A drive-through COVID-19 testing site in Southern Nevada in July. (Photo: Daniel Clark)
Nevada’s minority populations are the hardest hit by COVID-19 in terms of infection, hospitalization, and mortality rates, according to statewide data trends analyzed by the Guinn Center.
The analysis released Tuesday also examines the higher prevalence of other diseases for Nevada’s communities of color in general and underscores the effects of long-standing inequities in health care, social services, housing, income and other socio-economic challenges faced by communities of color that have been exacerbated by the pandemic.
The Guinn report and others, including a pair of recent studies on the Nevada workforce and the pandemic, reiterate the disproportionate impact of COVID on people working in low-wage jobs, and in turn underscore the lack of economic diversity in a state economy still driven by tourism and hospitality.
“This is an important issue. The economic impact in some ways has been more devastating than the Great Recession. The data will be useful in terms of where we should be directing resources and how we think about mitigation strategies,” said Nancy Brune, executive director of the Guinn Center.
Cases, deaths, and hospitalizations
White people represent roughly 50 percent of Nevada’s population, but only account for about 29 percent of Nevada’s confirmed COVID-19 cases, according to data collected by the state.
White people do account for about 51 percent of deaths, roughly equivalent to their representation in the population. Old age is a pronounced risk factor for severe COVID cases, the Guinn Center report notes. As of 2019, 20 percent of Nevada white people were over the age of 65, a substantially larger portion than other ethnic and racial groups.
In Nevada, African Americans make up about 9 percent of the population, and account for 8 percent of COVID-19 cases. But Black people are twice as likely to die from COVID-19 as white people are, making up 12 percent of deaths despite their population size.
Asian Americans are likewise twice as likely to die from COVID-19 as white people in Nevada. Asian Americans account for about 12 percent of deaths and 7 percent of COVID cases despite only comprising 9 percent of the state’s population.
Latinos in Nevada have contracted COVID-19 in the greatest numbers relative to their share of the population. While Latinos represent 30 percent of the state’s population they account for 40 percent of cases and about 22 percent of deaths.
Hospitalizations in Clark County reveal similar trends of COVID-19 disproportionately affecting people of color.
While statewide hospitalization data are not available for Nevada, data is available for hospitalizations within Clark County, which accounts for the majority of the state’s population and of confirmed COVID-19 cases and deaths in the state.
Those trends show white people in Nevada have the lowest hospitalization rate, at about 120 hospitalizations per 100,000 population. In contrast, African Americans have the highest hospitalization rate, at 216.9 hospitalizations per 100,000 population, nearly double the rate of whites.
The hospitalization rate for Latinos is 207 per 100,000. For Asian and Pacific Islanders the rate is 161 hospitalizations per 100,000 population.
Underlying issues and access to care
The Guinn report also examined how underlying health issues and disparities in health care access may contribute to the higher rates of COVID-19 hospitalizations and mortality among minority populations.
The Centers for Disease Control and Prevention (CDC) reported that advanced age and several underlying health conditions are major risk factors for COVID-19, including diabetes, heart disease, and lung diseases. Of those who required admission to an intensive-care unit, 78 percent had at least one of those underlying health conditions.
In Nevada, more than 80 percent of COVID-19 deaths have occurred among people over the age of 60, according to data from the Nevada Department of Health and Human Services.
Diabetes rates are higher among African Americans and Latinos in Nevada. Black adults have had the highest rates for diagnosed diabetes of all ethnic groups since 2014, according to data from the Nevada Behavioral Risk Factor Surveillance System analyzed by the Guinn Center. The prevalence of diagnosed diabetes among Latinos in Nevada is between 10 and 15 percent while white Nevadans have the lowest rate of diagnosed diabetes at less than 10 percent.
Cardiovascular disease is the leading cause of death in Nevada and one of the most significant risk factors for severe COVID-19 related illnesses.
While most ethnic groups have similar rates of cardiovascular disease, African Americans have the highest rates of cardiovascular mortality rates, according to data from the Nevada Behavioral Risk Factor Surveillance System.
“The higher mortality rates among this racial group may also be attributed to inequalities in access and quality to cardiovascular care received by African Americans,” reads the Guinn report.
In other words, lack of health insurance can exacerbate risk or delay medical care for COVID-19 among minority populations in Nevada.
Since the Nevada Medicaid expansion in 2015, the number of people without health insurance has declined significantly, however, there are marked disparities in the rates of uninsured across racial groups.
American Indians/Alaska Natives are uninsured at the highest rates in Nevada at more than 22 percent, followed by Latinos at 20.0 percent, and African Americans at 11.0 percent.
Nevada’s uninsurance rate was also the seventh-highest in the nation last year, according to an analysis by the Kaiser Family Foundation. Eleven percent of the population lacks health insurance — roughly 338,700 Nevadans — slightly above the national rate of 9 percent.
In a previous study on Nevada’s uninsured population, the Guinn Center found that Latinos accounted for about 36 percent of the state’s population, but almost 60 percent of those who are uninsured.
The report listed a number of possible reasons for the high rate of uninsured Latinos in Nevada including immigration statutes, lower rates of education, and low household incomes.
Nevada has the highest share of unauthorized immigrants as a share of the total population (7.1 percent), followed by Texas (5.7 percent) and California (5.6 percent), according to data from the Pew Research Center.
Communities of color and the economy
In April, the state’s unemployment rate reached 30 percent, the highest in the country and the highest rate ever recorded in U.S. history. Nevada’s unemployment rate has improved in recent months, but it is still higher than any prior recession at 14 percent, significantly higher than the national average of 10 percent, according to July data from the Nevada Department of Employment, Training and Rehabilitation (DETR).
Low wage workers in accommodations and food services have been hit the hardest by Nevada’s economic collapse, accounting for about 35 percent of unemployment insurance claims, according to data from the Nevada Department of Employment, Training and Rehabilitation.
In 2018, the most recent data available from the Bureau of Labor Statistics and U.S. Department of Labor, shows that 32 percent of Latinos and nearly 35 percent of Asians were employed in leisure and hospitality, a reflection of how workers in these two groups are at higher risk for unemployment, according to a preliminary assessment analyzing the impact of the COVID pandemic on the labor market in Nevada.
“In hospitality and gaming work is largely segmented by gender, race, and ethnicity,” said John Tuman, a UNLV political science professor and author of the preliminary report. “The labor there is primarily done by women and immigrants, that’s been well documented. During the Great Recession, those groups had elevated levels of unemployment because of their concentration in gaming and hospitality. We are expecting to see a fairly large impact here for Asians and Latinos.”
While post-COVID unemployment data by race is not available for Nevada, early figures are emerging.
Nevada was the state with the highest Hispanic unemployment rate for the second quarter at about 30 percent, up from about 5 percent last quarter, according to a report by the Economic Policy Institute.
The Guinn Center estimates that by September as many as 327,000 Nevadans could struggle to pay rent. People of color in Nevada are also more likely to be renters making them particularly vulnerable to evictions.
“We have been talking since early summer about evictions but to see that by looking at the data that those that are likely most affected or most vulnerable to the risk of eviction are in fact our communities of color because such a high number are renters,” said Brune.
More than two-thirds of Native Hawaiian/Pacific Islanders, and African Americans in Nevada are renters, according to data from the U.S. Census Bureau, and around half of American Indian/Alaska Natives and Latinos rent their homes.
Minority populations in Nevada are also more likely to be cost-burdened, meaning they pay more than 30 percent of their income on rent.
African Americans and Native Americans are “severely cost-burdened” at higher rates than other racial and ethnic groups and more than 30 percent of households pay more than 50 percent of their income on rent.
The Guinn Center report ends with recommendations on how the state might begin to mitigate the impact of COVID-19 on communities of color who have been disproportionately impacted by the pandemic.
“We hope that some of the recommendations will be considered by our decision-makers at the state and county level,” Brune said.
The Guinn Center recommends increasing support for Nevada’s Native American communities and addressing a lack of data and information available on the needs of Native communities by improving data collection.
Other recommendations include:
- Expanding access to COVID-19 testing and treatment for communities of color
- Expand rental assistance support for tenants
- Fund short-term training and educational opportunities
- Restore funding for health care and testing programs
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