The recent Black Live Matters protests made me think a lot – as a white man, as a husband and dad, as a biologist by training, as a health economist by day, as someone interested in COVID-19 data where I live by night … as a human, in summary. I don’t have grandiose pieces of advice or any deep thoughts, not for here (but if you call me, we can talk ;-)). Here, let’s continue our exploration of COVID-19 data in Maryland.
There are only 2 metrics that the MDH dashboard provides, around races: confirmed cases and deaths (and probable deaths but as this is not precise and small, let’s put this aside for the moment).
Today (June 12, 2020), communities worst hit (in crude numbers) are African Americans and Hispanics in terms of cases (17,345=28% and 16,293=27%) and African Americans and Whites in terms of confirmed deaths (1,133=41% and 1,164=42%). This is represented in the figure below. Note also the high number of “race not available” in the cases chart (this could mean a worst impact for some communities as some would fear negative consequences of disclosing their race).
But this means little if we don’t know how many Marylanders are in each categories. Numbers varies and I couldn’t find the following data from the Census or the CDC directly (the 2 sources I would consider the most reliable on this): number of people categorized in 1 and only 1 race at a time (which is an approximation of reality but allows for easier calculations below). I found the following data from SuburbanStats: in Maryland there are approximately
- 1.7 million African Americans (~27%),
- 318 thousands Asians (~5%),
- 479 thousands Hispanics (~7%),
- 3.3 million Whites (~53%) and
- 410 thousands of “others”.
Given this, we can see a different picture …
In this figure, on top, we see the evolution of crude case numbers since April (up to June 11). We also see the rapid rise of cases in Hispanics since they were separated from the “Others” (April 14). But at the bottom, I show the evolution of cases relative to the population. And here we can clearly see that, very early on, Hispanics accumulated cases in larger proportion compared to their less than half million population. Yesterday (June 11, 2020), there were 3,461 Hispanic COVID-19 cases per 100,000 population (compare that to 350 in Whites).
In the following figure, on top, we see the evolution of confirmed deaths since April (also up to June 11). Here, both African Americans and Whites are close and widely distancing the other communities. But at the bottom, the evolution of deaths relative to the population is shown. And here we can clearly see that African Americans (especially) and Hispanics are the worst hit communities compared to their general population. Yesterday (June 11, 2020), there were 66 African American deaths per 100,000 population and 58 Hispanic deaths per 100,000 population (compare that to 34 in Whites).
The table below summarizes cases and deaths relative to population on June 11, 2020, in Maryland:
|Community||Cumulative COVID-19 (cases / 100,000 pop.)||COVID-19-specific death rate (deaths / 100,000 pop.)||Share of the general population|
So even in Maryland, a US state ranked 6th best state overall and #8 for healthcare in 2019, disparities exist. Hispanics are the worst hit in COVID-19 cases (27% of cases and > 3,000 cases per 100,000) in cases while they represent only 7% of the population. And African Americans are the worst hit in COVID-19 confirmed deaths (41% of deaths and > 60 deaths per 100,000) while representing only 27% of the population. The CDC has an interesting summary of main causes of these disparities but also what people and organizations can do about it; a good read to start doing something about these inequalities.
To be continued …
As usual, you’ll find other graphs on my page about COVID-19 in Maryland (and figures above are updated with new data as they appear) and the data, code and figures are on Github.
Post Scriptum – but still important … Methodologically, there are a few caveats for all this. First, the concept of race is linked with so many other parameters that COVID-19 is probably exacerbating these other issues (with an indirect effect on people of color) rather than targeting a specific population (the virus itself does not choose who it will infect). Also, there is no explanation on how race information is collected: with a question on the test form (with all the reporting bias it contains), by linking the names or social security number to a previously recorded race identity, …? This is another source of potential bias. Third, we have here the 2 extreme metrics: cases and deaths. There is no information on hospitalizations, despite requests to the MD Department of Health or the Governor’s staff (no hospitalizations info for counties neither btw). I suspect here that race collection in hospitals is not performed (because unethical?) and/or there would be HIPAA issues if this data would be transmitted from hospitals to the state, for instance.