Disparity in Medical Outcomes
Written by Elizabeth Moon.
As of today COVID-19 deaths in the United States exceeded a third of a million, at 334,000. I follow the Johns Hopkins site, because it reaches down to county level with more information than most, and it gives the cases in both absolute case numbers, and numbers per 100,000, which allows comparison between counties with fewer than 100,000 population and the ones much more populous. I always look at my home county (Hidalgo) because…well…it was home. I was born in the county hospital in Edinburg and grew up in McAllen, before heading off to Houston for college, then the D.C. area for the Marines, and then back to Texas in Austin, San Antonio, and McAllen (again, yes) before landing where we are now.
So here’s what COVID-19 looks like in my home part of the state…Corpus to Laredo and points south. I’ll start at Laredo and work down the Rio Grande to Brownsville then start on the second tier counties, and so on. And I’ll point out an anomaly that I don’t recall seeing before today. Today Texas’ overall case fatality rate is 1.59
Webb (Laredo) * Case fatality rate 1.72 Poverty rate 25.67% 525 staffed hospital beds, 65 ICU beds.
Zapata Case fatality rate 0.99 Poverty rate 31.5% 0 staffed hospital beds or ICU beds
Starr * Case fatality rate 3.36 Poverty rate 33% 48 staffed hospital beds, 8 ICU beds
Hidalgo* Case fatality rate 4.38 Poverty rate 30% 1185 staffed beds, 260 ICU beds
Cameron* Case fatality rate 4.03 Poverty rate 27.78% 1177 staffed hospital beds, 105 ICU beds
Willacy (north of Cameron) Case fatality rate 3.71 Poverty rate 29.2% 0 hospital or ICU beds
Kenedy (north of Willacy) Case fatality rate 9.52 Poverty rate 10.6% 0 hospital or ICU beds
Brooks (west of Willacy, north of Hidalgo) Case fatality rate 4.62 Poverty rate 30.4% 0 hospital or ICU beds
Jim Hogg (west of Brooks, east of Zapata) Case fatality rate 3.24 Poverty rate 24.9% 0 hospital or ICU beds
Duval (east of Webb, north of Jim Hogg ) Case fatality rate 3.31 Poverty rate23.6% 0 hospital/ICU beds
Jim Wells* (east of Duval) Case fatality rate 2.38 Poverty rate 20.76%, 72 staffed hospital beds, 8 ICU beds
Kleberg* (east of Jim Wells) Case fatality rate 3.51 Poverty rate 23.2% 50 staffed beds, 10 ICU beds
Nueces* (Corpus Christi) Case fatality rate 1.89 Poverty rate 16% 1024 staffed beds, 123 ICU beds
Counties with an * had the state’s stats listed: confirmed cases, fatalities, case-fatality rate. Otherwise the state stats were zeroed out. Some also had dubious results for “population aged 65+” with a zero there but the insurance graph showing % of those over 65 with the various kinds of medical insurance.
The county I live in now has a case-fatality rate of 0.97, much lower poverty level…it’s now got several bedroom communities of tech people working in or on this side of Austin. Over 800 staffed beds, 157 ICU beds. Most people have health insurance.
The disparity in medical outcomes is matched by the disparity in available medical care, food security, and housing security. My home county’s case fatality rate of 4.38 means someone who contracts COVID there is more than four times as likely to die of it than someone where I live now. Texas’ overall case-fatality rate is not an ideal–but the offhand acceptance of much higher death rates in some counties is unacceptable…they’re people, not “just elders and Hispanics.” You know that already, but I’ve been stewing about this for months.
Elizabeth
Rural residents have always been poorer than city dwellers and received resources like schools, phone service, electricity, etc far later than neighboring towns, when it finally did arrive. Usually it required a subsidy or something on the order of the Rural Electrification Act to provide those services, as they cost more per person in less densely populated areas. But America stepped up and furnished those advancements, eventually.
COVID demanded an emergency, immediate response for our rural citizens. The Trump Administration of course didn’t even offer a proper emergency response for urban areas, at least not for prevention of COVID’s spread. Hospitals with ICU units were already available, so adding ventilators to their existing facilities didn’t require a large amount of funding, if they could find ventilators available.
Rural areas? They didn’t even have the basics to begin with. They were treated by the administration as acceptable collateral damage in the fight against COVID. How is it that Fox News and their viewers can muster a month of outrage over a War On Christmas every year, but not medical access for their rural (often) red state brethren? It’s hard to fathom.
1Simple solution: increase taxes, and do it progressively, so that you’re taxed much more on your second million dollars of income than your first. Spread the proceeds, apply them to public benefit.
2Just read in the Washington Post today of a doctor who drives 300 miles round trip to make sure a rural hospital gets enough vaccine to cover all of the first responders. This would be in northern Michigan, not the Upper Peninsula, but the lower. 1. This guy is amazing! 2.) He really shouldn’t be forced to do this but hey, they are out it he country. . .
3Thanks for these numbers. Poverty and racism are pre-existing health risk factors.
4My county in Maryland publishes daily deaths. Tgedeath rate is just about the national rate: 1 per 1,000.
What leaps out is that 145 of 180 deaths have been in covid concentration camps: retirement homes, lunatic asylum, prison, group homes. About 3 times the national rate.
We also know that workers in nursing homes typically split time between 2 or more places.
Isolation, even partial, works.
5So EM, we’ve been near neighbors, lived much of my life in several Cameron County towns. Worked in or traveled around every place you mentioned, especially Hidalgo/McAllen.
Truly a very different region from any other part of the US.
Endemic poverty, low education levels, political corruption, and still the area has grown tremendously. A much worse COVID45 impact isn’t surprisingly at all. Many diseases and parasites not found elsewhere in the US are endemic to the Valley too.
The population of the Valley close to the Rio Grande has more than quadrupled in ~thirty years. The much more sparsely populated interior counties [like Duval, Jim Hogg] not so much. Kenedy County [only town is Sarita], 1946sqmi, pop 404, has actually lost population [mostly giant ranches, King, Yturria, Armstrong; Dickus Cheney’s favorite hunting spot].
And all the while, still the Rethugs are steadily gaining more voters down here while the Democrats seem to be asleep at the wheel.
[PS– The Valley, at the GOM coastal area, is simply one of the best places anywhere for watersports– sailing, boating, fishing, surfing, windsurfing, etc. And now there’s an effing SpaceX Spaceport at Boca Chica Beach, one of the places I used to fish and sail at.]
6Sandridge: My mother and I used to go to Boca Chica. Lovely place. Wasn’t thrilled about the SpaceX Spaceport going there…too few wild places left. Takeoff from Mar a Lago instead!
I’m now working on a different area’s counties, Coastal Bend-ish, including Harris (fatality rate 1.42), Montgomery (posh outer suburb of H with fatality rate of 0.97), San Jacinto (fatality rate 4.47), Polk (2.83), Jasper (2.73), Fort Bend (1.08). There’ll be a post with a cluster of counties and more stats in each part of Texas, eventually, but I do have to work on the book in progress and care for the equines and the household.
Looking at other states in the Red Zone, I find that Kansas is losing medical personnel from smaller communities right now because of what one doctor calls “toxic individualism”–the “nobody can tell me what to do” and “experts don’t know nuthin'” combination. Town and county medical personnel have been vilified, threatened with death, for giving sound advice (wear the damn mask, don’t gather in groups, social distance…) The threatened personnel can find plenty of work somewhere else in this pandemic, so why stay in a town that touts its “small town values” of “taking care of our neighbors” if you threaten some of them verbally and physically and hate them for telling you *how* to care for each other by masking up.
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