Which neighborhoods are at high risk for COVID-19?

In early April, Minnesota Compass staff  partnered with WCCO TV news  to map areas of the Twin Cities at highest risk of severe COVID-19. We constructed these maps based on the prevalence of seven underlying health conditions in Minneapolis and St. Paul.

Minnesota Compass created these maps to show which neighborhoods and communities in Minneapolis and St. Paul have populations with relatively high levels of multiple health risk factors. These factors include asthma, chronic obstructive pulmonary disease (COPD), coronary heart disease, diabetes, kidney disease, obesity, and stroke.

More than 66,000 people in Minneapolis and nearly 82,000 people in St. Paul live in areas with high prevalence of at least three underlying health risk factors. That is equivalent to 16% of Minneapolis' total population and 27% of St. Paul’s total population.

Table 1 outlines the range of prevalence rates among the seven risk factors, and social determinants like poverty rates, and the percentage of population age 60+ for the highest ranked tracts in each city. 

In Minneapolis, some of the communities where we see concentrated elevated levels of risk include the Near North and Phillips communities. Elevated levels of risk also extend to portions of Camden, Central, Longfellow, and University communities.

The Near North community in North Minneapolis is particularly challenged by issues related to income and employment. Nearly 1 in every 3 residents lives below poverty and median household income stands at $36,900, nearly $20,000 lower than the citywide average. The unemployment rate in this community is double the citywide unemployment rate. Among those working, more than one in five are employed in health care and social assistance, a critical industry sector at all times but especially during the COVID-19 pandemic.

Layered over its economic challenges, the Phillips community in Minneapolis is particularly challenged by housing affordability, another social determinant that shapes health outcomes for residents. At 40%, this community’s poverty rate is double the citywide poverty rate. Three-quarters of households in the Phillips community rent their home, and more than half of these renters  pay too much for housing . The largest industry of employment for residents in this community is health care and social assistance, with 22% of working residents employed in the industry. The second largest is accommodation and food services, an industry hard-hit by COVID-19 layoffs.

In St. Paul, we see a cluster of elevated risk in several neighborhoods that include Frogtown/Thomas-Dale, the North End, and Payne-Phalen. These neighborhoods are home to large populations of St. Paul’s Asian and Black residents. Nearly one-third of residents in these neighborhoods are foreign born, with nearly half of residents speaking a language other than English in their homes. Median household income falls short of the citywide average in these communities, with at least one in four residents living below the poverty level.

Elevated levels of risk extend to portions of many other neighborhoods in the capital city, with very few neighborhoods exempt from high risk. Some of these neighborhoods include Dayton’s Bluff, the Greater East Side, Highland, West Seventh, and the West Side.

Communities with elevated risk for severe COVID-19 are communities that were already facing challenges related to poverty, employment, and access to transportation. These also tend to be communities with high concentrations of Asian, Black, Hispanic, and Latinx residents. While viruses do not discriminate, in and of themselves, our policies and institutions are not neutral in their outcomes. People living in the highest risk neighborhoods also shoulder a disproportionate share of health care jobs. They are, quite literally, on the front lines of this pandemic. Understanding the distribution of underlying health risk factors can help us identify which areas could benefit from targeted efforts at mitigation and where greater need for health care may emerge. Our findings give an idea of where targeted outreach, education, and community health efforts may be most critical. 

Our analysis draws on data from the 500 Cities Project from the CDC and American Community Survey 5-year estimates from the U.S. Census Bureau. Data were assembled at the  census tract level , the smallest level of geography for which reliable estimates are available. Given that our two cities neighbor one another, all census tracts in Minneapolis and St. Paul were analyzed together.

Data were assembled for  seven underlying health conditions identified by the US Centers for Disease Control and Prevention (CDC)  as risk factors for severe illness from COVID-19: asthma, chronic obstructive pulmonary disease (COPD), coronary heart disease, diabetes, kidney disease, obesity, and stroke.

Census tracts were ranked by prevalence of each underlying risk factor. Census tracts that fell within the top 20% of tracts with highest prevalence of underlying conditions are considered high prevalence on that condition. Census tracts that have a high prevalence of 1-2 underlying conditions are mapped in yellow. Census tracts with a high prevalence of 3-7 underlying conditions are mapped in red and are considered highest risk in this analysis.