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How California is addressing COVID-19 health inequities

COVID-19 has highlighted existing inequities in health. Many of these inequities are the result of structural racism. One form this takes is the unequal distribution of and access to health care resources.

Committed to a California for All, the state is identifying communities most impacted and directing resources to address COVID-19 health inequities. The most impacted communities have changed as COVID-19 has evolved. We continue to strive for a healthy California for all. Reducing COVID-19 risk in all communities is good for everyone, and California will continue to ensure that no community is left behind.

California took action to make sure vaccines and other resources were equitably distributed. Some examples of this include:

  • Partnering with mobile clinics in local schools and places of worship
  • Providing free transportation to vaccine sites
  • Continuing to provide vaccines, testing, and treatment in our hardest-hit communities 

State public health leaders cannot address COVID-19 health inequities alone. A healthy California for all requires partnership with the private sector, local government, and community partners at all levels.


Overview of COVID-19 disparities in our diverse communities

COVID-19 disproportionately affects California’s most marginalized communities, as well as essential workers such as those in health care, grocery, and cleaning services.

Death rate for Latino people is 11% higher than the rate for all Californians

Deaths per 100K people:

260 Latino
233 all ethnicities

Case rate for Pacific Islander people is 83% higher than the rate for all Californians

Cases per 100K people:

47,020 NHPI
25,708 all ethnicities

Death rate for Black people is 19% higher than the rate for all Californians

Deaths per 100K people:

279 Black
233 all ethnicities

Case rate for communities with median income <$40K is 16% higher than the rate for all Californians

Cases per 100K people:

29,713 income <$40K
25,708 all income brackets

Case and death rate source data

Note: This data is cumulative since the first COVID-19 case was reported in January 2020. Case rate is defined as cumulative COVID-19 cases per 100K population. Death rate is defined as cumulative COVID-19 deaths per 100K.


How COVID-19 has impacted our communities

Statewide COVID-19 impact by race and ethnicity over time

The groups most impacted by COVID-19 have changed as:

  • New variants appeared
  • People got vaccinated
  • Treatments became available
  • Week ending
  • COVID-19 {METRIC} by race/ethnicity, {REGION}
  • {METRIC} per 100k
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  • 2020–present
  • Updated {PUBLISHED_DATE} with data from {REPORT_DATE}. Data is updated on Thursdays.

Statewide COVID-19 impact by race and ethnicity over time source data

Chart information

  • Rates are not adjusted for factors like age, vaccination status, and comorbidities. These factors may vary between race and ethnicity groups and affect the rates.
  • Population estimates do not include “other” or “unknown” race and ethnicity categories, therefore their percentage of state population is not available. To see cumulative race and ethnicity data broken out by age groups, see the California Department of Public Health’s COVID-19 Race and Ethnicity Data.
  • “Other” race and ethnicity means those who don’t fall under any listed race or ethnicity. “Unknown” race and ethnicity includes those who declined to state or whose race and ethnicity information is missing.

COVID-19 impact by race and ethnicity in the last 30 days

Latino, Black, and Pacific Islander communities have been disproportionately affected by COVID-19. We have made some strides in addressing disparities within these communities, but we must do better.

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  • Compare cases adjusted by population size across each race and ethnicity.
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Cases, deaths, and tests relative to percentage of population and case, death, and test rate per 100K by race and ethnicity group source data

Chart information

  • Population estimates do not include “other” or “unknown” race and ethnicity categories, therefore their percentage of state population is not available. To see cumulative race and ethnicity data broken out by age groups, see the California Department of Public Health’s COVID-19 Race and Ethnicity Data.
  • Numbers between 1 and 11 are shown as “<11” to protect patient privacy.
  • “Other” race and ethnicity means those who don’t fall under any listed race or ethnicity. “Unknown” race and ethnicity includes those who declined to state or whose race and ethnicity information is missing.

COVID-19 health equity metric

The health equity metric measures the positivity rate in the most disproportionately-impacted communities. These communities are identified in the Healthy Places Index, developed by the Public Health Alliance of Southern California, as census tracts that have less healthy community conditions such as low median income, education completeness, and health care access. Health equity quartile positivity is the COVID-19 positive rate in the lowest 25% of Healthy Places Index census tracts.

  • Test positivity
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  • Health equity quartile positivity
  • The health equity metric is not applied to counties with a population less than 106,000.
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  • Updated {PUBLISHED_DATE} with data from {REPORT_DATE}. Data is updated on Thursdays.

Health equity metric source data

Chart information

  • Data shown is a 7-day average of positivity rate with a 7-day lag.
  • Data shown is for the 7-day period ending February 26, 2022.
  • The health equity metric is not applied to counties with a population less than 106,000.

Data completeness is critical to addressing inequity

We know a lot about the impact of COVID-19 on certain communities, but we can better invest our resources by increasing the collection of race, ethnicity, and sexual orientation and gender identity data. We can better respond to health disparities by having more complete data. This data collection requires close cooperation with private sector partners, laboratories, and state and county officials. View resources on how to improve reporting on race and ethnicity and sexual orientation and gender identity.

    • Reporting by race and ethnicity in California
      • Data shown is a cumulative 30-day total.
      • Sexual orientation and gender identity are not collected for tests.
      • Numbers between 1 and 10 are not shown to protect patient privacy.
    • Updated {PUBLISHED_DATE} with data from {REPORT_DATE}. Data is updated on Thursdays.
    • Reporting by race and ethnicity, sexual orientation, and gender identity source data

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    • In California, race and ethnicity data for tests is complete.
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    • Tests
    • Cases
    • Deaths

  • How other factors increase risk of infection and severe illness
  • Californians in crowded housing or transportation, and with less access to paid leave and other worker protections, have a higher risk of infection of COVID-19. Social determinants of health, such as food insecurity, lack of health insurance, and housing instability can increase the risk of poor outcomes. These social determinants of health are often the result of structural inequities like racism.
  • Community case rate by median annual household income bracket
  • Community case rate by amount of crowded housing
  • Community case rate by health care access
  • Median annual household income bracket
  • Percentage of community living in crowded housing
  • Percentage of community without health insurance
  • Income
  • Crowded housing
  • Access to health insurance
    • Data comes from the American Community Survey and is statewide. It does not reflect individual counties.
    • Data shown is a cumulative 7-day total with a 7-day lag.
  • Community case rate by income, crowded housing, and access to health insurance source data

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Underlying health conditions

Underlying health conditions can also increase the severity of COVID-19. These health conditions are more common among disadvantaged populations. The more medical conditions you have, the higher your risk of getting severe COVID-19 that can lead to hospitalization or death. The best way to reduce your risk is to stay up-to-date with your vaccinations.

Here are some common medical conditions that may make you more likely to get severe COVID-19. The CDC lists other medical conditions that increase your risk of severe COVID-19.

History of Adverse Childhood Experiences (ACEs)

People with ACEs experience abuse, neglect, or household challenges before age 18. They are at risk for poorer physical, mental, and behavioral health.

Exposure to prolonged ACEs can:

  • Affect immune functioning
  • Increase risk for chronic health conditions like:
    • Heart disease
    • Obesity
    • Kidney disease
    • Diabetes

People with ACEs may be more sensitive to new stresses, like the COVID-19 pandemic. Learn how to manage stress.

Disabilities

People with disabilities are more likely to:

  • Get COVID-19
  • Have worse effects when they get COVID-19
  • Have chronic health conditions
  • Live in shared group settings
  • Face more barriers in accessing health care

Disabilities can include:

Obesity

People who are obese may experience worse effects from COVID-19. People who are very obese are at higher risk of severe COVID-19. Learn more about obesity from the CDC.

Pregnancy

People who are pregnant or recently gave birth are at higher risk of severe COVID-19. Learn more about pregnancy from the CDC.

Chronic kidney disease

People with chronic kidney disease are at risk of severe COVID-19. This includes people who received a kidney transplant. Learn more about kidney disease from the National Kidney Foundation.

Diabetes

People with diabetes (type I or 2) are at higher risk of severe COVID-19. Learn more about diabetes from the America Diabetes Association.

Weak immune system

Some medical conditions or treatments may result in a weak immune system. These conditions include:

  • Cancer
  • Leukemia
  • Autoimmune disease
  • Transplant
  • HIV

People with a weak immune system are less able to recover from  COVID-19. They are also at higher risk of severe COVID-19. If you have a weak immune system, consider pre-exposure prophylaxis with EvuSheld in addition to vaccination.

Learn more about weak immune systems from the CDC.

Heart conditions like heart failure and high blood pressure 

People with heart conditions are at higher risk of severe COVID-19. This is because COVID-19 can cause blood clots in the vascular system. Learn more about heart conditions from the National Heart, Lung, and Blood Institute.

Lung diseases like asthma and tuberculosis

People with lung diseases are at higher risk of severe COVID-19. This is because COVID-19 can cause inflammation in the lungs. Learn more about lung diseases from the American Lung Association.

Strokes and dementia

People who have had a stroke or other condition that affects blood flow to the brain are at higher risk of severe COVID-19. Learn more about cerebrovascular disease from the National Institute of Neurological Disorders and Stroke.

Substance use disorders

People with a substance use disorder are at higher risk for severe COVID-19. These substances include alcohol, opioids, and cocaine. Learn more about substance use disorder from the National Institute on Drug Abuse.

Sickle cell disease

People with sickle cell disease are at higher risk of illness and death from lung infections. COVID-19 can cause severe lung infections. Learn more about sickle cell disease from the American Society of Hematology.

Explore more data

State data

Statewide and county cases, deaths, hospitalizations, and tests, including by vaccination status, gender, and age

Vaccination data

State and county data about vaccination, including by race and ethnicity and age

Variants

Data about which variants are in California, including Delta and Omicron

Data and tools

In-depth models, dashboards, databases, and information about California’s COVID-19 data reporting