“If there was no residential segregation at all, either at the county or lower levels, we would have almost equal proportions of [COVID-19] distribution throughout the country—but we don’t.”
The COVID-19 pandemic highlighted existing inequalities in the United States. A new study now shows that counties with higher income inequality are more susceptible to a higher rate of death due to the deadly virus.
The research was conducted by sociology Professor Tim Liao at the University of Illinois Urbana-Champaign, and was published last week in JAMA Network Open, a monthly medical journal.
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“We needed actual data to really fully understand the social dimensions of the pandemic,” he said in a statement. “We knew all along that racial inequality was important, but most of the time people were missing the more complete picture, which includes economic inequality.”
It helps to think of income inequality like a pie. In the United States, $98 trillion of household wealth is held by the wealthiest 20% of the population. The upper middle and middle classes share just one piece of the pie and people in the lower class just get a sliver, according to the National Bureau of Economic Research. In short, this means a small number of ultra wealthy people have access to the largest slices, while middle and lower income people just get the crumbs.
That inequality plays a significant role in outcomes associated with COVID-19.
In an interview with COURIER, Liao explained that he began the study last summer after noticing how little attention was being given to the role economic inequality has played in COVID-19 infections and deaths. He, alongside DePaul University sociology professor Fernando De Maio, analyzed data from every county but one in the United States (it was excluded because of incomplete information). They collected 200 days of data from Jan. 22, 2020, when the first case of coronavirus was documented in Washington state, to Aug. 8.
According to their findings, the researchers found a 1% rise in income inequality in a county corresponded to a 2% rise in COVID-19 incidence and 3% rise in mortality. In comparison, when they looked at race, the authors found a 1% increase in a county’s Black population corresponded to an average 1.9% increase in COVID-19 infections. There was also a 2.6% increase in mortality. For a county’s Hispanic population, a 1% increase corresponded with an average 2.6% increase in infections and a 1.9% increase in mortality.
“This analysis found racial/ethnic composition, while important, does not reveal the full complexity of the story,” the study states. “Income inequality—a measure not typically included in public health county-level surveillance—also needs to be considered as a driver of the disproportionate burden borne by minoritized communities across the United States.”
As Liao explained: “If there was no residential segregation at all, either at the county or lower levels, we would have almost equal proportions of [COVID-19] distribution throughout the country—but we don’t. There’s huge consequences of that.”
Plus, he added, there is an additional factor in occupation. “A lot of [Black and Hispanic] communities have high proportions of frontline, essential workers that typically work in more crowded households. If they live in major metropolitan areas, they also tend to rely on public transportation—all those things come together, and you can imagine the consequences.”
To Liao, the data shows that “high levels of income inequality harm population health, irrespective of racial or ethnic composition.”
Two factors were constant, he explained. “It doesn’t matter how you cut it, the two general conclusions always, always come out: One is the racial dimension and the other is income inequality.”
But, he continued, addressing the issues that have allowed COVID-19 to disproportionately hurt communities of color isn’t a simple fix. Things like systemic and structural racism, unequal access to health care, education, and income inequality all play a role.
“When you have those problems you’re going to have unequal outcomes to diseases as well,” he said.