COVID-19 Testing Accessibility
How equitable is the spatial distribution of COVID-19 testing locations in Gainesville, FL?
Equity and COVID-19
According to the 2018 Bureau of Business and Economic Research (BEBR) report, “Understanding Racial Inequity in Alachua County”, Alachua County has high levels of racial inequity and a clear spatial segregation of communities. Black households in the county are 2.5 times more likely to be unemployed, compared to the non-Hispanic white population. Black households also have found to have the lowest rates of vehicle and home ownership, the largest household sizes, and the least job type diversity. Many of these disparities play into the coronavirus pandemic, as they affect individuals abilities to work from home and avoid high risk situations.
The highest percentage of racial minorities reside in East Gainesville, which lags behind in terms of economic development as compared to the western part of the city. East Gainesville residents have been found to lack basic opportunities and services, such as grocery store access.
Do these inequities extend into the distribution of COVID-19 testing locations?
Vulnerability to COVID-19 can be determined by numerous demographic, economic, and health factors. With reference to the indicators and methodology of the City Health Dashboard COVID Local Risk Index, the vulnerability index below was created at the census tract level.
Tracts with the highest level of vulnerability to COVID-19 appear in dark blue, and are predominantly clustered on the eastern side of the city. There are three tracts classified as most vulnerable: 6, 7, and 19.02, all of which are alongside NE Waldo Road.
The Vulnerability Index is a weighted aggregate of:
40%:
- Households below poverty (%)
- Unemployment rate
- Median household income
- Population without high school diploma (%)
- Population under 18 years of age (%)
- Population with a disability (%)
- Population who speak English "not well" or "not at all" (%)
- Housing structures with 10+ units (%)
- Mobile homes (%)
- Renters (%)
15%:
- Minorities (%)
- Population 65+ (%)
45%:
- High blood pressure
- Coronary heart disease
- Diabetes
- Chronic kidney disease
- Obesity
- Smoking
Permanent Testing Sites
There are 16 permanent testing sites available within the City of Gainesville. Two of these are on campus, and only accessible to those affiliated with the University of Florida. There are three public sites, two provided by the Alachua County Department of Health and one by the North Florida/South Georgia Veterans Health System. The remaining sites are located within commercial clinics, such as CVS or CareSpot UrgentCare.
These permanent testing sites are predominantly clustered on the western side of the city, in areas shown to have lower vulnerability to COVID-19.
- Since vehicle ownership and transportation are inequities reported by the BEBR study and play a substantial role in exposure to the coronavirus, a network analysis was run showing service areas of each permanent site for pedestrians, bicyclists, and drivers. The analysis is based on street access, and does not guarantee bike lanes and sidewalks in all areas.
The map below shows 5, 10, and 15 minute walking periods from each permanent testing site. A 5 minute walk is period is often considered a standard for the period people are willing to walk before opting to drive. Only one of the three most vulnerable tracts, tract 7, is served at all by walk times. This area is near the Lincoln Estates neighborhood on the map, and the service area is only a small portion along the far western edge of the tract.
With biking as a mode of transportation, more of the city is served. Bike service areas extend into the western portions of all three of the most vulnerable tracts.
The entire city of Gainesville has access to test sites within a 15 minute drive, so the map below only shows drive times of 5 and 10 minutes. Within a 5 minute drive, only the eastern and northern edges of the city (which are composed of vulnerable census tracts) do not have access. Most of the city is served by permanent testing sites with a 10 minute drive, except areas in tract 6, 18.02, 19.02 which are within the top 30% of vulnerability classes. A section of tracts 20 and 18.13, in the far eastern and western edges of the city respectively, are also not served and rank as areas with low vulnerability.
Temporary Testing Sites
Before the permanent county testing site at 100 SE 10th Avenue opened on July 1st, the City of Gainesville had a mobile COVID testing bus which made stops in new locations almost daily. This service lasted from 5/21 until 6/27. Currently, the only testing sites available are those shown in the Permanent Testing Sites analysis.
- Most sites were only visited by the mobile testing service once, for a 2.5 hour period. However, some sites had repeat visits and in September there was a weekend long pop up testing site at the Martin Luther King Jr. Center. Temporary sites are mapped below, by time spent at each location.
Temporary testing sites are predominantly in east Gainesville, providing access to populations not served by the permanent locations. Although none of these sites were open simultaneously, and many were only open for 2.5 hours total, the maps below show the walking, biking, and driving service areas of each testing location.
The temporary sites significantly increased walking access to testing sites in vulnerable tracts. All three of the tracts (6, 7, 19.02) in the highest vulnerability class are served by these locations to some degree.
When looked at collectively, the biking service areas of the temporary sites cover nearly the entire city. Only tract 9, which is in the far north of Gainesville and ranks in the top 20% of vulnerability classes, significantly lacks coverage.
The network analysis for driving times to temporary sites was again run only for 5 and 10 minute intervals. Within 10 minutes, the majority of the city can access sites.
Conclusion
The permanent COVID-19 testing sites are not equitably accessible throughout Gainesville, and are actually less accessible to the census tracts where the most vulnerable populations are located. For those in the most vulnerable census blocks, who are statistically less likely to have a vehicle, these locations are difficult to access. The temporary sites are a strong initiative to increase access to testing in East Gainesville, however the pandemic is still upon us and these sites are no longer available.
The same trends of spatially segregated communities and discrepancies in opportunity mentioned by the 2018 BEBR report on Racial Inequity is reflected in the response to the coronavirus pandemic. To increase accessibility, I propose a permanent testing site in East Gainesville. The public testing location at 100 SE 10th Avenue was established by the City of Gainesville and Alachua County department of Health immediately after the conclusion of the mobile testing program, and is currently the eastern most site and closest to serving a highly vulnerable census tract. Shifting this site, or establishing a new one, at the Martin Luther King Jr. Center, a previous temporary testing site, would be a start to increasing accessibility for residents in highly vulnerable census tracts 6 and 7.
Citations:
CDC 500 Cities Project (2019). 500 Cities: Census Tract Level Data – 2019. Atlanta, GA: Centers for Disease Control and Prevention (CDC), Division of Population Health, Epidemiology and Surveillance Branch
City Health Dashboard (Tech.). (2020, October 29). Retrieved December 7, 2020, from NYU Langone Health website: https://www.cityhealthdashboard.com/technical-documentation
GeoPlan Center. (2020c). Florida Census Block Groups – 2018. Derived from 2015 US Census data with selected fields from 2014-2018 American Community Survey Data. Gainesville, FL: University of Florida Geoplan Center.
Sandoval, H. H. (2018, January 12). Understanding Racial Inequity in Alachua County (Rep.). Retrieved December 7, 2020, from Bureau of Business and Economic Research (BEBR) website: https://www.bebr.ufl.edu/sites/default/files/Research%20Reports/ri1_baseline_report.pdf