We Don’t Need a Map to Tell us Who COVID-19 Hits the Hardest in St. Louis

Community Engagement; Faculty; Policy; Public Health; Social Work

While it is clear that COVID-19 does not discriminate based on factors such as an individual’s race and economic status, we do know that it is disproportionately impacting those who are least likely to have the resources to fight it.

And recently, COVID-19 data from the City of St. Louis confirms it. In a map listing positive COVID-19 cases by zip code, we see a greater concentration of cases in low-income and highly segregated zip codes in the City of St. Louis. Sadly, that data is not surprising.

Low-income individuals are more likely to experience detrimental health and financial outcomes, and even more so for African American populations. COVID-19 has the potential to be particularly devastating in St. Louis, as St. Louis was ranked as having the sixth highest rate of minority residential segregation among the 50 largest metros in the United States.

Policymakers should keep the following in mind as COVID-19 continues to unfold in the city.

1. The data clearly shows that this disease discriminates by income and race.

In cities like St. Louis, the zip code in which you live is a main predictor for future health outcomes.

Looking at the entire metro area, we anticipate that COVID-19 will affect some neighborhoods more than others. Even without a COVID-19 outbreak, we know babies in The Ville are six times as likely to have a low birth weight and twice as likely to die before their first birthday compared to babies in Clayton. And adults don’t fare much better. People living in the Ville are much more likely to be diagnosed with asthma, obesity, and diabetes—risk factors for COVID-19.

What makes the initial statistics about COVID-19 infections by zip code so alarming is that households without insurance or transportation are likely to go untreated and untested for the disease, so the real number of cases might be even higher than reported.

2. The disease discriminates because of the working conditions and living density of the poor.

Low-income individuals in St. Louis may live in crowded areas, utilize laundromats, rely on public transportation, and are less likely to afford getting grocery deliveries. These realities of day-to-day life increase their exposure to COVID-19 infection. Additionally, Brookings Institute research tells us low-income households are less likely to hold jobs that enable remote work while others may quit to care for children.

Research from Social Policy Institute highlights how frontline workers, such as those in home health agencies or warehouses, may lack personal protective equipment and face increased risks of contracting COVID-19. They also may not receive generous employee benefits, such as health insurance coverage, vacation time and retirement savings contributions from their employer.

3. Policy changes can ease the situation.

Disaggregated by zip code, these COVID-19 cases repeat a story we see too often in St. Louis—low-income communities of color are left with the greatest health and economic burden. Policymakers should look closely at not only this data, but the underlying social indicators exacerbating the strain on these households and community. This includes ensuring there is adequate testing in segregated zip codes and taking positive actions to benefit low wage workers.

We don’t need a map to tell us that policymakers, health officials, corporations, and St. Louis residents themselves must continue to break down economic barriers to create partnerships and solutions that support the most vulnerable in our city – those who were already facing a disproportionate social, financial, and health burden prior to COVID-19 entering their lives.

Michal Grinstein-Weiss is the Brown School’s Shanti K. Khinduka Distinguished Professor and director of Washington University’s Social Policy Institute. Brinda Gupta, is the Social Policy Institute Program Manager. This article appeared as an op-ed in the St. Louis Post-Dispatch on Friday, April 10, 2020.

A more in-depth version of this piece is available on the Social Policy Institute’s website