For better health outcomes, the evidence is clear that safe and affordable housing must be a priority not just for public sector agencies but for nonprofit organizations, health care providers, and private sector employers.
With only a few exceptions, Delaware’s least wealthy ZIP codes tend to move up the list when you re-rank by the highest COVID-19 positive case rates.At first glance, that statement won’t surprise those who have made the case that COVID-19 hits minorities and the poor harder than it does others.Of the state’s 66 ZIP codes, 18 were not large enough to have COVID-19 data released by the state and therefore aren’t ranked on the list on the opposite page. Those areas are listed in the footnotes.
[caption id="attachment_188099" align="alignright" width="323"] Dr. Kara Odom-Walker | Photo c/o State of Delaware[/caption]
Outgoing Department of Health and Social Services (DHSS)Secretary Dr. Kara Odom Walkersaid that while DHSS prefers census-tract data to ZIP code data, which is based on postal routes and can be too small for credible analysis,the data does tell some important stories.“What you’ve shown is that the patterns are real,” said Walker, who spoke to the Delaware Business Times prior to leaving her position on July 31. “What we know is that ZIP code doesn’t define our residents because of where you work, where you shop, and other risk factors.”Walker said that when talking about how social determinants impact contracting the virus, neighborhoods do emerge.Among other findings from the data overlay:
Three of the state’s 20 wealthiest ZIP codes – two of them in Sussex County - also ranked in the top 20 for case rates.
Five of the state’s 20 wealthiest ZIP codes were not large enough to have COVID-19 data released by the state, while 10 of the state’s least wealthiest ZIP codes did not as well.
Some of the heaviest hit counties in the state for positive cases rank much lower when it comes to testing, and there appears to be a disproportionate amount of testing going on in some wealthier ZIP codes than the reported cases.
“Disparities matter,” Walker said. “Many of the [neighborhood] factors we see are the same that we see in the at-risk community – where people work, lack of access to cleaning supplies, the ability to isolate safely, and the presence of chronic conditions such as diabetes, kidney disease, and heart disease.”Walker said she’s not surprised that Sussex County ZIP codes rank highly for both COVID-19 case rate and COVID-19 testing rank, which DBT used as an additional filter to see if wealthier communities had access to more testing.“We’ve overtested in Sussex County so we can catch every possible contact, which means we’ve emerged with more cases,” she said. “We’re getting out the word and getting more people tested. I see on the list areas with lots of workers in the poultry industry. We need to continue to do outreach to smaller areas, census tracts that we need to pay particular attention to. And these trends overlap with what we’ve seen with opioid outcomes.”Walker conceded that when she previewed the data, she said “this is so cool” before spending some time sorting and categorizing the data.“I think this data will be useful to your readers,” she said. “I’m lucky where I live but I can’t let down my guard. The next emergence could be associated with the University of Delaware, or a church, or a funeral, or by someone who comes into your neighborhood. No one is immune to COVID."“This data shows that your community matters and your behavior matters," she continued. "The Northeast Corridor is doing better [than the rest of the United States] because we’ve normalized mask-wearing and social distancing. We’re seeing a lot more movement in the summer. People want to hang out at the beach with family members now because they’re not going to be able to do it in the winter.”The rankings include one of the state’s wealthiest ZIP code in Dewey Beach, where the state saw a major outbreak. Walker said that’s not a surprise when you have people living and working in an area for the whole summer, adding that positive cases may also go back to the patient’s home state, which could impact the numbers.“The high-wealth ranks really jumped out at me,” Walker said. “A lot of the people at the top of the list are at the beach and near poultry processors. I think the state has done a really good job of testing at-risk residents, but it also shows that we really did have a problem and thank god we were paying attention.”Rather than providing her thoughts about the data, noted University of Delaware epidemiologist Dr. Jennifer Horney pointed DBT toward a study she and fellow UD researcher Ibraheem Karaye recently published on social vulnerability and COVID-19, where they found that racial minorities and people with limited English are nearly seven times more likely to be infected with coronavirus in the United States.The study goes on to conclude that “large-scale disasters differentially affect the health of marginalized communities. In this study, minority status and language, household composition and transportation, and housing and disability predicted COVID-19 case counts in the U.S. Addressing the social factors that create poor health is essential to reducing inequities in the health impacts of disasters." A PDF reprint of the article and list that ran in the August 8th issue of Delaware Business Times is available here.
By Peter Osborne