communities have endured. Periods of declining or flat case rates are met with reopenings at the state and local levels that fuel future surges, even while case rates among many people of color remain higher than other groups and above what the state considers lower rates of transmission.

Using data from the California Department of Public Health, we calculate the rolling 7-day average case rate by race and ethnicity from mid-April 2020 until now. 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.

Our data show that average daily case rates for our NHPI, Latinx, Black, and AIAN populations have frequently exceeded one of the criteria set by the state to allow counties to move toward reopening. On August 28th, 2020, the state established criteria for loosening and tightening restrictions on activities in the Blueprint for a Safer Economy. 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. Statewide 7-day average case rates for Latinx and NHPI populations rarely dipped below the 7 new daily cases per 100,000 threshold and were often far above this threshold even as county economies reopened.

As of January 25, 2021, the state lifted the regional stay-at-home order for all areas, allowing even purple tier counties to consider resuming business activities that had been closed. At that time, 7-day average case rates among Latinx and NHPI populations were over eight times the 7-day average threshold for the state’s purple tier. Alarming case rates among these communities of color have done little to slow the reopening of our state and county economies during the summer, and now, winter surges.

These trends are 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 occupations.iv Black workers are likewise overrepresented as food preparation workers, customer service representatives, and office clerks. These are some of the positions directly affected by the reopening and restricting of retail and foodservice sectors during and after surges.

Limitations: While our analysis demonstrates the link between reopenings and increasing case rates, other factors have contributed to surges. The winter surge that eclipsed case rates seen over the summer suggests a unique, added effect from fall and winter holidays along with other factors, like private gatherings between households. In addition, 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 and will reopen following the lifting of the state’s regional stay-at-home order rather than opting for a stricter approach.


The Impact on 7-Day Average Case Rates by Race

To show the disparate impact of reopenings on rates by race, we plot 7-day average case rates by race against holidays and key reopening and closure dates throughout the pandemic. The summer and winter surges and the resulting increase in rates for Latinx and NHPI populations in particular, were preceded by rapid reopenings during periods of case declines.

Using the summer surge as an example, we see that 7-day average case rates by race 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. Holidays alone do not appear to correlate with surges in case rates. For example, Mother’s Day on May 8th and Labor Day on September 7th did not coincide with an increase in 7-day average case rates. Even Thanksgiving and Christmas occurred during a visible surge in case rates that was preceded by reopenings in October 2020. Now, as the state and counties move away from the regional stay-at-home order 7-day average case rates remain higher than rates observed at any time during the summer surge.

Methods: To track reopening and closure dates, we reviewed the Governor’s and the State Public Health Officer’s orders and their social media accounts that the state often uses to post updates on reopenings. 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 where the county opened faster or slower than the state.

Click holiday, reopening, and closure dates on and off to see how these dates compare to lows and highs in case rates. Hover over a dateline to learn more about what happened 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.

Hover plotlines for more information about each event.
* Purple Tier Case Rate Threshold: California’s Blueprint for a Safer Economy set a past 7-day average of no more than 7 new daily cases per 100,000 as one of the criteria counties must meet to move from the most restrictive purple tier to the second most restrictive red tier in order to reopen many nonessential indoor businesses.
Chart tips: Click and drag to zoom into an area of the chart. Mouse over legend items to spotlight a group, or click legend items to turn on and off. Hover over a date line on the chart for more information about each event.
The Impact on Changes in 7-Day Average Case Rates by Race

Focusing on three reopening periods preceding the summer surge, we further highlight the disparate impact of reopenings on case rates by race. We compare periods where just a holiday occurred, or fewer sectors reopened and a holiday occurred, to periods with expanded reopenings to disentangle the effect of reopenings from holidays. The data show greater case rate increases 2 and 3 weeks after broader reopenings – particularly for Latinx and NHPI populations, followed by Black and sometimes AIAN populations.

Methods: We zoom in on three periods around May 8th, May 25th, and June 12th. We use May 8th as a baseline, which marked the state’s limited reopening of low-risk businesses and retail, mainly for curbside pickup, this period 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. 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.

Results

Our analysis demonstrates the disproportionate impact of the state’s reopenings on case rates for people of color, particularly for our Latinx, NHPI, Black, and AIAN populations. These findings should have implications moving forward as our state again lifts restrictions and counties consider reopening sectors even as case rates remain at levels higher than any rate seen in the first nine months of the pandemic. They point to particular reopenings where private and public interests in spurring economic activity have come at the expense of communities of color.

  • Two and three weeks after May 8th, our baseline, where few businesses reopened and in very low-risk settings (curbside pickup for retail), rates were relatively unchanged by race/ethnicity compared to the beginning of the period, except AIAN individuals who experienced a larger growth three weeks after.
  • Two and three weeks after May 25th, rates among the NHPI and Latinx communities increased significantly. Furthermore, two and three weeks after June 12th, rates among NHPI, Latinx, Black, and AIAN people increased rapidly. As a reference, three weeks after June 12th, the 7-day average case rate exceeded 10 cases per 100,000 for NHPI and Latinx individuals.
  • By late June, after the state allowed for the reopening of restaurants, bars, wineries, gyms, cardrooms, and hotels, there was a clear upward trajectory of cases for most racial and ethnic groups but especially for Latinx and NHPI people. Case rates continued to spike through July, with higher case rates and higher rates of increase borne by Latinx, NHPI, AIAN, and Black people.
  • On June 28th, the state began requiring counties, including Los Angeles, to close bars. There had been an uptick in 7-day case rates for Latinx, NHPI, Black, and AIAN people by this point. On July 13th, the state expanded closures to indoor and outdoor operations for bars and breweries not offering sit-down meals and expanded closures of indoor businesses across the state–affecting 80% of the population. At this point, there is a clear upward trend across all races. This upward trend in case rates is visible in the data before the June 28th and July 13th closures, especially for Latinx, NHPI, Black, and AIAN individuals.
  • Case rates began to increase rapidly among Latinx and NHPI populations in October and early November, following changes to the state’s Blueprint, reopenings in LA County, and numerous county-exits from the state’s purple tier. They surged for all groups by late November, and following Thanksgiving, reached unprecedented levels in the pandemic.
  • On December 6, 2020, the state implemented the regional stay-at-home order for the Southern California and San Joaquin Valley regions while the Bay Area voluntarily joined. By then, 7-day average case rates for NHPI and Latinx populations were twice the levels seen during the peak of the summer surge in July 2020.
  • As of January 25, 2021, the state lifted the regional stay-at-home order for all areas with evidence of declining case rates. However, 7-day average case rates among Latinx and NHPI populations were still over eight times the 7-day average threshold for the state’s purple tier and nearly three times their peak rates seen during the summer surge.

Tracking and Monitoring Racial Equity Over Time

Our 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. 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 summer and winter surges and before the state took the more dramatic measure to close or pull back indoor operations of several businesses. These comparisons demonstrate the need to disaggregate rates by race in determining reopenings as some groups could provide an earlier indication of a changing course in the pandemic and the need to slow reopenings. The state’s efforts to account for health equity and require counties to create targeted investment plans have not eliminated the disproportionate impact of COVID-19 on NHPI, Latinx, Black, and AIAN communities. Instead, they have led us to a point where stay-at-home orders are lifted amid higher case rates for these groups.  

Plotting case and death date over time by race, we see how our NHPI, Black, and Latinx populations have most consistently borne the brunt of this pandemic as our state and counties have pulled back and ramped up reopenings and closures. The roller coaster of state and county reopenings has had a visible effect on infections and deaths among these communities. These data can also be used by our elected officials to make decisions about reopenings, and now, vaccine distribution to move our state toward recovery while prioritizing all people’s health and safety. To date, 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 with the lowest rate each day. We include the state’s overall case and death rates for comparison.   

These line charts show the progression of statewide racial disparities in cumulative 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 on the day.   

The death rate charts show fluctuations in our NHPI and AIAN communities’ rates due to corrections in their data reporting that have visible effects on their death rates given their relatively smaller populations. Dramatic increases or decreases in case or death rates for these groups should be interpreted with caution.

Chart tips: Click and drag to zoom into an area of the chart. Mouse over legend items to spotlight a group, or click legend items to turn on and off.
* Purple Tier Case Rate Threshold: California’s Blueprint for a Safer Economy set a past 7-day average of no more than 7 new daily cases per 100,000 as one of the criteria counties must meet to move from the most restrictive purple tier to the second most restrictive red tier in order to reopen many nonessential indoor businesses.
Chart tips: Click and drag to zoom into an area of the chart. Mouse over legend items to spotlight a group, or click legend items to turn on and off.
Chart tips: Click and drag to zoom into an area of the chart. Mouse over legend items to spotlight a group, or click legend items to turn on and off.
Chart tips: Click and drag to zoom into an area of the chart. Mouse over legend items to spotlight a group, or click legend items to turn on and off.
Results
  • Highest Case and Death Rates: Our Latinx and NHPI populations have the highest case rates. Our Black, NHPI, and Latinx populations have the highest death rates.
  • Lowest Case and Death Rates: Our White and Asian populations have the lowest case and death rates, and their rates have risen quite slowly over time.
  • Changes in Case Rates Over Time: Since mid-April, the NHPI community has most consistently had the highest disparity in case rates. Disparities for the Latinx community grew after May and in July for the Black and AIAN communities.  
  • Changes in Death Rates Over Time: From mid-April through mid-November 2020, the Black community experienced the largest inequities in death rates. By late-November, the death rate among the NHPI population was the highest. The death rate for the Latinx community began growing rapidly in July, and by early 2021 reached the same levels seen among the Black population.
  • Changes during surges: During the summer and winter surges, NHPI and Latinx populations experienced the highest 7-day average case rates followed by Black and AIAN populations. Similarly, during each surge, the 7-day average death rate among Latinx and Black populations began to pull away from the White and Asian rates.
  • Shortcomings in Data Collection: Large fluctuations in death data for NHPI and AIAN populations point to inconsistencies in how the state and counties have collected data over time. Additionally, while the state reports data for individuals identifying as Other and Multi-Race, it is unclear who is included in these groups. This makes it difficult to accurately report their case and death rates, but our early analyses suggest individuals identifying as Other may be disproportionately impacted. These issues demonstrate the need to improve data reporting for NHPI, AIAN, Other, and Multi-Race individuals to ensure we are accurately tracking the impact of the COVID-19 pandemic on these communities.

Recommendations

Given ongoing conditions, controlling the spread of COVID-19 must be prioritized over economic recovery. Our government, at all levels, must act. Disparate pandemic impact on working-class Californians and Californians of color must be addressed. We must not prematurely reopen the economy and allow the pandemic to ravage our most vulnerable residents and communities once again. Vaccines should be distributed equitably. In addition, we must also support workers, the hardest-hit communities, local public health departments, and small businesses.

The following recommendations are directed to local, state, and national policymakers to provide guidance to address the inequitable economic and health impacts of the COVID-19 pandemic and what is needed to strengthen our public health infrastructure.

  1. Strengthen the state’s framework for regional and county reopenings to prevent a repeat of the winter surge:
    • Reimplement and revise the Regional Stay at Home Order adjusting criteria from the order to include 7-day average rates by race and for release from the order, current ICU capacity. Projected and current ICU capacity provides us two measures of transmission and risk levels in our state. However, ICU capacity alone does not take into account disproportionate impact by race where some groups in our state may still be bearing the largest load in cases and deaths. 
    • Revise the state’s Blueprint for a Safer Economy to include a more stringent tier below the Purple Tier. This new tier should strongly encourage counties that have been released from the Regional Stay at Home Order but are still surpassing certain thresholds for overall ICU capacity or 7-day average rates for any racial group to keep non-essential businesses, outlined in the Regional Stay at Home Order, closed.
  2. Center equity in vaccine distribution:
    • Use data to identify hotspot communities that have been hardest hit by the pandemic and target and prioritize vaccine distribution in these communities;
    • Prioritize vaccinating individuals and their families who have been disproportionately impacted by COVID-19 or who are at high infection risk. These individuals include, but are not limited to, Latinx, Black, NHPI, and AIAN individuals, essential workers who must work in-person and live in multi-generational/multi-family households, and individuals living in congregate settings;
    • Ensure that vaccine distribution sites are accessible through multiple modes and are open during hours that accommodate a variety of work schedules;
    • Build trust and leverage trusted messengers in impacted communities to facilitate vaccine access and uptake; and
    • Engage and center Latinx, Black, NHPI, and AIAN communities in COVID-19 vaccine policy responses.
  3. Expand worker protections and voice:
    • Make medical grade face masks available to workers whose jobs require them to work in-person;
    • Increase public health departments’ workplace compliance personnel;
    • Create workplace public health councils and protect workers against retaliation for reporting employer non-compliance with public health directives;
    • Provide monetary stipends and free quarantine facilities to infected low-wage essential workers; and
    • Enact policies to guarantee workers’ right to return to their jobs following illness and quarantine.
  4. Provide additional government aid to vulnerable individuals and communities:
    • Extend unemployment insurance to all workers impacted by the pandemic;
    • Target government aid to impacted households and hotspot communities; and
    • Find a path to cancel rental obligations and mortgage payments for low-income Californians.
  5. Provide additional support for public health dept and small businesses:
    • Increase state and federal funding for public health departments to fulfill their mandates; and
    • Provide financial support to small businesses, and low-income entrepreneurs.
  6. Build a cadre of community-based responders in hardest-hit communities by leveraging trusted community organizations:
    • Create a statewide Equity Corps program that would channel funds to community-based organizations working in COVID-19 hotspots and for highly-impacted communities. Funding would support their resident outreach efforts, including providing information on public health guidance and vaccine access, as well as connecting residents to resources to help them bridge the digital divide, access support for mental health, food, housing, and other basic needs, and inform them about new rights and resources for workers and tenants.

Conclusion

California strives to be the most compassionate, progressive state in the union. We can achieve this by protecting the lives of Black, Latinx, NHPI, and AIAN Californians by not prematurely lifting regional restrictions and equitably distributing vaccines.

California’s recent decision to lift Regional Stay at Home orders does not mean that county governments must align with the state’s guidelines. Counties with high case rates and severely strained health systems should think twice before aligning with the state. Decisions to reopen aspects of the economy even as case rates remain high will lead to increased infections and have disparate impacts. Recent scientific modeling by Columbia University makes clear that vaccinations alone will not end the pandemic. Restrictions together with vaccines reduce the number of infections.v Lifting restrictions too soon equals increased infection, illness, and death. In California, those falling ill and dying will be disproportionately Black, Latinx, AIAN, and NHPI. Making decisions that result in illness and loss of life for our most vulnerable neighbors is far from compassionate or progressive.

Reopenings not only lead to infections and illness, but they also do not put us on a path to economic recovery. Although it runs counter to what some would think, 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.vi The best approach to spur economic activity is to invest in ending the COVID-19 public health threat.

Elected officials’ pursuit of balance between public health guidance and business interests has resulted in Black, Latinx, NHPI, and AIAN Californians’ disparate case and death rates. Elected officials at all levels of government must rise above the false choice between Californians’ lives and livelihoods by keeping regional restrictions in place until all racial and ethnic groups reach lower levels of daily new cases per 100,000. Reopening economies when racial and ethnic group case rates remain above the established threshold fuels disparate impacts.

It is indisputable that the pandemic has preyed on those made vulnerable by structural and systemic racism. Our policymakers must not perpetuate structural inequity through their reopening and vaccine distribution decisions. Instead, they must pursue policies that end inequities.

About the Data

Our Data Sources

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.

Population Estimates:
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/.

Our Methodology

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 death 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 are 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 the following days following misclassification events and corrections in the data.

Reopening Dates:
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 the 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 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 a 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.

Acknowledgements

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, Matt Trujillo, and John Kim.
Conceptualization support from John Kim and Chris Ringewald.
Editing support from Mike Russo, Amy Sausser, Ron Simms Jr., Katie Smith, Chris Ringewald, and Leila Forouzan.
Messaging and communications support from Ron Simms Jr. and Katie Smith.
Design and page development by Rob Graham and Katie Smith.

Citations

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/.

COVID-19: Statewide Vulnerability & Recovery Index

Report publication date:  02-03-2020
Data as of:  01-31-2021

The pandemic vividly reveals how the deep-seated legacy of racist land use, employment, education, and health policies devastate California’s low-income communities of color. These communities were struggling before being hard hit by the pandemic. Now, COVID-19 lays bare the long-term effect of failing to address systemic inequity. As state and local governments craft their annual budgets, they must center equity in their budget processes and provide immediate relief by directing investments to offset long-standing inequities in public health, education, jobs, living wages, food security, and economic and housing stability. RACE COUNTS’ new COVID-19: Statewide Vulnerability & Recovery Index provides policymakers, advocates, and other Californians a tool to inform equity-based resource allocations and a means to target services equitably.

In less than one year, over 3,250,000 Californians have contracted the virus—and over 40,000 have died from it. Amongst those, Latinx and Native Hawaiian and Pacific Islanders (NHPI) have the highest case rates. Black, NHPI, and Latinx Californians have the highest death rates.1

As an example of economic impact, Los Angeles County has the largest number of people living under or near the poverty line in California (about 4 million).2 Data show that L.A. communities in deep poverty (i.e., areas with higher percentages of residents under 200% of the federal poverty level) have nearly three times as many COVID-19 cases as those that are not.3

Thus, the need to better protect low-income communities—and Black, Latinx, NHPI, and American Indian and Alaskan Native (AIAN) Californians—from COVID-19 could not be more evident. At stake are not only their health and safety but also our collective well-being. Communities of color and low-income people are disproportionately on the frontlines as essential workers. Put plainly, they keeping our society running. They deliver our mail, groceries, and online purchases, provide care for the elderly and offer a whole host of other essential services and supports. These often-under-noticed activities allow businesses to operate and enable wealthier Californians to shelter in place safely. The short- and long-term health, safety, and welfare of essential workers should therefore be prioritized.

On January 8, 2021, Governor Gavin Newsom released his proposed state budget for the 2021-22 fiscal year. Notably, it includes several equity components, including a request to extend the state eviction moratorium, a one-time $600 tax refund for low-income people, $2 billion for safe school in-person instruction, and over $1 billion for COVID-19 public health activities.4

While this starting point deserves praise, the level of devastation in hardest-hit communities requires that equity be further integrated into both the Governor and Legislature’s decision-making about the state budget and any other governmental pandemic and recession policies. RACE COUNTS’ new COVID-19: Statewide Vulnerability & Recovery Index (the “Vulnerability & Recovery Index” or “Index”) is a tool that will help policymakers and community stakeholders pinpoint inequities and take action to reverse devastating trends. The Index shows how pandemic and economic relief allocations can meaningfully account for systemic biases based not only on race and class but also place. It identifies communities most at risk of being disproportionately impacted by COVID-19 – in terms of immediate and long-term health and economic risks.

Furthermore, while it may be challenging to focus on post-pandemic equity in the midst of unprecedented numbers of low-income Californians of color losing their jobs, homes, educations, and loved ones, these stark realities show that elected officials can no longer afford to ignore the systemic biases that undergird our society. Thus, in addition to using the Index to immediately locate and act in areas in dire need of relief, policymakers should lean into the Index for future equity-centered interventions. This means that long-term public investments, policy reforms, and programs should use the Index to offset entrenched racism within and across our employment, education, housing, health care, land use, and criminal justice systems. Below are a summary of the Index and its key findings, and policy recommendations for immediate and longer-term government actions that will effectively support the highest-need communities.

The COVID-19: Statewide Vulnerability & Recovery Index

The Index uses ZIP Code-level data to identify California communities most in need of immediate and long-term pandemic and economic relief. Policymakers and community stakeholders should use it to determine where to target interventions.

Specifically, the Index is comprised of three components — Risk, Severity, and Recovery Need with the last scoring the ability to recover from the health, economic, and social costs of the pandemic. Communities with higher Index scores face a higher risk of COVID-19 infection and death and a longer uphill economic recovery. Conversely, those with lower scores are less vulnerable.

The maps below show each ZIP Code’s Index scores from Highest to Lowest Need, emphasizing the Highest-Need ZIP Codes. These are the ZIP Codes in the top 20th percentile of the Index, or with the greatest need for support. We recommend that they be prioritized by government officials moving forward.

Methods: Behind the Index are three component scores. Each component score includes a set of indicators we found to be associated with COVID-19 risk, severity, or recovery in our review of existing indices and independent analysis. COVID-19 case rates are not included as an indicator because there is incomplete case data at the ZIP Code level across the state. The component scores are calculated with the following indicators.

Risk Score: Risk of COVID-19 infection derived from the average of Black, Latinx, AIAN, and NHPI residents as a percent of population, Essential Workers (%), Population under 200% of Federal Poverty Level (%), and Overcrowded Housing Units (%).

Severity Score: Risk of severe illness or death from COVID-19 derived from the average of Black, Latinx, AIAN, and NHPI residents as a percent of population, Population under 200% of Federal Poverty Level (%), Population Age 75+ in Poverty (%), Uninsured Population (%), Heart Attack Hospitalization Rate (per 10,000), and Diabetes Hospitalization Rate (per 10,000).

Recovery Need Score: Vulnerability of community to economic and social costs of pandemic derived from the average of Black, Latinx, AIAN, and NHPI residents as a percent of population, Essential Workers (%), Population under 200% of Federal Poverty Level (%), Unemployment Rate, and Uninsured Population (%).

These component scores are then combined into the overall Index. Using these results, we assign categories to each ZIP Code from Highest to Lowest Need.

Toggle between each map to see each ZIP Code’s overall Index score and underlying component scores. Zoom to a particular county or toggle on and off the Highest Need ZIP Codes. See our Data Table to explore the data more or see our Detailed Methodology for more information on our process for developing the Index.


Mouseover or click the map for more info
Key Findings
  1. Large portions of the Central Valley, the Inland Empire, Imperial County, and South / Southeast greater Los Angeles area fall within the Highest Need category. The Central Valley is home to large agricultural and food processing industries. The Inland Empire and South / Southeast Los Angeles both have a large presence of warehouses and logistics centers. Workers in these industries have faced unsafe working conditions due to a lack of personal protective equipment and safety practices and because they work close to others.5,6 Imperial County has exceptionally high unemployment and poverty rates. Nearly all of these regions are home to large communities of color, particularly Latinx residents.
  2. Many northern California ZIP Codes from Colusa up to Del Norte County are also in the Highest Need category. Many of these areas have high rates of hospitalizations for heart attacks and diabetes, conditions that are associated with more serious COVID-19 illness and death, resulting in high Severity component scores. Higher rates of essential workers contribute to higher Risk scores. Large AIAN populations, accompanied by higher poverty rates and large Latinx populations in some areas, all of whom have experienced a disproportionate impact from the pandemic, also contribute to higher Index scores.
  3. Risk, Severity, and Recovery Need scores generally align with the overall Index scores. However, a closer examination of component scores does reveal some differences. Santa Clara County has only two High or Highest Need ZIP Codes, while it has six with High or Highest Need Risk scores. San Diego County has 18 High or Highest Need ZIP Codes, but 25 with High or Highest Recovery Need scores and 24 with High or Highest Severity scores. These differences can help guide the specific types of supports needed in each area. For example, areas with the Highest Severity scores may need more outreach and services to older populations and those with certain medical conditions.
  4. Overall Index scores are strongly correlated7 with COVID-19 case rates based on the case data available at the ZIP Code level. This suggests that areas with higher case rates likely also have higher Index scores. As a result, the Index is a useful tool to measure the local impacts of the pandemic even though it does not directly include COVID-19 case data.
  5. The Index accurately captures many of the groups that have experienced the highest COVID-19 case and death rates. Highest-Need ZIP Codes have a large share of Latinx and AIAN Californians, and people in poverty. Many Highest Need ZIP Codes also have a high percent of Black residents.
  6. Small area-based race and ethnicity figures do not adequately capture NHPI populations, and in more urban areas, AIAN populations because they often are not as geographically concentrated as other racial and ethnic groups. As a result, statewide or countywide interventions in addition to targeted ZIP Code-based approaches are needed to support these two groups.

Recommendations

Our government, at all levels, must act immediately. Immediate action includes responding to ongoing COVID-19 infections, ensuring an equitable distribution of vaccines, and providing real economic recovery for hardest-hit communities.

Californians need financial support to weather the remainder of the pandemic. Aid for small businesses and low-income entrepreneurs is needed today. We must do more to prioritize the health and safety of low-income people of color and put them on a path to not only recover but thrive in the future. To do this, policymakers should focus on ZIP Codes with an overall score in the Index’s top 20th percentile.

The following recommendations for state, local, and national policymakers provide guidance on how to address the immediate and long-term health and economic impacts of COVID-19.

  1. Center equity in vaccine distribution:
    • Data show that because of structural barriers—such as access to health care, economic inequity, and historic and present-day racism—people of color are less likely to be vaccinated.8 To offset this, our Index—which accounts for racial inequities and others—should be used to prioritize communities most in need;
    • Prioritize vaccinating individuals and their families who have been disproportionately impacted by COVID-19 or who are at high infection risk. These individuals include, but are not limited to, Latinx, Black, NHPI, and AIAN individuals, essential workers who must work in-person and live in multi-generational/multi-family households, and individuals living in congregate settings;
    • Ensure that vaccine distribution sites are accessible through multiple modes and are open during hours that accommodate a variety of work schedules;
    • Build trust and leverage trusted messengers in impacted communities to facilitate vaccine access and uptake; and
    • Engage and center Latinx, Black, NHPI, and AIAN communities in COVID-19 vaccine policy responses.
  2. Build a cadre of community-based responders in hardest-hit communities by leveraging trusted community-based organizations (CBOs):
    • Create a statewide Equity Corps program that would channel state funds to CBOs working in COVID-19 hotspots and for highly impacted communities. The state funding would support CBO resident outreach efforts, including providing information on public health guidance and vaccine access, as well as connecting residents to resources to help them bridge the digital divide, access support for mental health, food, housing, and other basic needs, and inform them about the new rights and resources for workers and tenants.
  3. Provide additional support for local public health departments and small businesses:
    • Increase state and federal funding for public health departments to fulfill their mandates; and
    • Provide financial support to small businesses and low-income entrepreneurs.
  4. Protect workers and lift their voices and expertise to keep workplaces safe:
    • Make medical grade face masks available to workers whose jobs require them to work in-person;
    • Increase public health departments’ workplace compliance staffing levels;
    • Create workplace public health councils and protect workers against retaliation for reporting employer non-compliance with public health directives;
    • Provide monetary stipends and free quarantine facilities to infected low-wage essential workers;
    • Enact policies to guarantee workers’ right to return to their jobs following illness and quarantine;
    • Publicly and consistently, weekly at a minimum, disclose worksite outbreaks by employer and location;
    • Ensure workers affected by business closures—such as workers in non-essential retail, malls, gyms, and other categories deemed appropriate by public health officials—have immediate financial support, especially those who do not qualify for state or federal relief; and
    • Increase enforcement against businesses and employers that violate health orders to hold them accountable and, if needed, shut them down to protect public health.
  5. Target government aid to vulnerable individuals and communities:
    • Extend unemployment insurance to all workers impacted by the pandemic;
    • Target government aid to the most-impacted households, communities, and highest need geographic locations; and
    • Extend eviction moratoriums and find a path to cancel rental obligations and mortgage payments for low-income Californians.
  6. Build the future resilience of highest-need communities:
    • Direct public investments to improve the long-term overall socioeconomic welfare of communities in ZIP Codes with a Recovery Need score in the top 20th percentile. This should include a focus on offsetting longstanding under-investments in public health, jobs, living wages, education, food security, and economic and housing stability for low-income communities of color, and corresponding over-investments in incarcerating and policing people of color.
    • Partner with CBOs and messengers deeply rooted in serving communities in ZIP Codes with a Recovery Need score in the top 20th percentile to not only identify the root causes of racial and economic marginalization but also empower community members by leveraging their lived experiences to craft bottom-up solutions that have long-term durability and efficacy.

Conclusion

A legacy of racist policymaking created vulnerable communities that were fertile ground for COVID-19 infection, spread, and death. Only policies rooted in equity can begin to repair the harm that has been done. This means that policymakers must continue to take action to control the pandemic by maintaining life-saving restrictions, develop equity-based vaccine distribution protocols, and seed an equitable long-term economic recovery in California’s highest-need communities.

Policymakers should not give in to pressure from special interests, pursue low-hanging fruit, or divide resources equally by the number of political districts in a jurisdiction regardless of need. Rather, they should take an equity-centered approach.

An equity-centered approach must be rooted in data on disparate impact. The COVID-19: Statewide Vulnerability & Recovery Index provides the data needed to identify the California communities disproportionately suffering now, and most at risk of enduring negative long-term economic and health consequences. Our long-term, collective economic welfare is rooted in the well-being of the communities of color and low-income people who disproportionately make-up our essential workforce.

Our Highest Need communities and essential workers must be protected now and equipped for long-term success. Policymakers should ensure that vaccines are distributed equitably, build up our public health infrastructure—including community-based rapid response systems, protect workers, and target government aid to vulnerable individuals, communities, and small businesses. In addition, government investment should not stop at immediate pandemic relief. It must go further and target and allocate resources to build the future resilience of the Highest Need communities identified in the Index. Doing so is not only just, but also places us on a path toward greater equity and a more resilient collective well-being.

Data and Methods

Data Table
Methods

Three components make up the COVID-19: Statewide Vulnerability & Recovery Index:

  1. Risk Percentile Score measures the risk of COVID-19 infection;
  2. Severity Percentile Score measures the risk of severe illness or death from COVID-19; and
  3. Recovery Need Percentile Score measures the needs related to economic and social recovery.

We first calculate the percentage and rate estimates for each indicator and then assign ZIP Code percentile scores based on how they rank from highest to lowest for each indicator. Each ZIP Code is then given component scores by averaging indicator percentiles within each component and ranking these averages from highest to lowest to calculate percentile scores. Then we average the component percentile scores, and the percentile of that average is the COVID-19: Statewide Vulnerability & Recovery Index percentile score. The use of percentile scores and components to create a single composite index closely relates to the CalEnviroScreen 3.0 methodology.

To identify indicators, we 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. We then tested these indicators for their reliability9 at the ZIP Code level and their correlations with COVID-19 case rates. Because ZIP Code level case data are not available statewide, we relied on existing research around COVID-19 and community characteristics and our correlation analysis of indicators with case rates where data are available, to make the final indicator list. We narrowed our list to a set of nine indicators across the three components.

The Risk Percentile Score includes: Average percentile of Black, Latinx, AIAN, and NHPI residents as a percent of population, Essential Workers (%), Population under 200% of Federal Poverty Level (%), and Overcrowded Housing Units (%).

The Severity Percentile Score includes: Average percentile of Black, Latinx, AIAN and NHPI residents as a percent of population, Population under 200% of Federal Poverty Level (%), Population Age 75+ in Poverty (%), Uninsured Population (%), Heart Attack Hospitalization Rate (per 10,000), and Diabetes Hospitalization Rate (per 10,000).

The Recovery Need Percentile Score includes: Average percentile of Black, Latinx, AIAN, and NHPI residents as a percent of population, Essential Workers (%),10 Population under 200% of Federal Poverty Level (%), Unemployment Rate, and Uninsured Population (%).

Each indicator is naturally weighted by the number of components it falls within. In other words, because our race indicator falls across all three components, it is included three times in the Index, or essentially weighted by three. We excluded ZIP Codes without reliable11 estimates for at least half of the indicators within any component. ZIP Codes with less than 500 population are also excluded.

ZIP Code Categorization Methodology: Using the Index score, we calculate a percentile rank for all 1,236 California ZIP Codes included in our index. To identify our recommended list of Highest Need ZIP Codes for targeted interventions, we focus on ZIP Codes in the top 20th percentile of the index, which narrows to the 248 Highest Need ZIP Codes. ZIP Codes between the top 20th and 40th percentiles fall into the High Need category, and so on.

Limitations: COVID-19 data is not available at ZIP Code level statewide; therefore, this Index approximates the impact of the pandemic using indicators linked to COVID-19 through previous research and our own correlation analysis using available ZIP Code-level COVID-19 data. In addition, this Index includes only rates and percentages. As such, it does not measure the scale or consider the number of individuals impacted in each ZIP Code. This approach allows for less populated but highest-impacted ZIP Codes to be highlighted but could also result in some very high population ZIP Codes with high need to receive less focus. This Index relies heavily on American Community Survey data which is published for ZIP Code Tabulation Areas (ZCTAs) not ZIP Codes. As a result, the number and location of ZCTAs and ZIP Codes may not align perfectly. Finally, this Index does not take into account the resources and strengths of the communities and instead is focused on the risk factors and needs of the communities. Local community-based organizations are one such example of community strength and resources.

Data Sources:

  • Total Population, Race, Ethnicity. Housing, Employment, and Poverty Estimates: American Community Survey 5-Year Estimates, 2018. Tables referenced include: DP05, B25014, S1701, B17020, S2301, S2401, S2701. Retrieved from https://data.census.gov/cedsci/.
  • Hospitalization Data: California Office of Statewide Health Planning and Development, 2013-2014.

Acknowledgements

Recommendations developed in partnership with the RACE COUNTS Steering Committee.
Research and data analysis by Leila Forouzan, Elycia Mulholland Graves, Chris Ringewald, Rob Graham, and Jennifer Zhang.
Written by Leila Forouzan, Elycia Mulholland Graves, and Chauncee Smith.
Conceptualization support from John Kim and Maria Cabildo.
Editing support from Maria Cabildo, Mike Russo, Amy Sausser, Katie Smith, Ron Simms Jr., Chris Ringewald, and Jacky Guerrero.
Design and page development by Rob Graham and Katie Smith.

Citations

1 Latinx case rates are 3.1 times greater than the lowest racial group. NHPI case rates are 3.5 times greater than the lowest group. Black, NHPI, and Latinx death rates are 1.45, 1.55, and 1.88 times greater than the lowest racial group. See Maria Cabildo, Elycia Mulholland Graves, and Matt Trujillo. “Statewide Report: How Race Fuels a Pandemic.” Advancement Project California, December 2020. https://www.racecounts.org/covid-statewide/ (Data as of Jan. 31, 2021).

2 Caroline Danielson. “The COVID-19 Crisis is Affecting Low-Income Workers.” Public Policy Institute of California, March 19, 2020. https://www.ppic.org/blog/the-covid-19-crisis-is-affecting-low-income-workers/ (“[T]he poverty line on average for a family of two adults and two children is about $32,400; the deep poverty line is $16,200, and the near-poverty line is $48,500.”).

3 Maria Cabildo, Elycia Mulholland Graves, John Kim, and Michael Russo. “Report: How Race, Class, and Place Fuel a Pandemic.” Advancement Project California, 2020. https://www.racecounts.org/covid/ (case rate data as of Nov. 11, 2020).

4 “Governor’s Proposed Budget Summary 2021-22, Equitable and Broad-Based Recovery,” Office of Governor Newsom, Jan. 8, 2021. http://www.ebudget.ca.gov/2021-22/pdf/BudgetSummary/EquitableandBroad-BasedRecovery.pdf.

5 Manke, Kara. “California farmworkers hit hard by COVID-19, study finds.” Berkeley News, Dec. 2, 2020. https://news.berkeley.edu/2020/12/02/california-farmworkers-hit-hard-by-covid-19-study-finds/.

6 Kyle Bagenstose, Sky Chadde, and Rachel Axon. “COVID-19 deaths go uninvestigated as OSHA takes a hands-off approach to meatpacking plants.” https://www.usatoday.com/in-depth/news/2021/01/11/covid-19-deaths-not-investigated-osha-meatpacking-plants/6537524002/.

7 Correlation coefficients range from –1 to 1. The closer the correlation coefficient is to –1 or 1, the stronger the relationship between the two variables. The correlation coefficient for the relationship between the Index percentile scores and COVID-19 case rates, on December 29, 2020, is .65. We chose December 29, 2020, as the date for the COVID-19 data in the correlation analysis because it is both recent to the writing of this report and it is the date in December with the maximum number of ZIP Codes reporting COVID-19 case data. This analysis included case data for 514 ZIP Codes across 17 counties. The more ZIP Codes we are able to include in the analysis, the more confidence we can have in the correlation results.

8 Samantha Artiga and Jennifer Kates. “Addressing Racial Equity in Vaccine Distribution,” Kaiser Family Foundation, Dec. 3, 2020. https://www.kff.org/racial-equity-and-health-policy/issue-brief/addressing-racial-equity-vaccine-distribution/.

9 We use the Coefficient of Variation to determine estimate reliability. The Coefficient of Variation is calculated as the ratio of the standard deviation to the mean. The lower the value, the higher the reliability of the estimate.

10 We define essential workers using the Urban Institute’s report on worker exposure and risk (https://www.urban.org/sites/default/files/publication/103278/how-risk-of-exposure-to-the-coronavirus-at-work-varies.pdf) as a basis. We broadly include: Business and financial operations occupations; Community and social service occupations; Educational instruction, and library occupations; Healthcare practitioners and technical occupations; Healthcare support occupations; Protection service occupations; Food preparation and serving related occupations; Building and grounds cleaning and maintenance occupations; Natural, resources, construction, and maintenance occupations; and Production, transportation, and material moving occupations.

County Reports – Coming Soon

In March 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.

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