People in Poorer Counties Are Twice as Likely to Die of COVID, Report Finds

ICU nurse Melinda Hunt, facing, hugs the sister of a COVID-19 patient who she had been caring for after the patient died in 2021 in Shreveport, La. (AP Photo/Gerald Herbert, File)

By Michael McElroy

April 5, 2022

The report, its researchers say, is the first to study the link between poverty and pandemic death rates.

People living in poverty were at least twice as likely to die from COVID, a new report shows, evidence of a system, the researchers say, that “preys on the poor.” 

Written by several groups including the Poor People’s Campaign and a United Nations sustainable development network, the report is the first to closely analyze poverty’s effects on COVID death rates, the authors say.

“The COVID-19 pandemic exacerbated preexisting social and economic disparities that have long festered in the U.S,” the report found, and if the US is to be better prepared for either the next variant or an entirely new pandemic, it must prioritize income inequality.

North Carolina-based civil rights leader William Barber II, a co-leader of the Poor People’s Campaign, said in a news conference Monday that the report “revealed neglect and sometimes intentional decisions [by public health officials] to not focus on the poor.” 

The results are stark.

“Pre-existing disparities in healthcare access, wealth distribution, and housing insecurity yielded disastrous effects once the pandemic hit the US,” the report says. 

The researchers collected and analyzed data from more than 3,200 counties across the country, comparing death rates by poverty level, income, race, health-insurance status, and geography, something no other study had sought to do, Barber said. 

The findings were “further evidence,” he said, of the need “to put addressing poverty and low wealth at the front and center of our nations’ moral agenda,” and to shift the conversation beyond the same old metrics.

Even things like vaccine rates, for example, could not explain the death disparities among income groups, the report said. 

It found that in counties with high vaccination rates, poorer counties often had more deaths than wealthy counties of comparable size. And while vaccine rates can be lower in poorer counties than in wealthier counties, economic barriers including less flexible work schedules and the lack of access to transportation and child care are often to blame, Roll Call wrote last year

That, Barber says, means that COVID discussions about individual responsibility and behavior widely miss the mark.

“As a nation we do not talk about poverty,” Barber said. “We must talk about this.”

It was crucial that national health leaders and the public in general hear the report’s message, Barber said.

“Walk through this data, as hard as it is to look at,” Barber said. “Take the time to see what has been so far unseen. The findings are so contrary to a nation that claims first and foremost to establish justice.”

One person, Barber said, lost 23 members of her extended family in the pandemic, all of whom lived within 30 miles of one another. 

The reports’ findings are shameful, he said. “They should create a social sadness and a righteous anger among people of conscience.”

Subhead: The Findings

  • COVID death rates in poorer counties were often twice as high as in wealthier counties of similar size. 
  • Counties with the highest death rates had higher percentages of people of color.
  • Nationwide COVID surges were much worse in poorer counties. 

“During the third phase (winter 2020-2021), death rates were four-and-a-half times higher in the counties with the lowest median income than in the counties with the highest median income,” the report found. The rates were five times higher in the Delta surge and three times higher during the first Omicron surge in January. 

  • Median incomes are on average $23,000 less than counties with lower death rates, and uninsured rates are twice as high as the highest median income counties.
  • People with the financial means were able to work from home and retreat to safe locations, but many lower income people were unable to do so, working in essential fields that helped keep food and supply lines from collapsing.

What Now?

“Poverty and widespread inequality increases vulnerability to crises. While vaccines will prevent the worst impacts of COVID-19, they will not inoculate against poverty,” the report said. 

Living wages, shared economic prosperity, and inclusive welfare programs, the report said, were crucial steps toward addressing the “root causes that made the US vulnerable to such massive losses of human life.”

It continued: “Likewise, ensuring universal and affordable health care, housing, water, access to utilities, quality public education, and guaranteeing a robust democracy will establish a more equitable foundation upon which we can build back better from the pandemic.”

The researchers called on President Biden and federal leaders to look at the data, recognize the disproportionate burden and do something about it, and the Poor People’s Campaign is organizing a march on Washington on June 18.

Now that federal COVID funds have dried up, many COVID tests and treatments are no longer covered by insurance. The problem will only get worse without widespread action, the reports’ researchers say. 

“Even as short as one minute ago,” Barber said on Monday as he opened the news conference, “we found out about another person of poverty and low wealth dying because of COVID.” 

The virus did not discriminate, he said, but the country did. 


  • Michael McElroy

    Michael McElroy is Cardinal & Pine's political correspondent. He is an adjunct instructor at UNC-Chapel Hill's Hussman School of Journalism and Media, and a former editor at The New York Times.

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