Regina Sung, Contributing Photographer
After a spike in COVID-19 cases in recent weeks, as well as gaps in data that have made it harder to analyze this new wave of the pandemic, New Haven has released new data which once again shows that the virus has affected Black communities in the Elm City at disproportionately high rates.
New Haven Mayor Justin Elicker shared the data in a Monday press conference and mentioned racial disparities in several reported categories. New Haven’s general racial breakdown falls approximately evenly between Hispanic and Latinx, Black and white residents. But of the city’s 3,780 reported positive cases since the pandemic hit, 33 percent come from Hispanic and Latinx residents and 30 percent come from Black residents — while only 14 percent come from white residents.
The disparities are starker in other categories. Black residents make up a disproportionately high share of hospitalizations and fatalities — 43 percent and 45 percent — while Hispanic and Latinx residents make up 29 and 16 percent, respectively. White residents make up 20 percent of hospitalizations and 38 percent of deaths. City officials weighed in on the data, its related disparities and what the city is doing to address the current case spike, underscoring that incomplete data can only provide an incomplete picture of the problem.
“This has been a trend throughout the entire nation, and New Haven is no different,” Elicker said. “This underscores the inequities that exist in the healthcare system and the economic system that are closely tied to race and ethnicity.”
Elicker also shared data on Monday that was more specific to the recent uptick in cases, as the city has reverted back to its Phase 2 COVID-19 protocols. He highlighted that in the last two weeks, 31 percent of cases have come from the Hispanic and Latinx population in New Haven, 17 percent from Black communities and 9 percent from White residents. Although the data indicates that Hispanic and Latinx and Black New Haveners are being hit harder by the virus, 40 percent of positive cases did not report their race or ethnicity — which means that disparities reflected in the data may not reflect the full picture of who is being affected by the virus.
Director of Public Health Maritza Bond said the city needs to work hard to collaborate with community leaders among people of color to help spread COVID-19 information and education that is specific to their communities.
“We work really hard to get on media outlets and on supporting faith leaders to provide as much education, awareness and access as we can,” Bond said.
Causes for the disparities?
Brita Roy, an assistant professor of epidemiology at the Yale School of Public Health, said there are a number of various causes behind disproportionate rates of infection, hospitalization and death among people of color.
Roy said one possible cause of the higher rates of infection was that people of color are more likely to have jobs that require them to work outside the home, such as food distribution, the service industry or child care, which leads to higher exposure. She also said that people of color tend to live in overcrowded housing or areas that are more densely populated, which makes transmitting infection easier.
Beyond infection, Roy also said people of color across the country are much more likely to be hospitalized after catching the virus. According to Roy, people of color are more likely to have chronic underlying conditions such as obesity, hypertension and diabetes, which can cause a more severe case of COVID-19.
But Roy also noted that implicit bias in America against people of color has also been a factor in data collection in places like New Haven. She said there has been evidence of this bias throughout medical professionals. For example, she said that when a person of color reports symptoms to a doctor, they are more likely to be disbelieved or have their symptoms dismissed. The consequences of this, she said, can be devastating.
“Implicit bias exists everywhere in this country,” Roy said. “In many cases, [people of color] may not actually get care until they are really sick. So one of the reasons for these poor outcomes is that we are not addressing it early on.”
Roy also echoed Bond in stressing the need to collaborate with trusted community leaders to share information regarding the pandemic with communities of color. But she also advised the New Haven city government to work closely with essential businesses to ensure they implement safety protocols and everyone they employ has access to personal protective equipment.
Roy said that because a vaccine seems imminent, the importance of equitable access to any vaccine could not be understated. She said she hoped that the city could find a way to prevent cost from being a barrier to aid.
Gaps in COVID-19 data
Bond noted that one of the main concerns regarding disparities in COVID-19 cases is that the city does not know the racial and ethnic background of many individuals who have tested positive for the virus — a problem that has persisted throughout the pandemic.
Over the course of the pandemic, 22 percent of all positive results were from people whose race was not recorded. That number has dropped from the 54 percent reported as “unknown” in April. Bond has consistently urged testing providers in the city to take greater care to report race and ethnicity in testing results, as without this comprehensive data, she said it was harder for her office to paint a clearer picture of the communities in need of the most support.
In the data from the last two weeks, the number of COVID-19 positive residents whose race and ethnicity was unknown has jumped to 40 percent.
“This is unacceptable,” Bond said at the press conference. “As we are issuing tests in our city, we have to do a better job in knowing the race and ethnic background of those individuals so we can know who is really being affected by this pandemic.”
The Elm City’s plans
In addition to this new release of data, Elicker also reported that various city officials across New Haven have been quarantined as a result of rising rates in the city. Officials in the New Haven City Clerk’s office have been isolating, and Elicker said multiple officials with the Livable City Initiative, Department of Public Works and the New Haven Police Department, as well as the fire department have either tested positive or entered a 14-day quarantine.
Elicker said that while the city is not introducing any new safety protocols for city employees at this time, the city is working to reduce the number of situations where these employees can be exposed as well as encouraging staffers to self-screen before coming in to work.
Additionally, according to Elicker, one measure the city has taken in response to this data is to set up “pop-up” testing centers in communities with large percentages of people of color. Director of Public Health Nursing Jennifer Vazquez said these centers are available only on limited dates and aim to reach communities that do not have easy access to permanent sites. She said information for all dates for ongoing pop-up sites can be found on the New Haven COVID-19 Hub.
Elicker said that on Sunday, he visited Christopher Columbus Family Academy, where a pop-up site had recently been set up, and saw lines for testing wrapped around the block.
“We need to continue expanding access to testing in communities to make it very, very easy for people to get tested, especially at times when they don’t have to work,” Elicker said.
A bigger picture
As Elicker and other city leaders continue to make plans to address these disparities, Roy said it was important for city governments to also look at the bigger picture beyond COVID-19 when thinking about future policies.
In addition to health care access, according to Roy, people of color statistically have less access to high-quality education and “meaningful” employment opportunities — disparities that Roy said the city must examine with equal attention.
If the city does so, she said, both during this pandemic and in future crises, New Haven’s most vulnerable communities will not continue to be the ones facing the most severe health struggles.
“The COVID-19 pandemic has simply illuminated structural inequities that have existed for long, long periods of time,” Roy said. “I think looking at the root causes of structural racism and inequity will be the key to turn the tide on what we’re seeing right now.”
The first positive case of COVID-19 in New Haven was recorded on March 13 of this year.
Thomas Birmingham | thomas.birmingham@yale.edu