The coronavirus pandemic hit rural America last year, and deaths among white residents soared as the virus exacerbated longstanding health problems.
But beyond small towns and farmlands, new research foundCovid has killed black and Hispanic people at significantly higher rates than their white neighbors. Chronic diseases, declining vaccination rates, forced non-whites to bear the virus burden.
Rural Blacks and Hispanics suffered significantly higher casualties in the second year of the pandemic, with much higher mortality rates than in urban areas.
Racial disparities in Covid deaths are closing in towns and cities of all sizes. This is especially true these days, when vastly improved immunity across the population eased pressure on the health care system that seems to hurt non-white Americans the most.
But as the coronavirus death toll rises and health officials prepare for an even deadlier winter, scientists say that previous efforts to narrow the racial gap in vaccination He warned that it would not be enough to protect people from the damage caused by a large wave of the new coronavirus.
Nowhere were these difficulties more pronounced than in the countryside. Black, Hispanic, and Native American people in these places are in the second year of a large racial or ethnic group pandemic anywhere in the United States, according to a new study led by Andrew Stokes, an assistant professor of global health. recorded the most deadly in . at Boston University.
In these communities, the Biden administration’s reassurance that all Covid deaths are now preventable contradicts the difficulty of getting medical care.
Rural pharmacies are common Very fewmaking it difficult for poorer and less mobile residents to receive critical antiviral drugs.
Doctors say some black patients, especially those without insurance or living far from hospitals, take too long to seek help to benefit from new treatments. increase.
Black and Hispanic people also receive booster injections at lower rates, particularly in conservative states, as a result of what some doctors describe as a lack of awareness resulting from reduced public messaging.
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“The national sentiment is that everyone should be in a position to do what it takes to protect themselves from the virus,” said Bobby Jenkins, mayor of Cuthbert, Georgia. A certain Bobby Jenkins said: Pandemic. “But not everyone is in a position to do that yet.”
Racial disparities in Covid deaths are shrinking for several reasons, scientists say. Primary vaccination rates for blacks and Hispanics have risen nearly twice as fast as rates for whites.
54% of Hispanics outnumber 50% of Whites. Vaccination coverage among blacks is 43%, still lagging behind, but the gap is closing.
The virus also infected and killed very high rates of black and Hispanic people in the first year of the pandemic: at some point in 2020, black rural residents outnumbered white residents by about six times. were dying at a rate of 2.
These changes are so profound that, among America’s oldest, Covid mortality among whites has recently surpassed that of blacks, according to data from the Centers for Disease Control and Prevention.
But the narrowing of racial disparities is due in part to the worsening of the pandemic for whites, rather than the serious advances for blacks and Hispanic Americans. White Covid mortality increased by 35% from year 1 to year 2 of the pandemic. CDC foundDuring that time, mortality rates dropped by just 1% among Hispanics and 6% among blacks.
“This is not a move towards equity,” said Alicia Riley, a sociologist at the University of California, Santa Cruz.
National imagery also hides variations that are as much about geography as race, Dr. Stokes said. As the brunt of the pandemic shifted from big cities to rural areas with a higher percentage of white residents in late 2020, national tallies of Covid deaths will naturally include more whites. became.
However, Dr. Stokes’ team found that Covid deaths were more allocated to non-whites in rural areas, as in large and small cities. He used his CDC counts on his Covid death certificate through February, avoided more recent potentially incomplete data, and took into account the aging of the white population.
During the worst of this winter’s Omicron wave, death rates for blacks and Hispanics exceeded those for whites in towns and cities of all sizes. This is the same as during the peak of previous virus outbreaks.
At its peak this winter, black mortality rates were higher than whites at 34% in rural areas, 40% in small and medium-sized cities, and 57% in large cities and their suburbs. White urbanites died from Covid at a much lower rate than rural whites for most of the pandemic, so racial disparities were so great in cities.
Dr Stokes said the findings show that whether people live in big cities or small towns is just as relevant to their Covid experience as the part of the country they live in. . In his second year of the pandemic ending in February 2022, rural areas in the West, South and Northeast all have high rates of his Covid deaths among whites, despite significant differences in containment strategies in these regions. experienced a surge.
“It’s not enough to compare Massachusetts to Texas,” Dr. Stokes said. “You have to compare rural Massachusetts to rural Texas.”
According to Dr. Stokes, the results speak to the need for more aggressive immunization programs tailored to black Americans, especially rural Americans, ahead of a critical fall booster campaign. “Adopting an equitable vaccine strategy requires more than just making vaccines available,” he said.
Dr. Stokes said that in the small cities and rural areas of the South, where protective policies were rare, blacks suffered the highest Covid mortality rates of any racial or ethnic group in any region during the second year of the pandemic. I found
Those killed include Jackqueline Lowery, 28, a middle school science teacher and single mother of two in Darlington, South Carolina, a city of 6,000 mostly black people. was Laurie had just given birth to her son, so she hesitated to get vaccinated. without need — that the vaccine would contaminate her breast milk.
When she called her cousin Jessica Brigman, a nurse, in September to tell her she was sick, Ms. Brigman urged her to see a doctor. But Laurie, who was obese and had gestational diabetes, had other priorities. She had not yet tested positive for the virus, and she had to test positive before she was eligible to receive COVID-19 benefits from her employer. Meanwhile, she was using up her precious sick leave.
“She was the sole provider of care and had to pay the bills. She was absent from school for a week and was not going to get paid,” Mrs. Brigman said of her cousin’s concerns. rice field. “They kept telling her she needed proof of being Covid positive.”
By the time she got her Covid-positive results, Ms. Laurie was hospitalized, Mrs. Brigman said. About a week later, blood clotted near her lungs and she died of Covid while being transported to a better equipped North Carolina hospital. I remember my cousin’s worries about qualifying for leave.
“She was saying, ‘I need to get tested positive, I need to get tested,'” Mrs. Brigman said. “She never focused on anything else.”
Dr. Morris Brown III, a nearby primary care practitioner, said that in states that have refused to expand Medicaid coverage for low-income people, financial fears often prevent patients from seeking care. I’m here.
However, even if you decide to seek treatment, it does not guarantee that you will find it. Dr. Tony Graham III, a South Carolina hospitalist, said Pax Lovid’s antiviral order was denied until he found one in stock at a nearby rural pharmacy. All Covid-related public education campaigns that once existed dried up, leaving people in the dark about boosters and cures.
“Communication has decreased significantly,” says Dr. Graham.
Non-white people generally face the greatest disadvantage in surviving Covid at young and middle ages due to differences in chronic disease burden and workplace risks.
Teresa Andrasfey, a postdoctoral researcher at the University of Southern California, says that whites returning to work may be helping to reduce racial disparities in infectious diseases across age groups. But as long as non-white workers have close contact with customers and colleagues and can’t afford to stay home when sick, workplace-related disparities will continue, she said.
Black people have also continued to mask at higher rates. National poll shows“It’s rather black people who wear masks,” said Roy Lee Mackenzie, 78, of South Carolina.
In rural areas, health problems stemming from hospital closures, unemployment, low vaccination coverage and lack of access to healthcare have all exacerbated the impact of the pandemic. Vaccination rates were much lower in rural counties that voted for Donald Trump. Research ShowsNot just in rural areas where health care workers are in short supply and where there are many black residents.
Janice Probst, a rural health researcher at the University of South Carolina, said the state’s strategy to supply vaccines first to hospitals and then to large chain pharmacies was neither in town. He said it had the effect of leaving the less fortunate rural residents behind.
But in some areas, even progress in vaccination of non-white communities is not enough.
In Minnesota, black, Hispanic, and Asian adults under the age of 65 were more vaccinated than white residents during the first wave of Omicron. Research led by Elizabeth Wrigley Field, Assistant Professor of Sociology at the University of Minnesota. But in any case, middle-aged non-white people were killed more often by Covid. Blacks suffered twice the mortality rate as whites.
“The whole way pandemics are being framed by political leaders right now is that people can choose their level of risk,” Dr. Wrigleyfield said. But, she says, “the risks that social groups pose do not keep up with vaccination. Everything else in our society puts some people at greater risk than others.” Cause it’s disconnected from it.”
