An In Depth Look At Racial Divide In Orange County Through The Lens Of Coronavirus

IRVINE, CA —University of California Irvine researchers evaluated the socioeconomic, geographic and demographic factors all playing a critical role in COVID-19 mortality rates in Orange County, according to a study published Thursday.

The findings, published in the journal Emerging Infectious Diseases, show that some groups were more likely to test positive and die from the virus, a UCI spokesperson says.

Within Orange County, risk factors for catching coronavirus and contracting COVID-19 shifted over time.

Orange County is the sixth most populous county in the U.S., with an estimated 3.2 million inhabitants,” according to Daniel Parker, UCI assistant professor of public health and the study's corresponding author. “Its relatively small land area, high population density and socioeconomic diversity provided a unique opportunity to explore important social, economic and demographic correlates of COVID-19 epidemiology.”

Parker discussed how the study came into being.

"At the beginning of the pandemic, in March 2020, cases were clustered in the more affluent coastal areas of the county but then shifted to north-central locations, particularly in the cities of Santa Ana and Anaheim," said UCI assistant professor of public health and the study's corresponding author, Daniel Parker. "We examined how contextual factors — such as levels of education, insurance and income — can lead to increased risk of infection or death."

The study researched testing and mortality data provided by Orange County Health Care Agency from March 1 to Aug. 16, 2020, while UCI and OCHCA used 11 drive-through sites to collect data on seroprevalence — the level of a pathogen in a population, as measured in blood serum.

Researchers analyzed age, race, gender, income, education, insurance coverage and household density per ZIP code.

• Seniors, males and Hispanic or Latino individuals were more likely to be diagnosed with the virus.
• Asians were more likely to die than non-Hispanic whites.
• Hispanic and Latino individuals had 1.7 times the odds of testing positive for infection than non-Hispanic whites.
• Residents with lower incomes were more likely to test positive for COVID-19.
• People from ZIP codes with higher household density, less education and less insurance coverage were more likely to be infected and die.

With a diverse local Asian population, Parker and researchers found "lumping them into a single category" masked other important differences in risk of infection or death.

"A pandemic is really made up of many local epidemics — each playing out according to local contextual factors," Parker said. "The way COVID- 19 has rolled through Orange County is different from the way it's currently burning through Myanmar, for example. It's important to understand and document local contextual factors associated with infectious disease outbreaks and the resulting disparities in morbidity, mortality and quality of life."

The UCI study concluded that reasons for the patterns of disparity within the county are "likely complex and related to issues of accessing health care and general social determinants of health."

The study recommended developing socioculturally appropriate approaches emphasizing equity and working with community-based organizations to ensure access to health services.

The research team included Bernadette Boden-Albala, Tim Bruckner, Veronica Vieira and Schott Bartell of UCI's Program in Public Health; Philip Felgner of UCI's School of Medicine; Vladimir Minin and Catalina Medina of UCI's Donald Bren School of Information and Computer Sciences; and Dr. Matthew Zahn, medical director of the Communicable Disease Control Division, and senior epidemiologist Alissa Dratch of the Orange County Health Care Agency.