by Meghan McIntyre, Virginia Mercury
A new report this month by the Center on Society and Health at Virginia Commonwealth University shows race, ethnicity and neighborhood are the biggest predictors of whether a Northern Virginian will die before reaching the age of 75. Furthermore, those factors had a greater impact on whether people lived or died during the COVID-19 pandemic compared to before it.
Disparities in accessing health care are “not an accident, and it has a lot to do with policy choices – much of it’s rooted in systemic racism,” said Dr. Steven Woolf, the lead study author and director emeritus of VCU’s Center on Society and Health.
The VCU researchers analyzed the racial and ethnic makeup of counties, legislative districts and census tracts before the pandemic from 2015 to 2019, and identified 15 “islands of disadvantage” – marginalized neighborhoods with low life expectancies often located only a few blocks away from much more affluent communities.
Researchers then used that data to understand the driving forces of premature mortality, or death before age 75, in those areas during the pandemic from 2020 to 2021. The report was commissioned by the Northern Virginia Health Foundation.
Prior to the pandemic, the report shows Northern Virginians’ risk of dying before age 75 was far lower than the statewide average, but rates of premature death varied across census tracts by more than sixfold. Researchers also found approximately two-thirds of deaths that occurred in the region before age 75 could have been averted by preventative services or better treatment.
While Woolf agreed Northern Virginia has an abundance of medical services and resources for getting care compared to other areas of the state such as parts of Southwest Virginia, he said low-income families still face a number of barriers in trying to access health care even when it’s right down the street.
“For example, if you have to have multiple jobs in order to bring income to put food on the table and you’re living paycheck to paycheck, you may not have the time to go to a doctor’s appointment,” Woolf said.
That has resulted in “neighborhoods that have almost third-world living conditions that are across the street from neighborhoods with golf courses and expensive homes,” Woolf said.
When the pandemic hit, these areas became “hot spots” where many more people died prematurely from COVID-19 and other causes.
From 2020 to 2021, as premature death rates increased across the region, the wealthiest 10% of census tracts in Northern Virginia saw no increase, the report found.
While COVID-19 was the third leading cause of premature death across the region during this period, it was the top cause for Hispanic individuals. Among Prince William’s Hispanic population, COVID-19 death rates were almost six times higher than for Alexandria’s white population.
The probability of dying from COVID-19 was highest in Prince William County. People living in Prince William County were 77% more likely to die from COVID-19 than residents of Fairfax County, according to the study.
The report also shows rates of premature death from liver disease, drug overdoses, diabetes, heart disease and stroke all increased significantly in these low-income areas during the pandemic – likely due to disruptions in access to health care services.
Woolf said these disparities can also be seen in differences in funding allocated throughout the region, with resources going to the “best schools in town so that they have the best artificial turf on the football fields or the best iPads to use in their classrooms” while “schools on the other side of town are struggling just to have current textbooks.”
Woolf said the data could help inform policymakers about where health needs are the greatest.
“They shouldn’t, however, need to rely on a university study to have this data,” he said. “There should be the capacity within our local government agencies to do this kind of analysis for themselves, and often they have access to data that’s restricted and not available to researchers like us.”
In a press release for the report, the Northern Virginia Health Foundation stated it hopes “local officials, community leaders, and state representatives will use the new report to work together on expanding opportunities for health and wellbeing across the region.”
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