Correction: On July 30, the state said an “automation error” caused approximately 225 deaths to be incorrectly added to the overall death count; a subsequent quality check by Department of State Health Services epidemiologists revealed COVID-19 was not the direct cause of death in these cases. The numbers and charts in this story have been updated to account for this error and are current as of July 30.
Texas’ southernmost county, Cameron, is home to just 1.5% of the state’s population, but it accounts for nearly 5% of its known COVID-19 fatalities.
Cameron County — where 89% of residents are Hispanic and nearly a third live below the poverty line — stands out as just one stark example of widespread disparities in COVID-19 outcomes. Across Texas and the nation, the novel coronavirus is deadlier for communities of color and low-income communities.
These disparities, and a wealth of other demographic information, became more apparent this week when new tallying methods at the state health agency revealed a more complete picture of who has died in Texas and where. Trends showing that Black and Hispanic individuals had been disproportionately hit by the virus were clear nationally and apparent in local snapshots, but until earlier this week, the Texas Department of State Health Services’ limited demographic data had clouded the picture of those disparities statewide.
Hispanic Texans make up about 40% of the state’s population, but they account for 49% of its known COVID-19 fatalities. Black Texans also appear slightly overrepresented in the fatality toll, representing 14% of fatalities but just 12% of the state population. Texas reported a total of 6,274 fatalities Thursday evening.
By contrast, white and Asian Texans died at lower rates relative to their share of the state’s population.
Sometimes called the great equalizer, the novel coronavirus has been anything but — a deadly reality in a state like Texas, where the Hispanic population is expected to become the largest group in the state by mid-2021.
The disparities should not have been a surprise, said Jamboor Vishwanatha, director of the Texas Center for Health Disparities at the University of North Texas Health Science Center.
“What COVID did is essentially shined a bright light on existing disparities,” Vishwanatha said, citing disparities in rates of preexisting conditions like diabetes and cardiovascular issues, as well as social factors like income inequality and access to health care. “You would expect something like this to happen.”
Research has found that higher-paid employees are more likely to have the option to work from home, and that Black and Hispanic employees are less likely to be able to work remotely. In Texas and across the country, front-line employees like janitors, grocery clerks and transit workers are more likely to be women and people of color, an Associated Press analysis of U.S. Census Bureau data revealed.
That’s forced low-income workers and people of color to risk their health at work, exposing them to the virus while others earn a paycheck from home.
“Many of these folks, particularly early on, were exposed to the disease,” Dr. Georges Benjamin, executive director of the American Public Health Association, said Wednesday at an event put on by The Academy of Medicine, Engineering and Science of Texas.
Benjamin said a higher prevalence of chronic illnesses like hypertension and heart disease is contributing to disparities.
Geography has also played a role. Many of Texas’ deadliest hot spots have emerged in communities of color: among immigrant workforces at the meatpacking plants in the Panhandle; in Houston, one of the country’s most diverse cities; and in the Rio Grande Valley, where the population is majority Hispanic.
In general, most deaths have been recorded where most Texans live — in big cities like Houston, Dallas, San Antonio, El Paso and Austin. But some counties, like Cameron and Hidalgo in the Rio Grande Valley, are mourning an outsized number of people relative to their population. Both counties are about 90% Hispanic.
Even in bigger urban areas, some whiter, wealthier counties seem to be faring better than poorer counties with more diverse populations. Travis County has some 400,000 more residents than El Paso County but fewer deaths, according to state data. According to census data, Travis County is about half white and a third Hispanic, with a median household income around $76,000 annually; El Paso County is 83% Hispanic, with a median household income around $44,000 annually.
And the virus’ true death toll is almost certainly higher than reported; for experts, the question is by how much.
The state may be showing a particular undercount in Hidalgo, a majority-Hispanic county in the Rio Grande Valley that is being ravaged by COVID-19. County health officials, using local medical records, report 576 deaths; the state, now relying on death certificates, revised its tally for the county down from over 450 to 312. Local officials said the difference is caused by delays in the issuance of death certificates.
Meanwhile, Vishwanatha said, access to testing has been more limited in communities of color.
Pointing to local data from North Texas, Vishwanatha said there is a disparity between communities of color and white groups not only in chance of getting infected but also in chance of dying from the disease. The gulf is even wider for mortality rate than it is for infection rate.
“We are currently facing a critical situation where some of our communities are really suffering. We need to do everything to overcome these disparities. But hopefully this COVID situation has brought out something that we should have been tackling all along — how to overcome these chronic health disparities that our communities suffer,” Vishwanatha said.
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