New King County data: Inequitable health impacts of COVID-19 reflect the intersections of social and economic factors

Data and research, Novel Coronavirus, ,

Signs since early in the pandemic have shown that COVID-19 more greatly impacts communities of color and impacts some neighborhoods more compared to other neighborhoods – within King County and across the United States.   

Newly available data from Public Health—Seattle & King County (PHSKC) illustrates how these different impacts are associated with social and economic inequities that existed long before the emergence of the COVID-19 pandemic.   

PHSKC created a social and economic risk index in 2020 to help leaders and managers direct resources and prevention efforts to communities with the greatest COVID-19 inequities. Now, that data is available to the public through a new data dashboard and a report with analysis and key takeaways. 

The data shows (and the report explains) how multiple interconnected structural and systemic factors are associated with COVID-19 disease rates across King County neighborhoods (census tracts) over the course of the pandemic, including:  

  • Employment as an essential worker  
  • Education level 
  • Income level 
  • Household size  
  • Race/ethnicity 
  • Country of birth  
  • Household English proficiency  

Which factors line up with the largest health impacts? 

The report describes how the starkest COVID-19 health impacts are found in areas with greater numbers of essential non-healthcare workers, lower education levels, lower income levels, and where increased accessibility to these services/resources was needed more people of color.  

Using data from the index, Public Health and other government and community partners expanded COVID-19 testing locations, access to care coordination (resources to support people in isolation and quarantine, such as groceries and financial assistance to replace lost income), and vaccination sites in areas where increased accessibility to these resources was needed.  

Further opportunities to reduce risk of COVID-19 among essential non-healthcare workers – such as by improving working conditions and the ability to engage in prevention measures like staying home when ill (by providing and encouraging use of paid sick leave), and continuing to increasing access to resources such as testing and protective equipment  – could in turn reduce the observed disparities in COVID-19 related to race, language, place of birth, education, and income.   

Understanding SERI – the Social and Economic Risk Index 

PHSKC combined factors that measure social and economic conditions to create a single Social and Economic Risk Index (SERI) score.  Higher scores represent higher levels of social and economic risk and lower scores represent lower risk. The index aligns closely with previous measures of socioeconomic risk across King County, such as the Determinants of Equity report and the COVID-19 Vulnerable Communities Data Tool. 

The accompanying report looks in detail at testing, positive cases, hospitalizations, and deaths. For example, overall during the past year, King County residents in census tracts with the highest risk on the index also tested positive for COVID-19 at higher rates, compared to areas with lower risk. However, people in communities with low SERI scores (i.e. lower risk) got tested more frequently for COVID-19 than people in communities with higher SERI scores – even though the higher risk communities had higher rates of COVID-19 cases. 

Notably, over time, the testing gap narrowed. This correlates with decisions made, using this index as a guide, to locate more testing sites and outreach efforts in communities with higher risk. By March 2021, the testing rates in higher and lower risk communities were about the same.  

A snapshot of the Social and Economic Risk Index dashboard
A snapshot of the Social and Economic Risk Index dashboard

The index illustrates how factors such as racism, workplace conditions, and access to information can impact health. As a result of historic and ongoing systemic racism and discrimination, which limits educational and professional opportunities, Black, Indigenous and People of Color are disproportionately employed as essential workers (such as in healthcare facilities, farms, factories, retail, and transportation). In turn, some of those workers may experience working conditions where it can be more difficult to practice social distancing, access personal protective equipment, or have access to sick leave or health benefits needed to seek testing, medical care, or recover from COVID-19. And census tracts with more essential non-healthcare workers had lower testing rates but higher COVID-19 cases, hospitalizations and deaths.  

Explore the analysis and report  

The data dashboard includes an overview of the SERI as well as interactive maps showing how the index relates to COVID-19 testing, positive test results, hospitalizations, and deaths. For those interested in a deeper dive, you can view the results by census tract; see how the trends have changed over time; or explore the data for each individual social and economic factor included in the index. For a detailed summary of the analysis and key takeaways, review the Technical Report. 

Policymakers, community groups, and others can use the SERI to support planning and emergency response in the future, as well as to inform policy change to address the underlying issues that increase risk of negative outcomes in King County communities. 

Originally posted July 28, 2021