By measuring socioeconomic, clinical, mobility, and demographic risk factors, the Parkland Center for Clinical Innovation (PCCI) is mapping the most at-risk populations in Dallas County during the pandemic. The organization created a Vulnerability Index, which can be overlaid with a map of COVID-19 outbreaks and testing centers locations. The goal is to help authorities understand where to provide more testing, care, and other targeted resources. The neighborhoods are clustered in southern and East Dallas, but some of the more affluent ZIP codes in the north with an older population are also at high risk.
PCCI has been working with the county and health officials to map the COVID-19 cases from the beginning of the pandemic in North Texas, visualizing county data about where the disease is spreading. The mapping can pinpoint where positive cases more often turn into hospitalizations and become more severe, which usually coincides with neighborhoods consisting of high uninsured rates and underlying conditions. They also created a proximity index to guide public health officials and clinicians to predict individuals risk of exposure based on proximity to other cases.
This latest endeavor creates a Vulnerability Index, which measures a number of factors to identify higher risk areas based on a number of factors. The analysis factors in underlying health conditions like hypertension, cancer, diabetes and heart disease, age, and what is called social depravation, a term for measuring the impact of the social determinants of health. These include quality of housing, educational opportunities, healthy food, employment opportunities, and other factors.
As you can perhaps expect, the map looks similar to many others measuring disparity in Dallas. Housing, education, access to healthy food, employment opportunities, upward mobility, and even lifespan often reflect a similar north-south divide in Dallas County, though there is some differences on this index because age is such an important factor. That means areas that are otherwise well off but have a higher number of elderly residents will reflect as more vulnerable. The pandemic has provided a new way to measure disparity in North Texas.
The fundamental questions are ‘What’s your access to health care? How do you access the healthcare system, food and nutrition, housing, and stability?’ As well as all of those other factors that you know to go into vulnerability,” says Dr. Kelvin Baggett, the City of Dallas COVID-19 Czar. “We recognize that you can layer on those other factors, and depending on how you model vulnerability, you can see an overlapping correlation between those things as well.”
The last factor to be considered when determining vulnerable areas is the mobility of the population, meaning how isolated the people there remain. “Those areas do tend to be highly populated by residents that have the type of jobs that require movement and are not conducive to working from home,” says PCCI President and CEO Steve Miff. “With more social depravation, there is more mobility as well. Often times it is by necessity and not by choice.”
While the disproportionate impact of the pandemic on Black and Latino communities is well documented, PCCI CEO Steve Miff says that when social depravation is the primary reason that racial and ethnic disparities exist in for the impact of COVID-19. “The disparities that we see are substantially corrected when you control for social depravation,”” he says. “They are the COVID-19 risk equalizer across different races and ethnicities.”
When the vulnerable ZIP codes information is combined with actual COVID-19 cases and testing sites, gaps in care can be recognized and testing and treatment can be redeployed in an efficient way to maximize impact. By highlighting the most at-risk communities, officials can see where they need to prioritize response should there be an outbreak of COVID-19.
The data’s goal is to help health authorities and organizations tailor neighborhood responses, rapid deployment of testing or educational resources about isolation, interventions to address social deprivation, and provide culturally sensitive interventions in Black and Hispanic communities.
“From a community health perspective, these latest PCCI analytics continue to support our ongoing efforts to proactively identify hot-spots, rapidly deploy targeted testing that is accessible locally, inform and educate the community using culturally-sensitive approaches, and align other critical resources to support individuals and their families during these difficult times,” said Dr. Philip Huang, the director of Dallas County Health and Human Services, in a release.