Tthe affluent city of Woodbridge, Conn., has less than half the population of neighboring Ansonia, and yet it is home to more people who have received a Covid-19 vaccine. The inequality is strong: in Woodbridge, where residents have an average household income of $ 138,320 per year, 19.3% of the population was vaccinated as of Feb. 4, according to the Connecticut Department of Health. In Ansonia, where the average income is $ 45,563 per year, only 7.1% got their first chance.
Connecticut has the sharpest difference in vaccination rates between its richest and poorest communities – a 65% difference – according to a STAT analysis of local vaccine data in ten states with the largest wealth gaps. Four other states – California, Florida, New Jersey and Mississippi – have also vaccinated a significantly higher percentage of people in the richest 10% of the counties.
The differences vary: in California, 156 shots were given to residents in the richest areas for every 100 vaccines in the poorest provinces, while in Mississippi 111 vaccines were given to residents of the richest provinces for every 100 doses in the poorest places.
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In Washington, DC, the vaccination rate in the richest two wards is more than double that in the two richest.
The findings support, with hard data, anecdotal reports from across the country that wealthy people could access vaccines before low-income people. “We see individuals with privilege and access clearing people away,” said Tekisha Dwan Everette, executive director of Health Equity Solutions in Connecticut, and a member of the governor’s Covid-19 advisory team. state.
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But the analysis also reveals that some states appear to be distributing more vaccines than others. Among states with the largest wealth gaps, Texas, Tennessee, New Mexico, Pennsylvania and Illinois did not show a significant distribution of income at the provincial level in the vaccination figures. The analysis excluded states, including Georgia, Louisiana and Massachusetts, that did not receive the provincial data on recipients.
However, because provinces may contain different populations, the analysis is not a definitive indication of equity. Several experts have said they expect more accurate data to reveal wealth inequalities, even in countries with fair data at the provincial level. And in a number of these states, there were still racial differences.
Olivia Goldhill / STATSources: State and Washington, DC, Department of Health
Any gap in the vaccination of the rich against the poor inevitably exacerbates racial differences. Blacks and Latinos are much more likely to live in poverty than whites, and although they have died at a higher rate throughout the pandemic, they receive fewer vaccinations than whites.
The data suggest that the first wave of vaccines in some countries benefited the rich. ‘There really are two Connecticuts. We, as a state, need to focus more on that, ‘says Tiffany Donelson, chief executive of the Connecticut Health Foundation.
Inequality has been a hallmark of the pandemic since its inception, Everette said, referring to Covid-19 testing sites that were more accessible to wealthy people. “Instead of learning from the lesson, we recreate the privilege,” she said.
Just locating vaccination sites in different and lower-income areas is not enough: ‘People travel outside their own geographical region to get a vaccine elsewhere,’ she said.
Similar problems have been seen in California. “We’ve heard the stories of people in LA driving to Compton or to another part where other sites are,” said Anthony Wright, executive director of Health Access California.
Government policy can help address inequalities. Vaccination points in Texas should set aside a portion of vaccines for vulnerable communities, work with local leadership and distribute the vaccine in racial areas, said Imelda Garcia, chair of the Texas Expert Vaccine Allocation Panel. In contrast, California provinces are expected to focus on equity, but no specific requirements are set on how to do so, said Darrel Ng, spokesperson for the California Covid-19 Vaccination Task Force.
But the explosion of vaccines in Texas, while not reflecting income inequality, has benefited white residents excessively, according to state data. Racial data has not yet been recorded for all vaccinations, Garcia said, and more complete data collection could show a more equitable distribution: ‘The data does not reflect what is happening. I can know that the data is missing. ”
Similar concerns about missing data apply to the analysis of the province, as several states with the largest distribution did not disclose this information. Julie Swann, head of the Department of Industrial and Systems Engineering at North Carolina State University, said these data need to be tracked and shared. “If we start measuring who they reach in terms of race, ethnicity or income, they will do the extra things to reach everyone.”
The rush to vaccinate people as quickly as possible probably had limited capital in the first phase of implementation. ‘[States] was worried that they would lose their assignment if they did not move quickly, ”Swann said. “Everyone was scared.”
The distribution of vaccines has so far focused mainly on healthcare workers and those over 75 years of age. communities, ”said California’s Ng.
But the lack of equality in the first phase for health workers is also an indication of disadvantages facing poorer communities. Fewer people will be vaccinated in areas with a scarcity of hospitals, which are often poorer, rural areas. Central Valley in California, for example, has a much less robust health care system than Silicon Valley.
“The areas that have heavier health infrastructure and workers have by definition received more of the vaccine,” said Wright, of Health Access California.
Connecticut is taking several steps to address the inequality in vaccines, State Health Department spokeswoman Maura Fitzgerald said, including vaccinating vaccines for people in vulnerable communities and setting up a vaccination phone line for residents without internet.
In New Jersey – where STAT has found that the vaccination rate is 28% higher in the richest counties – the health department is working with partners, including places of worship and senior centers, to provide education and access to vaccinations through mobile clinics and possibly door-to-door by vaccinations in areas severely affected by Covid-19, said Donna Leusner, spokeswoman for the health department. Washington, DC, has partnered with hospitals, community health centers and other organizations to bring about equity, a health department spokeswoman wrote, and about 20% to 30% of the vaccine supply is targeted at diverse populations, including homeless shelters and faith-based initiatives.
Meanwhile, Liz Sharlot, a spokeswoman for the Mississippi Department of Health, said the state is working with black pastors, historically black colleges and universities and leading African-American doctors to address the inequality. And Florida – where the vaccination rate is 23.6% higher in the richest counties – is working with places of worship and other sites in underserved communities where the vaccine can be administered, a health ministry spokesman said. Allocations of vaccines in Florida per country are based on the size of the population older than 65 years.
While older people are more vulnerable to Covid-19, the distribution of vaccines based on age can contribute to inequalities. In Connecticut, the northeastern part of Hartford has a life expectancy of 68.9 years, compared to 84.6 years in the West Hartford Center, so a smaller portion of the residents are eligible so far. The state only opened vaccinations for 65-75-year-olds this week. “In Hartford, you miss a large portion of the population,” said Donelson, of the Connecticut Health Foundation.
Online booking systems also contributed to the differences. A vaccine distribution system that makes appointments for those who can best discuss it necessarily rewards those with time and commitment. People regularly have to call five different health care centers to get on a vaccination list, said Georges Benjamin, executive director of the American Public Health Association. “It tells you a lot about the lack of planning,” he said.
Online booking systems require a computer, Wi-Fi and the ability to navigate through a complex system, Wright said. Richer people are more able to take time off from their jobs and have easier access to the transportation that needs to be vaccinated.
“People who are richer will be more involved in the vaccination,” he said. “It shows how much more we need to do to make proactive efforts to reach the most vulnerable.”
STAT’s methodology
STAT examines differences in ten countries with the highest wealth gaps, measured by the Gini coefficient, which provide rural or equivalent local data on the vaccination rates of the population.
For each state, we examined the distribution rates for vaccines in the richest 10% and the poorest 10% of the provinces. For most states, we used federal data on average household income. In Connecticut, we used vaccine data and average household income for cities and towns. And we analyzed the average household income and vaccination rates for each division in Washington, DC. In New Jersey, which has 22 counties, we compared the richest and poorest three counties.
STAT uses the vaccination figures posted on local Department of Health websites on February 6-10. Connecticut, Florida and New Jersey provided the percentage of residents who received their first doses. Mississippi administered the doses of vaccines according to the country in which they live; California administered the vaccine dose per 10,000 inhabitants; Washington, DC provided the population fully vaccinated by the division.