How COVID-19 affected suburbs' minority communities

From the outset of the COVID-19 pandemic, health officials warned that every American was vulnerable to infection and the virus would not discriminate.

But that's exactly what it did.

Black and Hispanic residents were infected and died from COVID-19 at higher rates than other races and ethnicities in Illinois and throughout the country, provisional data from the U.S. Centers for Disease Control and Prevention shows.

That's the case in Chicago and many suburbs as well.

According to data available from the Illinois Department of Public Health and local public health departments:

• Deaths of Hispanic residents of Chicago and the suburbs from COVID-19 occurred at a rate two times higher than deaths of Hispanic residents from all causes in 2019.

• That disparity is greatest in Kane County, where the rate of death from COVID-19 is almost three times the 2019 death rate of Hispanics from all causes.

• Black residents account for 9.8% of the COVID-19 deaths in suburban DuPage, Kane, Lake and Will counties, but for just 6.9% of all deaths in those counties in 2019.

“It's unfortunately not unexpected,” said Dr. Kiran Joshi, medical co-leader at the Cook County Public Health Department. “It mirrors what we've seen in public health for decades. COVID just made it worse.”

Tracking the disparity

Within weeks of the pandemic taking off in Illinois, Black residents already were experiencing a higher death rate compared to other racial and ethnic groups, IDPH Director Dr. Ngozi Ezike noted. Soon after, cases and deaths among the state's Hispanic population exploded, too.

“If you know the disparities exist in terms of health outcomes, you can imagine that overlaying a new disease is only going to exacerbate whatever inequities already exist,” Ezike said on April 5.

At year's end, the trend hasn't abated.

The state's Hispanic population represented just 5.6% of the 108,937 Illinois residents who died in 2019, according to IDPH records. However, a Dec. 12 report from the National Center for Health Statistics shows Hispanics in Illinois account for 17.8% of the state's 12,397 COVID-19 deaths listed in the report.

Non-Hispanic Black residents made up 16.4% of the deaths in 2019, but they are 19.5% of all COVID-19 deaths in Illinois, the report shows. Both figures are higher than population figures would suggest, with Black residents making up 13.9% of the state and a much smaller portion of the suburban population — 10.3% of the suburbs overall and 6.3% in the five collar counties outside Cook County, according to census figures.

Similarly, Hispanic residents make up 17.8% of the state's population but account for 27.4% of the state's COVID-19 caseload since the beginning of the pandemic, according to recent IDPH figures.

And those are only the cases where the race or ethnicity of the infected person is known. Racial and ethnic demographic information is missing from nearly a third of the state's 911,308 cases, according to IDPH.

Joshi said fear of drawing the attention of federal immigration authorities has increased the likelihood some residents of Hispanic descent not only will limit the amount of information they give medical workers but also put themselves at risk by not seeking medical attention at all.

“You have people who are really afraid to leave their homes to take care of themselves,” Joshi said.

History of distrust

About 76 in every 1,000 Hispanic residents in the state has contracted the virus, according to IDPH and census figures. The rate is 47 in 1,000 non-Hispanic Black residents of Illinois. Among non-Hispanic whites in Illinois, 41 in 1,000 have contracted the virus.

Although white Illinoisans constitute nearly 61% of the state's population, they account for less than 51% of the state's COVID-19 cases and 58% of the state's deaths from the respiratory disease.

One hurdle for public health officials is overcoming distrust in minority communities stemming in part from unethical practices in the past, most notoriously the Tuskegee syphilis study. Black men were recruited in 1932 into the study, which lacked informed consent and continued without subjects being given penicillin even after the drug emerged as an effective treatment in 1947, according to the CDC.

Public health officials are reckoning with the aftereffects today as they attempt to assuage the doubts of millions of Americans over the COVID-19 vaccine.

“There's a lot of work to be done there, and there are very valid reasons why that skepticism exists,” Ezike said recently. “Public health has not always done right by communities of color.”

Joshi has seen firsthand the suspicion from some of his patients.

“Over my career I've experienced many patients who've said, ‘I don't want you experimenting on me,'” he said. “It's part of the narrative and I get it.”

Public health experts also point to circumstances that existed long before the pandemic that helped spur the racial and ethnic disparity of this virus's effects.

The lack of access to health care, because of geography or inability to pay, is one of the most significant, they said.

Minorities are also more apt to live in densely populated areas and in congregate settings, experts said, which increases the possibility of transmitting the virus.

Employment also plays a large role as many lower-wage “essential” jobs that can't be done from home are held by minorities, placing them at greater risk.

“We will be doing analysis on this pandemic for years to come,” said Kara Murphy, president of the DuPage Health Coalition. “But certainly one of the contributing factors to a person's — and their family's — risk to exposure and to be able to best preserve their safety is the ability to stay at home during this.”

Suburban outcomes

IDPH officials did not respond to a public records request for racial and ethnic demographic information for COVID-19 cases and deaths by county. The agency collects that information daily but reports it only on a statewide basis on its website.

But there are ways to analyze the effects of the pandemic on suburban minority communities.

By comparing IDPH countywide demographic data on all deaths in 2019 and the CDC's data on COVID-19 deaths, a pattern of racial and ethnic disparity emerges.

In 2019, people identified as Hispanic made up just 9% of the combined deaths in Cook, DuPage, Kane, Lake and Will counties, according to IDPH data. When it comes to COVID-19, Hispanic residents have accounted for 17.8% of deaths from the virus in those counties, according to CDC figures.

The largest gap is in Kane County, where Hispanic residents were 10.9% of 2019's total deaths but are 30.6% of the COVID-19 deaths.

Elsewhere, Cook County reported 10.2% of all deaths in 2019 were Hispanic residents, compared to 26.2% of COVID-19 deaths. In DuPage County, Hispanic residents represented 4% of all 2019 deaths but 11.1% of deaths from the virus.

In Lake County, Hispanic residents were 6.9% of all 2019 deaths but are 22.5% of the county's COVID-19 deaths. In Will County, Hispanic residents accounted for 6.1% of deaths in 2019, but 14.4% of the county's COVID-19 deaths.

McHenry County figures couldn't be analyzed because the CDC's COVID-19 death records were incomplete.

For Black residents in Chicago and the suburbs, the COVID-19 death rate isn't as stark, in part because Black Illinoisans already were experiencing a disparate mortality rate, public health officials said.

In 2019, the deaths of non-Hispanic Black residents represented 24.4% of all deaths in Cook, DuPage, Kane, Lake and Will counties. Today, 24.7% of COVID-19 deaths in those counties are Black residents, according to the data from IDPH and the CDC.

In Will County, Black residents make up 17.7% of the COVID-19 deaths, compared to 10.6% of all 2019 deaths.

Black residents in DuPage County represent 7.7% of the county's COVID-19 deaths but were only 3.8% of all deaths in 2019. In Lake County, Black residents are 10.3% of the COVID-19 deaths, compared to 7.9% of the county's 2019 deaths.

In Cook and Kane counties Black residents are dying of COVID-19 at slightly lower rates compared to 2019 deaths from all causes.

But in the suburban portion of Cook County, Black residents represent 19.8% of COVID-19 deaths compared to 17.6% of all 2019 deaths, according to data on COVID-19 deaths supplied by the Cook County medical examiner's office and IDPH mortality data for 2019.

In Kane County, Black residents represented 4% of COVID-19 deaths, lower than the 5.7% of all deaths in 2019. Kane County also has the fewest COVID-19 deaths among the five counties.

The non-Hispanic white population represented 63% of all 2019 deaths in Cook, DuPage, Kane, Lake and Will counties, according to IDPH records. However, just 45.1% of the COVID-19 deaths were white residents of those counties, according to the CDC.

In an effort to combat the health disparities seen during the pandemic, IDPH launched a number of outreach initiatives and made a point of establishing testing sites in communities “disproportionately impacted” by the virus, IDPH officials said.

Unfortunately, the potential to understand how well those efforts worked might never be known, particularly when it comes to the demographic details on testing. Of the more than 12.6 million COVID-19 tests taken by Illinois residents, IDPH officials know the race or ethnicity of barely half the people who took them.