‘Perfect storm’ hits Ala.

Rural communities suffer highest rate of COVID cases

HAYNEVILLE, Ala. — Sparsely populated Lowndes County, deep in Alabama’s old plantation country, has the distinction of having the state’s highest rate of COVID-19 cases and its worst unemployment rate.

Initially spared as the disease ravaged cities, the county and other rural areas in the state are now facing a “perfect storm”: a lack of access to medical care combined with poverty and the attendant health problems, including hypertension, heart disease, lung disease, kidney disease and diabetes, that can worsen the outcomes for those who become sick with the coronavirus, said Dr. Ellen Eaton.

“I think a lot of people fell into this idea that we were immune because we’re not in tight spaces like in New York and New Jersey, and we’re in wide-open areas,” said Eaton, who specializes in infectious diseases at the University of Alabama at Birmingham.

But no longer. Lowndes and nearby poor, mostly black counties in rural Alabama are facing an increase in confirmed infections. Their outbreaks are also affecting urban areas, since many of the sick need to be transferred to city hospitals.

Less than 30 miles from the white-domed capitol in Montgomery, Lowndes lies along the highway where the Rev. Martin Luther King Jr. led voting rights marchers from Selma to Montgomery in 1965. Today, it has a population of 9,700, and at least 220 have tested positive for the virus. The surge in Lowndes and neighboring counties may be inextricably linked to their demographics — and thus their history as home to plantations where slaves grew the cotton that fueled the Confederacy. About 75% of Lowndes’ population is African American, and nearly 30% live in poverty. Its jobless rate rose to 26% as area manufacturing plants closed during the pandemic.

The problem can also be seen elsewhere in the rural Deep South, where a tally by John Hopkins University shows a heavy concentration of cases.

Black people have suffered disproportionately in the pandemic. An Associated Press analysis in April of available state and local data shows that nearly one-third of those who have died are African American, with black people representing about 14% of the population in the areas covered in the analysis.

As can be seen in Lowndes, some health conditions that exist at higher rates in the black community make African Americans more susceptible to the virus, and they also are more likely to be uninsured.

Alabama’s figures reflect that national picture. About 27% of the state’s 4.9 million residents are black, but African Americans represent 44% of the nearly 600 who have died.