Polluted US areas are among worst-hit by coronavirus – putting people of color even more at risk

Emily Holden in Washington and Nina Lakhani in New York, The Guardian•April 14, 2020

Photograph: Loren Elliott/Reuters

The coronavirus pandemic is hitting hard in America’s most vulnerable communities already burdened by toxic industries and environmental pollution. Experts warn that this elevates the risk of developing complications from Covid-19.

Polluted neighbourhoods in cities such as Los Angeles, Houston, Newark, and Detroit, as well as the Navajo Nation are among the country’s worst virus hotspots, a Guardian analysis found. It follows a preliminary US study published last week indicating that even small exposure to pollution in the years before the virus outbreak is associated with a 15% higher risk of death from coronavirus.

As the virus sweeps across the US, major risk factors include poverty, pollution, pre-existing medical conditions, substandard housing and inadequate health care, running water and nutrition. These are issues that most commonly afflict poor people of color.

“Environmental justice communities were already the most vulnerable, marginalized, uninsured and sickest, with high rates of asthma, respiratory illness, diabetes and heart disease,” said Robert Bullard, professor of urban planning and environmental policy at Texas Southern University.

The Guardian researched deaths per capita, and speed of spread of the virus in a number of US cities and communities and found:

Los Angeles, California. There have been at least 296 deaths from Covid-19 in Los Angeles county, which includes the city of Los Angeles, and where the death rate was three per 100,000 people on Monday – 50% higher than the statewide average. The county has some of the worst air quality in the US.

Detroit, Michigan. Wayne county – which includes Detroit – has had more than 700 Covid-19 deaths, and its death rate of 40 per 100,000 people, is more than 250% higher than the statewide average. Detroit had the country’s 12th worst soot pollution in 2019, according to the American Lung Association (ALA) and thousands of households lack running water.

Houston, Texas. Harris county, which includes metropolitan Houston, had 79 confirmed coronavirus cases per 100,000 people by Monday – 61% higher than the state average. Last week, officials confirmed that African Americans accounted for two-thirds of the early Covid-19 deaths in the city – home to widespread heavy polluting industries – despite accounting for only 22.5% of the total population.

The Navajo Nation. Navajo county has the highest virus rate in Arizona with 317 cases per 100,000, compared with 53 per 100,000 statewide. The Nation has longstanding environmental and health inequalities.

Already struggling communities

Pre-existing medical conditions such as hypertension, diabetes and heart disease alongside older age, obesity and compromised immune systems from cancer treatment or smoking, increase the risk of developing Covid-19 complications requiring critical care, according to the World Health Organization (WHO).

Many such health problems are more common among lower-income neighbourhoods, data on Native Americans and people of color from the Centers for Disease Control (CDC) shows.

In addition, polluting heavy industries such as power plants, manufacturing facilities and toxic chemical sites are much more likely to be built near these communities, described as “sacrifice zones” by environmental justice advocates.

“The sacrifice zones are where the virus definitely is taking hold, because you’ve got all these pre-existing conditions,” said Mustafa Ali, formerly an environmental justice official at the EPA in the Obama era.

The pandemic is hitting already struggling communities, just as the Trump administration advances sweeping regulatory rollbacks of protections for the environment and public health. The US Environmental Protection Agency (EPA) has told companies they don’t need to monitor and report pollution – if they can argue they have been disrupted by the coronavirus pandemic.

Detroit

Detroit, Michigan: ‘Now comes Covid-19, so of course our numbers are going to escalate, because our community is so vulnerable already.’ Photograph: Alamy Stock Photo

Age-adjusted death rates from heart disease, cancer, diabetes, kidney disease, pneumonia and influenza are all higher in Detroit, where almost 80% of the population is black, than the US average

About 300 out of every 100,000 Detroit residents died from heart disease compared with 165 in the US at large, according to the CDC and Michigan health department.

“That’s where we begin, and then there has been another really dangerous overlay of diseases as a result of the [mass] water shutoffs,” said Gloria House, an activist with We the People of Detroit. “Now comes Covid-19, so of course our numbers are going to escalate, because our community is so vulnerable already.”

Nearly a quarter of Wayne county, more than double the national rate, lives in poverty, which has been exacerbated by factory shutdowns over several decades.

Houston

The annual town Christmas parade takes place in the Manchester neighbourhood in industrial east Houston, Texas. Photograph: Loren Elliott/Reuters

EPA rollbacks could have devastating consequences around Houston – a massive industrial region with more than 500 petrochemical facilities, a busy shipping channel, sprawling highways and commercial railroads. “By anyone’s standards, Houston has one of the highest densities of polluting industries in the country, if not the world,” said Elena Craft, senior director at the Environmental Defence Fund (EDF), which coordinates a local project tracking air quality.

Located on the pollution-heavy east side is Pleasantville, a community of 3,000 people, which is 75% African American and 25% Latino, and is close to the port, a freeway and metal recycling plants. Forty per cent of the population is over 50, and most families do not have private medical insurance. The closest county hospital is 10 miles away, since the local one was permanently closed after flooding during Hurricane Harvey in 2017.

“There’s a lot of sick and vulnerable people in our community and we’re absolutely worried. But the disparities existed before Covid, and will still be there after unless action is taken to improve the quality of life for all citizens,” said Brigitte Murray, a retired nurse and activist.

Los Angeles

People swim in the Pacific Ocean next to the Huntington beach pier in front of an offshore oil rig in Huntington Beach, California. Photograph: Étienne Laurent/EPA

“Los Angeles has some of the worst air pollution in the country and there is very good epidemiological evidence that particle and gaseous pollutants exacerbate both asthma and COPD [chronic obstructive pulmonary disease],” said Dr John Balmes, a pulmonary critical care doctor at Zuckerberg San Francisco general hospital.

Both conditions increase the risk of bad Covid-19 outcomes. Before this pandemic, air pollution was believed to cause around 30,000 deaths annually in the US.

Despite significant improvements over the last two decades, the Los Angeles-Long Beach metropolitan area topped the latest list for the highest number of smog days and ranked among the worst places for soot pollution, according to the ALA’s most recent air quality index, which analyzes annual and short-term spikes in contaminants.

In 2017, 38 per 100,000 adults in LA county were admitted to hospital for asthma – one of the highest rates in the state.

“It doesn’t surprise me that LA county and environmental justice communities across the country are suffering a disproportionate burden of Covid-19,” added Balmes. “Health disparities always come down to economic disparities which is shameful in the United States.”

Almost 49% of the county identifies as Latino or Hispanic, 15% as Asian and 9% as African American. Just under 84% are US citizens; one in six residents lives in poverty.

The Navajo Nation

The Navajo Nation was quick to ramp up prevention and mitigation measures after reporting its first case on 17 March. But it’s struggling to contain the spread on its vast territory through Arizona, New Mexico and Utah, with 813 confirmed cases including 28 deaths as of 13 April.

In Coconino county, where Navajo people account for about 60% of cases, the death rate is eight times the state average.

Chronic environmental and health inequalities could be significant: the Navajo Nation is an extreme food desert with just 13 stores for 180,000 people on the reservation. In addition, about a third of people lack indoor plumbing and electricity. As a result, many Navajo struggle to access affordable fresh produce and clean drinking water – essential for a strong immune system.

One consequence is higher rates of diabetes, which affects one in five Navajo, compared with one in 11 in the general population. The evidence suggests diabetics face a higher chance of serious complications including death from Covid-19.

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New Jersey

Just west of the US focus of the coronavirus in New York City, 10 New Jersey counties are among the country’s 50 hotspots with the highest rate of cases.

This includes Essex county, home to the city of Newark, which is surrounded by heavy polluting industries, including “the state’s largest incinerator, the country’s longest Superfund site, fat-rendering plants, plastic plants, natural gas plants – you name it,” said Maria Lopez-Nunez, director of environmental justice and community development at the Ironbound Community Corporation.

Almost half of Newark residents are African American, and 36% are Latinos.

Mustafa Ali said the coronavirus crisis represented a crossroads for vulnerable populations. “We can either continue down the path that we’ve been following, or begin to build a real medical infrastructure in our country … and tie it to the [pollution hotspots] that have been unseen and unheard.”

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