As the United States enters its third month fighting the coronavirus pandemic, between 20,000 and 30,000 new cases have been diagnosed every day since the start of May. Even as data` remains highly limited, trends are beginning to emerge about which groups and parts of the United States are being hit the hardest — by the disease as well as economically.

Testing rates vary considerably between states and counties, making it difficult to assess the impact of the coronavirus on certain communities. In order to attempt to identify at-risk communities, 24/7 Wall St. reviewed the counties and county equivalent geographies that rank as the most vulnerable in the Centers for Disease Control and Prevention’s Social Vulnerability Index. The index uses data from 2018 to measure the ability of communities to prevent human suffering and financial loss when confronted with disasters or disease outbreaks.

The SVI uses 15 variables that fall into one of four categories: socioeconomic status, household composition and disability, minority status and language, and housing and transportation. These measures — which include poverty rates, unemployment, the presence of minorities or physically disabled populations, crowded housing, and populations living in institutions such as prisons or senior living centers — are one way of attempting to identify the counties that will be hit hardest by COVID-19 and could take the longest to recover. 

Although many of the counties on this list may not be the urban, population-dense places Americans might associate with the outbreak, the majority have high numbers of diagnosed cases and deaths per capita. 

In a conversation with 24/7 Wall St., Mark Siedner, associate professor of infectious diseases at Harvard University and clinician at Massachusetts General Hospital, explained that it made sense that these places identified as highly socially vulnerable would have high incidences of COVID-19 diagnoses and deaths. 

“…the determinants of health for COVID-19 in this country are quite parallel,” he noted. “the clear reality for centuries [has been] that health and disease is socially determined […] COVID-19 has magnified that effect quite acutely, by showing the substandard, systematic barriers to healthcare access in this country.” 

Many of the vulnerable groups included in the index have already been shown to have higher rates of vulnerability to COVID-19. For example, while the COVID-19 death rate among non-Hispanic white Americans is 45.2 per 100,000 people, it is 74.3 per 100,000 people identifying as Hispanic or Latino and 92.3 per 100,000 people identifying as Black or African American. 

In one 2011 paper published in the Journal of Homeland Security and Emergency Management, CDC employees said, “The social and economic marginalization of certain racial and ethnic groups, including real estate discrimination, has rendered these populations more vulnerable at all stages of disaster.” Notably, a number of counties on this list are home to substantial American Indian populations, a group that has long struggled with the historical socioeconomic disadvantages that can be traced to their forced relocation by the U.S. government. 

This includes McKinley County, New Mexico, which is home to part of the Navajo Nation and where nearly 80% of the population identifies as American Indian. The county has more COVID-19 cases per capita than the vast majority of U.S. counties.

Click here to see what places the CDC says are the most vulnerable to disasters like COVID pandemic.
Click here to see our methodology.