How Race, Class, And Place Fuel A Pandemic

No matter where we live, the color of our skin or where we come from, we all want to be safe and protect our loved ones from COVID-19. But race counts – even during an all-encompassing global pandemic. Even when the crisis has impacted every community and every walk of life.

Tags
Economic Opportunity, Healthcare Access, Place

Published
May 05, 2020

Table of Contents

Our research shows that race matters in a particularly sharp and uncompromising way in the COVID-19 crisis — and unless our collective response starts with addressing our unequal conditions, none of us will be safe.

The COVID-19 crisis shows that one of the deadliest underlying conditions in America is systemic racism. For generations, racial and economic segregation has limited Angelenos’ mobility, resulting in the concentration of low-income Black, Latinx, Indigenous, and other people of color in socioeconomically disadvantaged communities – communities exposed to toxic chemicals and other unhealthy land uses, failing infrastructure, and lack of access to services. The average life expectancy in L.A.’s City Council District 8 in South Los Angeles is 78.0 years, while the average in Council District 5, which includes much of the Westside and parts of the San Fernando Valley, is 85.3 years.1

Los Angeles’s long history of housing segregation and the use of freeways to divide communities of color has not been a barrier to the virus; it has been fodder for its spread. The mandate to shelter in place challenges residents in these under-resourced communities. Organized community-level mutual aid mobilization is bridging gaps in government response, but more is needed.

To survive this pandemic, Angelenos need solidarity. The health and well-being of each Angeleno depends on the health of the person standing next to us and the person standing next to them. We need our elected and public health leaders to redouble their courageous efforts to focus resources on these highest-need communities and ensure that everyone, regardless of race and income, is safely housed, cared for and protected – without exception so that we can all be safe.

The people who have long been taken for granted in our daily interactions are now finally being recognized as essential and indispensable. However, the data we present here shows that as the contours of this pandemic shifted in L.A., these newly-celebrated essential workers were put squarely into harm’s way. Generations of wealth extraction and neglect have left communities of color with little but their mutual aid networks to weather this newest threat. Now is the time to stand up and address the unequal conditions that have made communities of color more vulnerable and eliminating these unequal conditions for good.

This crisis is an international crisis. Local government and public health officials are working within a chaotic environment with a lack of federal leadership early on. Given this, we understand the strain that our local officials are undergoing. This report is offered to highlight the disparate impact on Black, Latinx, Indigenous, people of color, and low-income communities. Our intention is to partner with local elected and health officials to reverse these trends.

How Place Is Fueling A Pandemic

While uneven access to testing impacted where the earliest cases were detected, this analysis shows the progression of COVID-19 in L.A. County. What started as a virus initially found in wealthier, predominantly White communities — presumably those most likely to travel overseas — shifted across geography and took hold in predominantly Black and Latinx communities.

We analyzed data from The Los Angeles Times’ data desk, which is continually tracking and updating data from all of California’s county health agencies, including daily updates from the Los Angeles County Department of Public Health (LACDPH).

Our analysis shows how all confirmed cases of COVID-19 have moved through the county by community from when LACDPH first began reporting cases by geography until now. We use the same countywide statistical areas LACDPH uses to report its data. These areas often correspond to cities, neighborhoods, and unincorporated areas throughout the county.

Key findings

  • In March 2020, the areas with the largest number of cases were Los Angeles’s historically wealthier communities, both suburban (such as Encino and Torrance) and more urban (including West Hollywood, Beverly Hills, Santa Monica, and Brentwood).
  • By mid-April 2020, new cases began appearing in lower-income areas, including the southeast and southwest parts of metro L.A., and northeast to the San Fernando Valley.
  • In early May 2020, the pandemic took root in South and Southeast L.A., as well as parts of the San Fernando Valley and far reaches of L.A. County, including Pomona, Santa Clarita, Palmdale, and Lancaster.
  • By March 16th, 2021, one year after L.A. County issued its first Health Officer Order concerning the COVID-19 pandemic, cases continued to be concentrated in lower-income communities of color in Southeast LA, South LA, the San Fernando Valley, Antelope Valley, and the San Gabriel Valley.

How Place And Class Fuel A Pandemic

Alongside these geographic changes, the virus’s impact has also shifted in economic and racial terms. Using a similar approach to the Los Angeles County Department of Public Health’s report on racial and economic disparities, we estimated how the spread of the virus shifted over time by race and class.2

We matched case data to demographic data published by Los Angeles County. We compared each area’s percentage of residents below 200% of the Federal Poverty Level to the median (or midpoint) in the county and grouped them into two equal categories: those with a HIGHER percentage of residents in poverty compared to the county median and those with a LOWER percentage. We start our analysis on March 27th, 2020 where more communities were consistently included in the COVID-19 case data.

Key findings

  • Through early April 2020, our data show lower-poverty areas had slightly more cases than higher-poverty areas.
  • By the second week of April 2020, the growth of cases in poorer communities accelerated faster than in wealthier areas, and the gap began to grow.
  • The trajectory of cases in wealthier communities has grown at a relatively slow, steady rate, with arguably some flattening of the curve. This may be due to the ability of residents of wealthier areas to shelter in place.
  • By April 20th, 2020, a new dynamic came into play, with a steeper increase in cases in higher-poverty areas that continued through the summer.
  • By March 16th, 2021, the number of cases in higher-poverty areas was about 2.9 times the number in lower-poverty areas.

How Place And Race Are Fueling A Pandemic

Despite the tremendous efforts of the County’s Department of Public Health (LACDPH) and Department of Health Services (LACDHS), as of April 26th, 2020, we only had race and ethnicity data for 55% of L.A. County’s COVID-19 cases. We therefore used area race and ethnicity to provide a fuller picture of the racial impact of the pandemic over time, starting with the pandemic’s earliest days.

Again, using case data published by the Times and demographic data from Los Angeles County, we compared each area’s percentages of residents for each race and ethnicity to medians across the county. We then grouped them into two equal categories: those with a higher percentage within each racial/ethnic group compared to the county median and those with a lower percentage. We start our analysis on March 27th, 2020, where more communities were consistently included in the COVID-19 case data.

Key Findings By Racial Group

  • White: Communities with a higher percentage of White residents have stayed on the same continuous incline of cases, and since April 18, 2020, have had consistently lower case numbers than lower-White areas.
  • Latinx: Initially there was a lower prevalence in higher-Latinx areas (which may reflect limited access to testing and reluctance to access care due to distrust of public institutions). After a tipping point in early April 2020, cases began to increase more rapidly compared to lower-Latinx areas. By March 16th, 2021, higher-Latinx areas had 2.7 times as many cases as lower-Latinx areas. This gap has remained the same since mid-November 2020.
  • Black: Since the beginning of the pandemic, higher-Black areas have been on a steeper increase in cases compared to lower-Black areas. By the third week of April 2020, there was an even steeper curve and a widening gap between the higher-Black and lower-Black areas. Since May 1, 2020, the gap has remained about the same. As of March 16th, 2021, higher-Black areas had roughly 1.4 times as many cases as lower-Black areas.
  • Native Hawaiian and Pacific Islander: Higher- and lower-NHPI areas had a similar number of cases in late March and early April 2020, but as April progressed the gap in cases widened. As of March 16th, 2021, higher-NHPI areas had 1.5 times as many cases as lower-NHPI areas. This number has remained about the same since April 1, 2020. The disparate impact on NHPI residents may be underestimated here due to small population numbers and their population being geographically dispersed.
  • Asian: From the beginning of the pandemic through mid-June 2020, higher-Asian areas had a higher number of cases with a more steady and narrow gap compared higher-Latinx and Black areas. By mid-June 2020, higher- and lower-Asian areas showed similar curves in cases.
  • American Indian or Alaska Native: Higher- and lower-AIAN areas show similar curves in cases throughout the pandemic.  As of March 16th, 2021, higher-AIAN areas had 1.1 times as many cases as lower-AIAN areas.  These relatively similar curves could be due to their population being dispersed geographically, misidentification, and the tendency of data to collapse their identities with other racial/ethnic groups.

Our findings coincide with the conclusions from LACDPH’s report where Black, Latinx, NHPI, and low-income populations were the hardest hit populations for cases and deaths in the county.2 Ultimately, it appears that successful implementation of shelter-in-place rules in wealthier, more White communities has kept the trajectory of cases steady and even accomplished some flattening of the curve. By mid-April 2020, the COVID-19 crisis took a different trajectory for communities of color, particularly for higher-Latinx and Black areas where their curves have reflected steeper growth in cases compared to their lower counterparts.

Conclusion: A Racialized Pandemic

Because race, class, and geography are so closely linked in Los Angeles, the impact of COVID-19 is being felt most strongly by those who live at the intersections of these circles of vulnerability.

Decades of discriminatory housing, banking and economic policies by corporations and public institutions have prevented Black, Indigenous, and Latinx residents in Los Angeles from acquiring the kind of economic security needed to weather a crisis, thrusting them onto the front lines of exposure to the virus. Many are public transit-dependent, living in over-crowded housing far from supermarkets and other essential businesses; thereby, less able to safely shelter or forgo a paycheck the way wealthier and White Angelenos are often able to do.

On top of increased exposure, they also suffer disparate mortality rates, often due to overlapping vulnerabilities created by generations of disinvestment from public health infrastructure and other structural inequities. Housing segregation and the legacy of redlining means more Californians of color live in denser, multi-generational households where infection can spread more easily; a less-healthy built environment starves low-income people of color of access to safe places to recreate and exercise or to buy healthy food; racialized criminal justice systems disproportionately put Latinx and especially Black residents at high risk of infection in jails and prisons; and the epidemic of houselessness that has overtaken Los Angeles means many people of color have no place to go for shelter from the virus.

These underlying disparities that lay the groundwork for these unequal trajectories in COVID-19 are well-known to our county health agencies. LACDPH and LACDHS have each taken an active role in tackling the unequal conditions in our county – from creating the Center for Health Equity to advance racial and economic justice, to implementing a Whole-Person Care pilot to more holistically integrate justice-impacted individuals and other vulnerable groups into our health care system, among other examples. However, actions at the federal level and other public agencies early in the pandemic have fostered a lack of trust or feelings of safety that have hindered the effectiveness of the pandemic response. Immigrant and undocumented or mixed-status families have been targeted by Trump Administration policies ranging from ICE raids to the public charge rule to shutting down even legal immigration channels. And many Black residents have a long-standing and understandable mistrust of government institutions due to negative interactions with law enforcement and well-documented incidences of police violence.

In the end, this data should make all of Los Angeles mobilize in support of these communities. The story the data tells is of wealthier, Whiter communities being taken care of by primarily Black and Latinx workers, who must not be made to fend for themselves as we allow business to go back to normal. Los Angeles needs to extend the community of care and affirm that the lives of Black, Latinx, Indigenous, and Pacific Islander families matter as much as White families do.

Recommendations

Despite decades of disinvestment, many of the most heavily-impacted communities have trusted home-grown community infrastructure and institutions that deploy resources to meet people’s immediate needs. The pandemic and its multi-pronged threat requires us to act with speed to equitably deliver resources to low-income communities of color based on their exposure risk, their prevalence of underlying conditions, and their lack of access to critical services and infrastructure. This is a matter of equity – but since no Angeleno will be safe from this virus until all of us are, it is also the only option to safeguard the lives of all.

To support our communities, we offer the following immediate recommendations. We are excited to work alongside our community partners, philanthropy and those that have been working on the front lines of this health crisis – particularly those in the County’s Departments of Public Health and Department of Health Services – to ensure the health and safety of everyone, regardless of race and income. These recommendations are focused on short-term needs to get through the worst of this crisis. Long-term, far more must be done to remedy underlying disparities, including a major investment of public health resources and services in high-need regions.

A surge in culturally appropriate public education campaigns.

  • Campaigns should be designed and executed with local, authentic community leaders that have pre-existing relationships and trust with those communities, and should be delivered through established media channels (such as La Opinion, the Sentinel, KJLH, and Univision).
  • The content should be developed collaboratively, but must emphasize that both testing and treatment are free for patients, since it is completely subsidized by the state of California.
  • Community-based organizations, including nonprofits, congregations, labor unions, and others, should also be leveraged to reach out to their membership directly either through phone-banking or through use of “neighborhood education teams” that include organizers and gang intervention workers who have credibility and familiarity with the neighborhoods and residents.

A surge in funding and equipment for local community clinics and other parts of the local infrastructure that have trust and relationships in the neighborhoods.

  • Community clinics in the hardest-hit communities must immediately receive additional resources for testing and personal protective equipment for their workers.
  • All health providers in these neighborhoods should also partner with community-based groups to help get the word out to their constituencies about the availability of increased testing and services.
  • There must also be coordination with law enforcement to ensure that unnecessarily-high police presence does not interfere or discourage residents from accessing services.
  • For those who do not have reliable access to telephone services, additional testing options beyond the 211 appointment system must be made available.
  • All individuals who live and work in county youth and adult detention facilities must be tested to ensure their safety, and the safety of the households and communities to which they return. Youth and adult detention facility staff should be screened daily through questionnaires and temperature checks.
  • If a person tests positive but does not have a housing situation allowing them to safely quarantine, they should be provided free, voluntary options for medical shelter.

A surge in the supply of personal protective equipment, cleaning and sanitation supplies, and food and meals, especially for seniors, in the hardest-hit neighborhoods. Residents must be protected at work, in their homes, and when they are out and about for essential shopping and errands.

  • This should be happen concurrently with a surge in PPE and cleaning supplies at work sites with a high concentration of low-income workers of color, particularly in the care and service sectors, regardless of where such work sites are located.
  • Community-based organizations in the hardest-hit communities should be leveraged as neighborhood distribution points for these critical supplies to reinforce their trust and ties to community residents AND to strengthen their standing as critical institutions needed to weather this current crisis as well as to support an equitable approach to any recovery as the virus subsides.

An equity-based response must avoid important dangers. It must NOT:

  • Use messaging or framing that suggests that their vulnerability is somehow the fault of these communities themselves because of lifestyle choices and cultural practices.
  • Increase policing to enforce stay-at-home order. We plan to track the race-based police stop data made available by SB 1421, and public officials will be held accountable if the pandemic leads to increased criminalization of highly-impacted communities.
  • Punish family-centric practices and culture. Physical distancing is taking a toll on Angelenos. It especially runs counter to Black, Indigenous, Latinx, and people of color’s family-centric cultural norms. Enforcement measures must be culturally astute not punitive. Community leaders can help develop creative ideas for how we can continue to support one another while keeping risks low.
  • The COVID-19 pandemic response is the crucible of our time. It has simultaneously laid bare systemic racial and economic inequities and uplifted the capacity of community driven infrastructure to deploy to meet existential threats. We are a long way from repairing the harm caused by inequitable systems; nonetheless, we are at a critical juncture. The time to center equity in our immediate and long-term response has arrived.

Acknowledgements

Many partner organizations supported us by co-creating the framing and recommendations for this; they also endorse these recommendations:

  • Anti-Recidivism Coalition (ARC)
  • Brotherhood Crusade
  • CD Tech
  • Children’s Defense Fund-California
  • Coalition for Humane Immigrant Rights (CHIRLA)
  • Coalition for Responsible Community Development
  • Community Coalition
  • East Yards Communities for Environmental Justice
  • InnerCity Struggle
  • Khmer Girls in Action
  • Los Angeles Alliance for a New Economy (LAANE)
  • Los Angeles Black Worker Center
  • L.A. Voice
  • PICO California
  • Power California
  • SEIU Local 99
  • SEIU Local 2015
  • Urban Peace Institute

Research and data analysis by Leila Forouzan and Elycia Mulholland Graves with support from Chris Ringewald, JuHyun Sakota, Ryan Natividad, Laura Daly, and Jennifer Zhang. Conceptualization, writing, and editing support from Jung Hee Choi, Matt Trujillo, Tolu Bamishigbin, Amy Sausser, Daniel Wherley and Wendy Killian. Design and data visualization by Katie Smith and Rob Graham.

Data Sources & Methodology

Data Sources

COVID-19 Cases: L.A. Times Data Desk, California Coronavirus Data, Place Totals. Updated on 03/29/2021. Retrieved from https://github.com/datadesk/california-coronavirus-data.

COVID-19 Cases: L.A. Times Data Desk, California Coronavirus Data, Agency Totals. Updated on 03/29/2021. Retrieved from https://github.com/datadesk/california-coronavirus-data.

Total Population, Race, and Poverty Estimates: Los Angeles County, Internal Services Department, Population and Poverty Estimates, 2018. Retrieved from https://egis3.lacounty.gov/dataportal/2014/09/09/population-and-poverty-estimates/ (link no longer active).

Methdology

We pulled data from Los Angeles Times Data Desk, where the Times is continually tracking and updating COVID-19 case data from all of California’s county health agencies, including Los Angeles County Department of Public Health (LACDPH). We filtered the data just for Los Angeles County and connected the data to the same countywide statistical areas LACDPH is using to report its data. The county frequently uses countywide statistical areas to report and track health data, and they serve as a foundation for their population estimates.  For the cities of Long Beach and Pasadena, we use agency level totals from the Los Angeles Times Data Desk.

Using population estimates published by the county, we calculated each area’s percentages of White and people of color residents as well as their percent of residents living under 200% of the Federal Poverty Level (FPL). We use 200% of the FPL as a measure of poverty given the high cost of living in the county and generally the low threshold for poverty in the United States where in 2020 the poverty threshold for a family of four was $26,200.3

We then split areas into two equal groups using the county median across cities and neighborhoods for each characteristic as a splitting point: HIGHER for areas greater than county median for cities and neighborhoods and LOWER for areas lower than the county median. We restrict our analysis by race and class to areas with 1,000 people or more to control for extreme values. While case data are available before March 27th, 2020, we start our analysis by race and class on March 27th – where there was greater consistency in how the L.A. County Department of Public Health reported cases by city and community.

Limitations: These data are continuously updated based on the Times and LACDPH reporting. At times, LACDPH makes slight changes in the cities and communities it reports data for. We try to account for these changes as much as possible in our analysis, but at times smaller communities may be missing data for a particular date due to the underlying data. These slight changes do not affect the overall trends and findings included in this report.

Citations

  1. Measure of America, A Portrait of LA County, City of LA Council District Extract. Retrieved from https://measureofamerica.org/los-angeles-county/
  2. U.S. Department of Health & Human Services, HHS Poverty Guidelines for 2020, Retrieved from https://aspe.hhs.gov/poverty-guidelines
  3. Los Angeles County Department of Public Health, April 28, 2020. Report on LA County COVID-19 Disaggregated by Race/Ethnicity and Socioeconomic Status. Retrieved from http://publichealth.lacounty.gov/docs/RacialEthnicSocioeconomicDataCOVID19.pdf