In rural America, Covid hits blacks and Hispanics hardest

The coronavirus pandemic hit rural America last year, causing a spike in white deaths as the virus exacerbated long-standing health problems there.

But through small towns and farmland, new study foundCovid has killed blacks and Hispanics significantly more than their white neighbors. Even at the end of the second year of the pandemic, in February 2022, overburdened health systems, poverty, chronic disease, and low vaccination rates kept non-whites bearing the burden of the virus.

Blacks and Hispanics in rural areas suffered exceptionally high tolls, dying far more frequently than those in cities during the pandemic’s second year.

In cities of all sizes, the racial gap in Covid deaths has narrowed. This has been especially true in recent times, when a significant rise in population immunity has eased the strain on healthcare systems that seems to be hurting non-white Americans the most.

wit Coronavirus deaths are on the riseStill, and health officials bracing for an even deadlier winter, scientists have warned that so far, efforts to close the racial gap in vaccination rates have not been enough to shield people of color from the devastating effects of large waves of Covid.

Nowhere were these difficulties more pronounced than in the countryside. Blacks, Hispanics and Native Americans in these places recorded the deadliest second year of the pandemic of any major racial or ethnic group anywhere in the United States, according to new research led by Andrew Stokes, assistant professor of global health. at Boston University.

In these communities, the Biden administration’s assurances that every death from Covid is now preventable is making it difficult to get medical care.

Rural pharmacies often raremaking it difficult for poorer and less mobile residents to get life-saving antiviral pills.

Doctors say some black patients, especially those who are uninsured or far from hospitals, are waiting too long before seeking help to benefit from new treatments.

And blacks and Hispanics were getting booster shots at lower prices, a consequence of what some doctors say is a lack of awareness caused by declining public reporting, especially in conservative states.

“The national message is that everyone should now be able to do what they need to do to protect themselves from the virus,” said Bobby Jenkins, mayor of Cuthbert, Georgia, a predominantly black city whose only hospital closed six months after the start of the pandemic. pandemic. “But not everyone is able to do it yet.”

Racial disparities in Covid deaths have narrowed for several reasons, scientists say. The early rollout of the vaccine prioritized older Americans who are disproportionately white. But over the past year, primary vaccinations for blacks and Hispanics have risen about twice as fast as those for whites.

The rate for Hispanics, 54 percent, now exceeds the rate for white people, which is 50 percent. The black vaccination rate of 43 percent still lags, but the gap has narrowed.

The virus also infected and killed blacks and Hispanics at such a greater rate in the first year of the pandemic — at one point in 2020, rural blacks were dying at about six times the rate of white residents — that it may have had fewer targets by the year. 2.

These changes have been so profound that among the oldest Americans, the death rate from Covid recently surpassed that of blacks, according to the Centers for Disease Control and Prevention.

But the narrowing of the racial gap is due in part to the worsening of the pandemic for white people, not to major gains for blacks or Hispanics. The death rate from white Covid rose by 35 percent from the first to the second year of the pandemic. CDC found. During this period, Hispanic deaths fell by just 1 percent, while those of blacks fell by 6 percent.

“This is not a movement for justice,” said Alicia Riley, a sociologist at the University of California, Santa Cruz. “The thing is, white people are getting sick and dying more from Covid.”

The national picture has also masked a shift that has to do not only with geography but also with race, the doctor said. Stokes said. As the brunt of the pandemic shifted from major cities to rural areas, which have a large proportion of white residents, in late 2020, the national Covid death count naturally included more white people.

But in rural areas, deaths from Covid were higher among non-white people, just as they were in big cities and in small or medium-sized cities. Stokes’ team found. He used the CDC count of Covid death certificates up to February, avoiding more recent and potentially incomplete data, and took into account the older age of the white population.

During the worst part of the Omicron wave this winter, the death rate for blacks and Hispanics exceeded the death rate for whites in cities of any size, as at the peak of every previous outbreak of the virus.

The death rate for blacks at the peak of this winter was higher than for whites: 34 percent in rural areas, 40 percent in small and medium towns, and 57 percent in large cities and their suburbs. The racial gap was so wide in cities because urban whites were dying from Covid at a distinctly lower rate than rural whites for most of the pandemic.

Dr. Stokes said the results showed that whether people lived in a big city or a small city sometimes had as much to do with their Covid experience as the part of the country they lived in. In the second year of the pandemic, ending in February 2022, rural areas in the west, south, and northeast saw a sharp increase in white deaths from Covid, despite stark differences in the containment strategies of these regions.

“It’s not enough to compare Massachusetts and Texas,” says the doctor. Stokes said. “You have to compare rural Massachusetts to rural Texas.”

Embarking on a critical drop booster campaign, Dr. Stokes said the results speak to the need for much more proactive vaccination plans tailored to black Americans, especially those in rural areas. “Establishing fair strategies for vaccines requires that we do everything we can to just make them available,” he said.

In small-to-medium towns and rural areas in the South, where protective measures were sparse, blacks suffered one of the highest Covid death rates of any racial or ethnic group in any region in the second year of the pandemic, the doctor said. Stokes found.

Among those killed was Jacqueline Lowry, 28, a high school science teacher and single mother of two in Darlington, South Carolina, a predominantly black city of 6,000. Having just given birth to her son, G. Lowry hesitated to get vaccinated because she was worried… without the need — that the vaccine would infect her breast milk.

When she called cousin Jessica Brigman, a nurse, in September to say she was ill, Brigman convinced her to see a doctor. But miss. Lowry, who was obese and had gestational diabetes, had another priority: She had not yet tested positive for the virus and needed to do so before she could claim Covid pay from her employer. In the meantime, she was wasting precious sick days.

“She was the sole breadwinner and she had to pay the bills and she wasn’t getting paid because she missed a whole week of school,” Mrs Wilson said. Brigman spoke of her cousin’s worries. “They kept telling her she needed Covid positive confirmation.”

By the time she tested positive for Covid, Ms. Lowry has been hospitalized, Mrs Lowry. Brigman said. About a week later, due to blood clots in her lungs, she died of Covid while she was being transported to a better equipped hospital in North Carolina. Mrs. Brigman recalled how her cousin was worried about getting Covid-related leave when she went down.

“She said, ‘I need to get a positive test, I need to get tested,’” Mrs Wilson says. Brigman said. “She was never focused on anything else.”

Dr. Morris Brown III, who handles primary care locally, said financial problems often deter patients from seeking care in a state that has refused to expand Medicaid coverage to low-income people.

However, even the decision to seek treatment does not guarantee that it will be found. Dr. Tony Graham III, a South Carolina hospitalist, said his orders for Paxlovid antiviral pills were turned down until he found the only rural pharmacy nearby that had them. Whatever Covid-related public education campaigns once existed, he said, have dried up, leaving people in the dark about boosters and treatments.

“There was a big drop in communication,” the doctor says. Graham said.

Non-white people tended to face the greatest challenges in surviving Covid in young and middle age, due in part to differences in chronic disease burden and workplace risks.

Theresa Andrasfay, a postdoctoral fellow at the University of Southern California, says the return of white people to the workplace could help narrow the racial gap in infections between age groups. But as long as non-white workers are in closer contact with clients and colleagues and can’t afford to stay home sick, she said, workplace inequalities will persist.

Black people also continued to disguise themselves more often. nationwide polls show, a split that villagers say is still clearly visible. “It’s more black people who wear their masks,” said Roy Lee McKenzie, 78, of South Carolina, who is still recovering from a 2020 Covid case.

In rural areas, hospital closures, job losses, low vaccination rates and health problems associated with poor access to healthcare have exacerbated the effects of the pandemic. Vaccination rates were much lower in rural counties, which voted more for Donald Trump. study showedbut also in rural areas with a shortage of medical workers and a large number of black residents.

Janice Probst, a rural health researcher at the University of South Carolina, said the state’s strategy of delivering vaccines first through hospitals and then through large chain pharmacies resulted in more disadvantaged rural residents whose cities had neither. another.

However, in some places, even progress in vaccinating non-white communities has not been enough.

Black, Hispanic and Asian adults under the age of 65 were more highly vaccinated than white residents during the first Omicron wave, according to Minnesota. research led by Elizabeth Wrigley-Field, assistant professor of sociology at the University of Minnesota. But in any case, middle-aged people of color were more likely to die from Covid. Blacks have twice the death rate as whites.

“The whole way that the pandemic is being created by political leaders right now is very much about people being able to choose their level of risk,” the doctor said. Wrigley Field said. But, she said, “the risk that social groups have does not match their vaccination. It’s unrelated to this because of all the other things in our society that put some people at more risk than others.”