Packed houses, higher danger
Crowded homes and poverty combine to raise infection risk
Every day, Isidoro Flores Contreras stands at the edge of a parking lot in Sand City selling $15 bouquets of flowers. And every evening, he returns to a small apartment that he shares with four other people.
Flores Contreras, who makes about $300 a week, is highly vulnerable to the coronavirus — both at work, which he had to stop until Monterey County’s health order was eased, and at home.
He lives in the most crowded ZIP code in Monterey County, sleeping in the living room of a twobedroom apartment. His housing conditions put him at high risk: The millions of Californians who live in overcrowded houses are more likely to be infected with the coronavirus, according to an analysis of health data by The California Divide, a statewide media collaboration.
The hardest-hit neighborhoods have three times the rate of overcrowding and twice the rate of poverty as the neighborhoods that have largely escaped the virus. And the neighborhoods with the most infections are disproportionately populated by people of color.
About 6.3 million Californians, or 16%, live in overcrowded housing. A third of those, 2.1 million, inhabit severely overcrowded housing. California has the second-highest rate of crowded households in the nation, about 2.5 times higher than the nationwide rate.
About two-thirds of the people who live in these crowded homes — some 4 million people — are essential workers or live with at least one essential worker. Health experts say this creates a perfect storm for the coronavirus: people crowded together in homes at night and spending days working on the front lines, exposed to a lot of people both at work and at home.
Hot spots for overcrowded homes are spread throughout California, including the Salinas Valley, Oakland, Los Angeles and desert towns near the U.s.mexico border.
Monterey County, home to many farmworkers, leads the state in overcrowding with 1 in every 7 households crowded. In Monterey and San Benito counties, nearly 1 in 10 households, the highest rate in the state, are both overcrowded and include an essential worker.
During a pandemic, this can be deadly.
Flores Contreras lives in the Alisal, a Mexican and Mexican-american community in Salinas where 61,000 people are squeezed onto a parcel of land less than 3 square miles.
The Alisal, where 22% live in poverty, is the center of the virus outbreak. About 31% of patients in Monterey County diagnosed with COVID-19 live in the 93905 ZIP code, even though just 14% of the county’s population lives there.
Many, like Flores Contreras, live doubled or tripled up, which heightens the risk of transmission. In the 93905 ZIP code, where the Alisal lies, 31% of homes are crowded. An average of 4.5 people live in each home.
The Census Bureau defines overcrowding as a home with more people than rooms, while a home with more than 1.5 people per room is severely crowded. California’s overcrowded homes are due, in part, to the sky-high cost of housing. Nearly a third of California renter households spend more than half their income on rent.
In Monterey County’s eleven ZIP codes, the five areas most heavily burdened by the virus had 2.5 times more crowded housing than areas with the fewest people diagnosed, as of June 8.
Drive 22 miles west from the Alisal, and you’ll arrive in Carmel-by-the-sea, a wealthy hamlet of fewer than 4,000 people along the Pacific. The median income is $91,000, and just 3.9% of homes are crowded. Fewer than five people (the county’s reporting cutoff) have been diagnosed with the virus, compared with 233 in the Alisal as of June 9.
Oakland is another area with wide disparities, based on which neighborhood people live in. In the ZIP code that contains the affluent Montclair neighborhood and Piedmont city, just 1% of homes are overcrowded. Fewer than 1 in 1,000 residents tested positive for the virus.
But across town, in majority Latino areas like Fruitvale, the infection rate was six times higher as of late May and 21% of homes are overcrowded.
An April analysis of New York City emergency department data found that neighborhoods with more residential overcrowding tended to have more emergency department visits for influenza-like illness in March compared with the previous four years.
“What we’ve been generally seeing is very high transmission rates within a household. … You can imagine if there’s less space, if people have to share room, it’s going to be really hard to isolate people,” said Justin Feldman, an NYU social epidemiologist who conducted the research.
Neighborhoods with more foreign-born residents, poverty and Latino residents had the biggest increases.
“And who do we know is living in crowded housing?” asked Feldman. “People who are lower income, they’re more likely to be immigrants, more likely to have to go to work.”
Social distancing is especially hard for essential workers, who must leave their homes regularly to keep the rest of the United States fed and sheltered.
According to an analysis by the Public Policy Institute of California, essential workers are more likely than nonessential workers to live in overcrowded housing — 16% versus 12%. More than a third of California’s labor force works in essential jobs that require them to be physically present, such as farming, fishing or forestry. Nearly a third of farmworkers and people who work in restaurants live in overcrowded homes.
Crowded housing also puts Latinos at higher risk. Latino households are nearly eight times as likely as white households to be crowded.
At the low-income health clinic where Dr. Efrain Talamantes works in Los Angeles, most patients arriving with coronavirus symptoms are essential or service workers, Latino, low-income and live in crowded housing.
“Patients who live in places where there’s no privacy … when you tell someone to get in a room and stay away from their loved ones, it’s almost nonsense to them,” Talamantes said.
He said patients often are just as worried about staying housed as they are about the virus, and fear being evicted if their landlord finds out they’ve contracted COVID-19.
“What we’re most concerned about is how this virus is going to exacerbate inequalities in communities where we’ve made so much progress since the last recession. It really takes a toll on the communities they’re in,” Talamantes said. This report is part of The California Divide, a collaboration among newsrooms examining income inequality and economic survival in California. Kate Cimini at The Californian reported this story with support from the California Fellowship through the USC Annenberg Center for Health Journalism.