San Diego Union-Tribune (Sunday)
Data: Pandemic is proving far worse for non-Whites
As virus crisis reaches first anniversary, statistics show it disproportionately harms Latinos in county the most
Nearly half the 267,000-plus San Diego County residents sickened by the novel coronavirus over the past year are Latino, but barely 1 in 5 people vaccinated so far are Latino, according to public health data.
Perhaps no two statistics more clearly reveal the disparities between people of color and Whites than these by-products of the COVID-19 pandemic.
There are many other points of disparity.
Be they infection rates, vaccinations, job losses, access to government relief and, of course, deaths — minority communities have fared worse than their White counterparts in almost every aspect of the coronavirus outbreak.
This week, as the nationwide lockdown unceremoniously marks its first anniversary, one indisputable fact has been laid bare: the Whitest, wealthiest and most powerful people have been largely insulated from the worst effects of the virus.
Meanwhile, more Blacks, Latinos and other ethnic groups continue to struggle.
Fewer people of color can work from home, because many are gardeners, factory workers, drivers or grocery clerks.
Children of color may be falling further behind in school because they lack Internet access, a stable place to study or other resources required in a stay-at-home world.
People of color also have less access to routine health care, to COVID-19 testing and to vaccinations, exacerbating inequities between Whites and minorities that have existed for hundreds of years.
“You become immune to it in a way,” said Esther Lopez, a Latina from Chula Vista who has spent the past 12 months consumed with fear of getting infected during one of her shifts at a South Bay supermarket and then sickening her children. “You know this is what happens because you’re a minority,” she said. “It’s been this way forever, but the pandemic has brought it to light.”
By most every metric, non-whites in San Diego County have borne the brunt of COVID-19.
According to the most recent data released by the county Health and Human Services Agency, Latinos account for almost half of all infections and make up 55
percent of the cases for which race or ethnicity is known.
That’s far higher than the Latino population in San Diego County at large, which according to the U.S. Census is 34 percent.
White patients account for just over 26 percent of COVID-19 cases locally, but they make up 45 percent of county residents. Blacks have actually been infected at a lesser rate — 3.6 percent — while they make up 5.5 percent of the population.
Disparities in the fatality rate are just as dramatic.
Just over 44 percent of the nearly 3,500 deaths attributed to the virus in San Diego County are Latino, public health data show.
Whites account for just under 37 percent of the local fatalities; Blacks account for 4.1 percent of deaths; and Asians, who make up 12.6 percent of the population, suffered 10.6 percent of COVID-19 deaths.
One area where most ethnicities were affected at proportions almost precisely equal to their prevalence in the population was in testing for the novel coronavirus.
County records through the end of December show 47 percent of those getting COVID-19 tests were White, just over the 45 percent they account for in the local population.
All of the other ethnicities reflected in county testing data were within 1 percentage point of their ratio to the total population.
Nick Macchione, the longtime Health and Human Services Agency director, said his office has worked for years to promote health equity across the county — most notably through the Live Well San Diego program.
Among other things, Macchione said his staff partners with community groups to promote healthy practices and to build trust across communities that do not always welcome government interventions.
“The issue is to break down the barriers to people who don’t know how to access these services,” he said.
Macchione said some factors outside the county’s control contributed to the disparities in infections and vaccines. State and federal health officials were largely responsible for rules on social distancing, protective gear and vaccine eligibility, he said.
“When you read into the numbers, I think San Diego fared well overall,” he said.
Health emergency
In January 2020, an unidentified San Diego County resident returned from Wuhan, China, where the virus that sparked the worldwide pandemic originated. County health officials took quick notice.
The traveler later tested negative for the virus, but by February evacuees from China were being housed, among other places, at Marine Corps Air Station Miramar to help prevent the spread of the novel coronavirus.
County officials declared a local health emergency Feb. 19, when seven patients were under investigation and under home quarantine.
By early March, county officials began warning schools, businesses and others on what to expect during the looming pandemic, which by then was unavoidably certain. They told people to wash their hands regularly and to avoid touching their face and eyes.
They put dozens of handwashing stations on the streets, warned people to avoid close contact and directed others to stay home if sick. They said residents should stock up on food and household supplies.
“Planning now helps you act more effectively to protect you and your family if COVID-19 does occur locally,” the county said in a March 9 news release.
The county confirmed its first COVID-19 case later the same day, a woman in her 50s who had recently traveled overseas. Mass gatherings of 250 or more people were banned March 12, along with visits to higherrisk facilities like long-term care and skilled nursing homes. Groups of 10 or more people were discouraged.
Gov. Gavin Newsom addressed the state on the evening of March 19, announcing a stay-at-home order that continues in some forms to this day.
“In a short period of time, COVID-19 has rapidly spread throughout California, necessitating updated and more stringent guidelines from federal, state and local public health officials,” Newson said.
Seemingly overnight, restaurants and bars closed, schools shut their doors, events were canceled, companies and government officials sent workers home and parks and other public spaces were declared off limits.
Toilet paper, bleach products and cleaning supplies disappeared from store shelves as the nation, and San Diego County, hunkered down.
Hard-hit South Bay
South Bay communities have seen the worst of the virus for most of the past year.
County public-health data show that the four ZIP codes with the highest numbers of cases are in Chula Vista, which is 60 percent Latino. The fifth-highest was in nearby National City and Barrio Logan, neighborhoods that also are heavily Latino, records show.
San Ysidro, another San Diego community just north of the U.s.-mexico border, has recorded more than 6,100 cases but has the highest proportion of residents contracting the virus.
Using the ratio of cases per 100,000 residents, San Ysidro reported more than 22,000 infections — almost 1 in every 4 people.
The number of positive infections in San Ysidro is notably higher than the second-most concentrated ZIP code in the county — 92154 in Chula Vista, where 16,000 cases per 100,000 residents were reported.
Many ZIP codes in northern San Diego County have been less impacted by the virus.
Communities like Del Mar, Solana Beach, La Jolla and parts of Oceanside and Escondido reported COVID-19 caseloads in the hundreds or in the low four figures, county data show.
The per-100,000 averages in those neighborhoods were generally between 1,500 and 3,500, well below the countywide rate of almost 8,000 — and as low as one-tenth of what many majority-latino communities experienced. Alexandra Perez Demma said she remembers the lockdown order last March “like it was yesterday.” She worries to this day how she will keep her Barrio Logan business, a boutique gift shop called Simon Limon, afloat.
“It was super scary,” said Perez Demma, who opened her storefront in 2018. “I was here at the shop and all of the sudden we had to close and stay home, and we had no idea what was happening.”
Perez Demma said she was turned down for a small business grant. No one told her she could appeal the rejection.
“We don’t have access to resources that more aff luent people would,” she said. “There’s not more business organizations and nonprofits in our community like there are in other neighborhoods. We were not getting any information.”
Like many small-business owners, Perez Demma came up with her own plan to protect her company.
She partnered with another activist to create “Walk the Block,” a weekly Saturday community event that has participating stores, galleries and pop-up restaurants along Logan Avenue open for outdoor shopping and dining.
“Without that, I don’t know that I would have survived,” Perez Demma said. “Literally, 100 people come through my doors.”
Uneven relief
Just before the outbreak, San Diego and most of the nation were riding high.
Unemployment rates were near historic lows, U.S. stocks were near record highs and consumer confidence was sturdy. The Senate had just acquitted President Donald Trump following his first impeachment, and the Democratic presidential primary election season was in full swing.
But the virus was spreading quickly around the world — almost nowhere faster than in the United States, which was slower to respond to the public-health threat than other countries.
Virtually every sector of the American economy was hobbled as classrooms went dark, businesses sputtered, jobs disappeared, rent and utility bills went unpaid. People who could work from home adapted, but many suffered.
The economic collapse was dire across the board, but hit minorities especially hard.
Unemployment in California soared from 4.4 percent on March 31, 2020 to 15.9 percent at the end of June, according to the Economic Policy Institute, an independent research group in Washington, D.C.
By early summer, joblessness for Black and Latino workers in California topped 18 percent; for Asians, the unemployment rate was 14.2 percent. And 13.5 percent of White people were out of work.
Andy Sanchez was among those whose income dried up with the lockdown.
Sanchez applied for government relief but was rejected because his company, San Diego City Painting, relies largely on independent subcontractors who are paid by the job rather than a defined salary.
“Most small businesses in the construction field subcontract work,” he said. “If you’re a small business and generating business in the economy, why would you be treated differently than other employers? We’re still putting food on the table for other people.”
Federal relief legislation set aside $600 billion under the so-called Paycheck Protection Program, but the benefits proved elusive for many minority-owned businesses.
Early reports on how the financial aid was distributed to American businesses showed the majority of loans — which did not have to be paid back if they were used for salaries — went to corporations and White-owned businesses.
The U.S. Small Business Administration reported in July that among the business owners who disclosed their ethnicity, 83 percent of the loans went to White people.
Eight percent of the loans went to Asian-owned businesses, 7 percent were awarded to Latino-owned companies and 2 percent to Black-owned businesses, the federal agency reported.
Sanchez was reluctant to blame race for his loan application being denied.
“We are used to the struggle,” he said. “We’re used to working hard and fighting for what we have. We are going to keep doing that whether there’s a pandemic or no pandemic.”
‘Most at risk’
The virus also affected minorities disproportionately when it comes to other mainstays of American society.
Researchers at UCLA, for example, reported last summer that Blacks and Latinos in California were more than twice as likely to have trouble making monthly rent payments than White people.
More specifically, 23 percent of those who could not pay rent in the initial months of the pandemic were Black and 20 percent were Latino, according to the Luskin Institute on Inequality and Democracy.
Those percentages were more than double the 9 percent recorded for Whites and Asians.
“These systematic racial or ethno-racial disparities are the product of systemic inequality,” researcher Paul Ong wrote in the study. “People of color, low-income individuals and those with less education and skills are most at risk.”
The coronavirus outbreak has had one positive outcome for needy families. The conversion of most schools to online instruction prompted a huge investment in technology.
In January 2020, two months before the lockdown, some 100,000 students in San Diego County lacked broadband connectivity, according to the Office of Education — approximately 1 in 5 children.
One year later, that number had been reduced to 22,000.
The same survey showed that 300,000-plus students had no access to mobile computing devices in January 2020, but by January 2021 the number had sunk to about 38,000.
Even so, experts worry that the damage done to this generation of students is serious — and worse for minorities.
A national report last June from the research consultancy Mckinsey & Co. said the average student would lose 6.8 months of learning due to COVID-19.
For Whites, the average loss was six months but Blacks forfeited 10.3 months on average and Hispanics lost an average of 9.2 months, the study said. The damage was most severe for low-income students, with an average loss of 12.4 months of learning.
“In addition to learning loss, COVID-19 closures will probably increase high school drop-out rates, currently at 6.5 percent for Hispanic, 5.5 percent for Black and 3.9 percent for White students, respectively,” Mckinsey reported.
“The virus is disrupting many of the supports that can help vulnerable kids stay in school.”
Equality vs. equity
The full breadth and scope of COVID-19 will surely be measured for decades to come, even for those who manage to defeat or dodge the virus.
The National Center for Health Statistics, an arm of the U.S. Centers for Disease Control and Prevention, reported last month that the life expectancy of an average American was 77.8 years, a drop of one year in the first half of 2020, compared to the same period in 2019.
“Provisional life expectancy at birth in the first half of 2020 was the lowest level since 2006 for both the total population (77.8 years) and for males (75.1), and was the lowest level since 2007 for females (80.5),” the report said.
The life expectancy for White people declined by 0.8 years, to 78 years, health researchers said.
Not surprising, the decline was more dramatic for Black people, whose life expectancy slumped by 2.7 years, to 72 years. For Hispanics, the decrease was 1.9 years, for a life expectancy of 79.9 years.
Aydin Nazmi, a social epidemiologist at California Polytechnic University in San Luis Obispo, examines the root causes of health inequities. The pandemic has exacerbated social disparities that have persisted for centuries, he said.
“If you are already in a place where you’re a person of color, or low income, you are already at a disadvantage in terms of health,” Nazmi said. “That’s not brain surgery. It’s been that way for a long time.”
Public policy can solve health inequities, Nazmi said, but not solely by enacting laws like the Affordable Care Act and social-service efforts like affordable housing programs that do not address underlying issues.
He said elected officials at every level of government should stop working to pass laws that treat everyone equally and instead focus on what will help those with the most demonstrable needs.
To make his point, Nazmi shows students a drawing of three people watching a ball game from outside a fence — one tall person, who can see over the fence; one average, whose sight line is just below the top of the fence; and one short, who also cannot see over the fence.
Giving each person a single box to stand on may be equal, he said, but equity is giving the middle-sized person one box and the shortest person two boxes.
“In order to achieve equity, we have to treat people differently,” Nazmi said. “This is a big systemic issue. It’s not (just) educational opportunities, the labor force, individual lifestyle or where you live — it’s all of that.”
Richard Villa, who runs a payroll service and serves as chairman of the San Diego Hispanic Chamber of Commerce, said members of his business group had problems accessing government relief funding.
Latino business owners were suspicious of the various grant and loan programs, he said; and worse, the standardized applications were in English, geared to White people.
Villa said he and other chamber officials met with small business owners and promoted the relief programs. They handed out masks and advised members about how to keep their businesses open during the pandemic.
“We built that trust; we changed the language,” he said. “We explained that these are your tax dollars that you are taking. Once we formalized that concept, we literally went from 3 percent participation to 12 percent.”
Gov. Newsom announced earlier this month that 40 percent of vaccine supplies would be earmarked for the most needy ZIP codes. That was welcome news to Lopez, the grocery store employee from Chula Vista. So far, she has avoided the virus even though she is in contact with hundreds of people a day.
She goes home after every shift and enters through the garage, where she takes off her shoes. She changes clothes and puts what she was wearing into a special laundry basket, then uses Lysol and disinfectant wipes before seeing her kids.
After three-plus months of waiting, Lopez secured her first dose of vaccine last weekend and expects to receive the booster shot next month.
“Thank God I didn’t get sick,” she said.