Data from Texas Health and Human Services shows that for COVID-19 patients, Dallas County has nearly twice the death rate as Harris County. Harris County has nearly twice the number of people Dallas County does (4.7 million to 2.6 million residents respectively), but Dallas County has nearly as many fatalities as Harris County from coronavirus, (249 to 241 respectively on June 4).
When looking at the two cities, the demographic differences don’t immediately explain the higher fatality rate. COVID-19 is known to impact Black patients and the elderly at a higher rates, and while Dallas does have a higher percentage of Black residents, (23 percent of the population in Dallas County, 20 percent in Harris County) it doesn’t account for the disparity. The elderly are another at-risk group, but both counties share of residents above the age of 65 in 11 percent. Dallas has a slightly higher uninsured rate (24 percent in Dallas compared to 22 percent in Harris). The two counties also have similar rates of diabetes at 11 percent, according to the Texas County Health Rankings. And according to the Census bureau, Harris County actually has a larger percentage of people living in poverty (17 percent to 14 percent in Dallas County).
Both Harris and Dallas County have given a similar number of tests per person. Dallas County had given 105,564 tests as of June 4, and Houston had tested 182,892. When population is factored in, both counties had given one test for every 22 to 25 people in the county. Dallas had 10,958 cases as of June 4, and Harris had 13,268 cases, meaning Dallas had a much higher rate of confirmed cases per test. Houston had a confirmed case for about every 8,000 tests, while Dallas had a confirmed case for about every 4,000 tests given.
Dallas County Health and Human Services Director Dr. Phillip Huang says that may be because Houston started testing asymptomatic individuals earlier than Dallas did, meaning Harris would have a lower confirmed test rate. Dallas County only tested those with symptoms for much of the pandemic. But while that explains the increase in cases, it doesn’t explain why the number of deaths is so similar despite Harris County having a much larger population. Dallas County has about 55 percent of the population of Harris County, but has 96 percent of the fatalities.
Density could be a factor. Dallas has about 3,000 people per square mile, while Harris is a bit more spread out at about 2,700 residents per square mile. Dallas is a bit more dependent upon healthcare as an industry than Houston, though Houston is more focused on construction, which has been an essential business during the pandemic.
Personal behavior, healthcare access and quality disparities, and other preexisting conditions may be a factor, though Unacast ranked every county in the country for social distancing, and gave both Dallas County and Harris County an F. When Medbelle ranked hospital cities in the U.S., Houston ranked ninth and Dallas 13th. Houston has the largest medical center in the world. Houston bested Dallas in healthcare infrastructure and quality of care and the two cities tied for access to care.
Huang wasn’t familiar with the death rate disparity between the two counties or why that would be the case. Follow the number of tests, confirmed cases, recovered cases, and fatalities here.