Since state and county health departments first began reporting demographic information about coronavirus cases and deaths, the numbers have made clear that Black and Hispanic Coloradans have been disproportionately impacted by the deadly pandemic.
But over time, the data have revealed a more detailed picture, suggesting that where Black and Hispanic Coloradans were similarly affected more than white Coloradans earlier in the pandemic, the number of new cases have declined for Black Coloradans, but remained significantly higher in the Hispanic community.
In March and April, data provided by the state and some counties showed outsized rates of infection in both the Black and Hispanic communities. In Denver County, where the relatively large and diverse population provides the most precise look at racial and ethnic distinctions, the rates of new cases among Blacks and Hispanics were two to three times the rate among whites.
Dr. Fernando Holguin, the director of the University of Colorado’s Latino Center for Research and Policy Center, focusing on Latino health disparities, said that during the peak of hospitalizations in March and April, he recalls walking through the UCHealth intensive care unit, when he realized just by looking around that the pandemic was spreading rampantly among the minority community.
“It seemed like maybe 80% were brown or Black. Most were Hispanic or had Hispanic last names,” Dr. Holguin said. “The disparities were really obvious.”
In the weeks after that, in May and June, the rate of new cases for Black Denver residents began to decline, nearing the rate for white Denver County residents. But the rate of new cases among Denver’s Hispanic community has remained about three times the rate among whites.
Experts and community leaders point to several factors to explain the difference in coronavirus rates, all centering on underlying and systemic disparities, from workforce demographics and lower overall incomes to language barriers and environmental quality issues that affect minority neighborhoods more.
“Obviously this pandemic has exposed stark inequalities in our society, and ones that have existed for a long time,” said Rudy Gonzales, the executive director of Servicios de La Raza, an advocacy group that emphasizes service for Hispanic and Latino Coloradans.
One of the prime reasons Gonzales emphasized for the disparity is the type of jobs filled by the Hispanic and Latino workers. Gonzales said only one of every six Hispanic workers surveyed recently said they have the ability to work online from home.
“We make up about 17% of total employment, but about 53% of agricultural employment, and in retail, restaurants and transportation, too.”
Gonzales cited a survey that found Hispanic and Latino workers are less likely to report they can work from home.
“About two-thirds of Latinos say they will not be paid if they don’t go to work,” Gonzales said. “We’re impacted because we can’t ‘stay at home’ like others can.”
A false rumor causes trouble
Dr. Terri Richardson, the vice chairwoman of the Colorado Black Health Collaborative, said that on top of the greater prevalence of underlying health issues that worsen coronavirus outcomes, like diabetes and hypertension, she suspects many Black Coloradans weren’t being tested early in the pandemic because of a lack of access and because of longstanding distrust of the medical system — meaning undetected spread in the community.
But another insidious factor may have contributed to an early spike in the Black community, she said. Early in the pandemic she and other health advocates became aware of a rumor being circulated, amplified over the internet and social media, that Black people were immune or less susceptible to the coronavirus.
“We were hearing stories about it coming out of our barbershops and salons, and we were like, ‘oh no.’” she said. “You know these things travel by word of mouth, and we had people talking about this like it was factual.”
Richardson said she and others working on health issues in the community had to combat the untrue rumor and get better information to people.
The race and ethnicity of Coloradans with COVID-19 is known for about 80% of cases statewide. The cases where the race and ethnicity is not known means the new and cumulative case counts fall within a range of possibility. In the more sparsely populated and less racially and ethnically diverse areas of the state, even the small number of cases without the racial and ethnic information means ranges of possibility too large to draw conclusions from. But in the denser, more diverse areas of the state, notably along Colorado’s Front Range, the distinctions become somewhat clearer.
Black Coloradans comprise 3.9% of the state’s total population, which makes discerning trends for the Black community more challenging than for Hispanic Coloradans, who make up 21.7% of the population, and white Coloradans, who make up 67.8% of the population.
More than half of Colorado’s Black population lives in Denver and Arapahoe counties. Another 20% live in El Paso County. With Jefferson, Adams and Douglas counties, the six counties account for 91% of Colorado’s Black residents.
Though the statewide data has a larger range of possible rates for Black Coloradans, it shows a similar trend: White Coloradans have had the lowest infection rate, Black Coloradans have had a higher rate, but that rate has declined some, leaving the state’s Hispanic community most impacted. The state health department’s data does not capture the data consistently earlier than the first week of May.
In Arapahoe County, the demographic data shows a trend similar to Denver County: a lower level of new cases for Black residents, and a sustained, higher rate for Hispanic residents.
Ean Tafoya, who works with the Colorado Latino Forum, an Hispanic and Latino advocacy group, said one of the more obvious and insidious factors at play is the concentration of the Denver-area minority population, relative to air quality.
“In these areas, where there is industrial-residential crossover, we know that the small particulate matter and air toxics are higher,” Tafoya said. “Long term exposure to these things affects all of this.”
The environmental issues in those areas, he said, lead to degraded baseline heart and lung health.
A Harvard study released in May concluded that even a small increase in long-term exposure to microscopic airborne particulate matter leads to worsened COVID-19 outcomes. The particulates are emitted by motor vehicles, airplanes, power plants and industry, among other sources. Industrial-residential crossover has historically been clustered in neighborhoods with more minority and low-income residents.
El Paso data follows trend
In El Paso County, ZIP code-level data suggest the same dynamic of higher rates among Black and Hispanic communities is at play. However, the progression of those rates over the past several months is not clear, because the numbers are provided cumulatively.
The population of El Paso County is 6.1% Black and 17.5% Hispanic. In ZIP codes where the Black population makes up more than the county’s average, the cumulative rate of coronavirus infections is nearly twice the rate of that in ZIP codes where the Black population makes up less than the county’s average. In ZIP codes where the population is more Hispanic than the county’s average, the rate of COVID-19 infections is 53% higher than in ZIP codes where the Hispanic composition is lower than average. In areas where the white composition is higher than the county’s average, the rates are about 40% lower than areas with higher concentrations of Black and Hispanic residents.
Another factor at play for some Hispanic Coloradans is a language barrier. If someone’s native language is Spanish, they may not be getting the official or most current information, unless it's being translated.
The Colorado Latino Forum advocated early during the pandemic, Tafoya said, for widespread translation of vital information, which he said was being overlooked in the state’s smaller and more rural counties: “None of these rural counties had the capacity to do the translation about COVID.”
Rudy Gonzales said Servicios de La Raza has focused lately on making sure the community it serves has access to basic necessities, given the job and income losses that have come with the closure of some businesses.
“We’re out here providing food, toiletries, disinfectants,” Gonzales said. “We have to make sure people still have these things. And we provide deliveries to our seniors, people who are isolated because of a COVID infection and our immigrant and refugee community.”
Although Richardson said there’s been progress made in getting better information to the minority community, she said she still worries in particular about the effect of protests and demonstrations that brought thousands of people into the streets over racial disparities in policing.
“Although everyone is wearing masks, and that’s great, when they pull them down and start shouting, that’s droplets in the air,” Richardson said, but added that she hasn’t been convinced yet that the protests could lead to rising new cases. “The jury is still out for me on that.”
Holguin said two other issues concern him: The first is immigrant detention centers, where he said the spread of the virus is bound to be rapid, because of crowded conditions, and because of the high prevalence among immigrants of the same chronic illnesses that exacerbate the virus and are present in minority communities.
He is also worries that ongoing drug trials, which are being accelerated, might not be adhering to best practices around racial and demographic composition. Where normal drug trials would be conducted using subject groups that reflect the population, the rush to find drugs that treat or prevent the virus could lead to missing important details about outcomes among minorities.