Over the past several days, there has been growing national recognition that New Orleans is experiencing one of the fastest rates of growth in confirmed coronavirus patients in the United States. In a report published Wednesday, The Data Center, a New Orleans-based research group, illustrated that it’s not just the rate of spread that puts New Orleans in a precarious position.
Along with the number of people contracting the virus, the new report urges national and local decision makers need to think about how outcomes for coronavirus patients will differ from place to place. Conditions such as poverty, internet access and savings will not only impact whether someone contracts the virus, but whether someone can survive it.
Those statistics also show how the economic fallout from the pandemic will be dangerous for the health of some New Orleanians even if they don’t contract the virus. Many people are already struggling to keep up with healthcare costs for preexisting, potentially fatal medical conditions. And business closures aimed to slow the spread of the disease have impacted the hospitality and service industries — key parts of the city’s economy — especially hard, forcing mass layoffs and furloughs of local workers.
“I think many people fail to recognize the conditions in which poor and African-American New Orleanians struggle to survive every day,” Dr. Allison Plyer, chief demographer for The Data Center, said in an interview. The city has “higher rates of blood pressure, and higher rates of diabetes, and other diseases and conditions that are likely to increase fatality rates from this virus.”
According to the Data Center, Orleans Parish has the sixth highest per capita coronavirus infection rate in the country. As of Thursday afternoon, Louisiana had 2,305 confirmed cases of the virus — nearly a thousand of which are in New Orleans — according to the Louisiana Department of Health. Out of those cases, 676 people statewide are hospitalized and 239 are on ventilators. So far, 83 people in the state have died after contracting the virus, 46 of whom were in Orleans Parish.
The Data Center report compared New Orleans with three other ‘hot spots’ around the country: Westchester County, New York; King County, Washington, which includes Seattle; and the combination of all five boroughs of New York City.
Perhaps the most important data is on household finances — median incomes, poverty rates and rent burdens. Compared to the other three hotspots, New Orleans doesn’t fare very well. The median income in New Orleans is $38,423 versus roughly $95,000 in King and Westchester Counties and $66,334 in New York City.
New Orleans’ poverty rate, according to the report, is 23.8 percent, more than double the rates in King and Westchester Counties and 6.5 percentage points higher than New York City. And according to the report, New Orleans has the highest percentage of renters spending 50 percent or more on rent out of the four hot spots.
“There are a myriad of reasons why lower-income and poorer communities will be more vulnerable to the COVID-19 virus,” the report said. “Lower-income individuals are more likely to be living in crowded households where there are more people than rooms, making quarantining sick family members more difficult. Low-income individuals are more likely to be working in service positions on the front line of COVID-19 including as at-home health aides for seniors, grocery store clerks, and nannies, and may not be able to ‘stay at home.’ Lower-income individuals are more likely to experience health conditions such as high blood pressure and diabetes that may increase the likelihood of hospitalization and death among COVID patients.”
The danger for low-income residents only grows, the report argues, when considering that lower-income people often hold the very jobs being slashed as the global pandemic takes its toll on the economy. In New Orleans, that means tourism and hospitality jobs.
That suggests that low-income people are at greater risk of losing their jobs.
“Even for those who don’t get sick, the economic consequences of eliminating a lot of low-income jobs in restaurants and hotels will be very difficult to withstand,” Plyer said.
Losing incomes, the report argues, is even more dangerous for those without savings and with high rent burdens.
“When incomes are lost, families that are severely ‘housing cost burdened’ may suddenly face homelessness. The COVID-19 crisis and related layoffs of low-wage service workers could significantly increase housing instability in cities where many renters are already severely housing cost-burdened.”
National studies have shown that homelessness, in turn, greatly increases a person’s health risks and could put people in danger of health maladies other than the coronavirus. That’s especially true for those with preexisting conditions during a time when the area’s hospitals expect to be overwhelmed and over capacity in a matter of days. In a recent letter to President Donald Trump, Louisiana Gov. John Bel Edwards predicted that the need for hospital beds in the New Orleans area will exceed capacity by April 4.
Another issue brought up in the report is internet access. According to the report, 17 percent of New Orleanians can only access the internet through a smartphone, while 20 percent have no access whatsoever. Those rates are much higher than the other three comparison areas.
The digital divide between households with internet access and those without it has been highlighted by the coronavirus crisis. Internet access is vital right now for people who have to work from home or who have children receiving their education online. But it’s also important in order to receive up-to-date information about the virus, how you can protect yourself and what to do if you’re coming down with symptoms.
The report also points out that nearly one out of five New Orleans households lack access to a car, making the city’s drive-through testing centers inaccessible. Those testing centers require people to remain in their car and aren’t accepting people on foot.
There was one other data point that Plyer said was important in this discussion, but that wasn’t included in the report: race. New Orleans has a much higher black population per capita than the other three areas — just short of 60 percent. Plyer said the center didn’t have enough time to incorporate race data into this week’s report. But she directed The Lens In a 2018 report from the Data Center called Advancing Health Equity in New Orleans.
The report cited several national studies that illustrate how health outcomes for black people are, in aggregate, worse than for white people. Many of the economic causes of this dynamic are already incorporated into The Data Center’s most recent coronavirus report. Black people tend to have lower incomes than white people, have less savings, spend more of their incomes on rent, according to the 2018 report, all of which affect healthcare quality.
But the 2018 report makes note of something that isn’t included in the newest report: national studies showing that black and white patients often receive disparate levels of medical care regardless of underlying economic status.
“More than a decade of research has explored how physicians’ implicit bias—unconscious and involuntary attitudes about race — can influence their communication, treatment recommendations, pain management decisions, and empathy, depending on the race of the patient in front of them,” the report said.