Geographic Inequality of COVID-19 in the United States

Johannes Norling, Mount Holyoke College

I use the index of dissimilarity to measure geographic inequality of COVID-19 between counties in the United States. This approach permits me to answer the following questions: how segregated are cases of and deaths due to COVID-19, and how has this segregation changed over time? In March 2020, 60 percent of people sick with COVID-19 would have had to move to another county in order for the distribution of cases to be proportional to every county’s population, a high level of segregation on par with racial segregation in the most segregated cities in the 1960s and 1970s. Cases spread more broadly as the pandemic continued, and by March 2021 inequality in cases had fallen by two-thirds. This overall decline masks substantial variation within versus between states over the three main waves of the pandemic that peaked in April 2020, July 2020, and January 2021. Counties within a state became more similar to one another as cases surged. “Hot spots” emerged at the state level. I additionally compare inequality between counties across a variety of characteristics: urban counties versus rural counties, voted Democratic versus voted Republican in the 2020 presidential election, and low versus high rates of mask use. For each comparison, I find more inequality between counties that share a characteristic than between the two groups of counties, meaning that no characteristic alone explains variation in exposure to COVID-19. Finally, using newly digitized historical mortality records, I compare geographic inequality in COVID-19 deaths to geographic inequality in deaths during the 1918 influenza pandemic, during which an even greater share of the population died. Geographic inequality in COVID-19 deaths is higher than inequality in COVID-19 cases, but is less than geographic inequality in deaths during the 1918 pandemic.

No extended abstract or paper available

 Presented in Session 66. Health and Hazards I : Pandemic Geographies