Consider, for a moment, two neighborhoods in Denver: Platt Park and Westwood.
Both are in the southern half of the city, separated by a two-mile drive along Mississippi Avenue over the railroad tracks. Both are home to lots of young families. And both, of course, are 16 months into weathering the coronavirus pandemic.
But, according to a new report by a respected Colorado health policy think tank, the two neighborhoods have had dramatically different experiences with the virus.
Westwood, where 90% of residents identify as non-white and many are low-income, has some of the highest rates of coronavirus cases of any neighborhood along the Front Range in the new study from the Colorado Health Institute. Platt Park — mostly white and relatively affluent — has some of the lowest.
The bracing disparity reinforces what researchers and public health authorities have seen throughout the pandemic: Coronavirus hasn’t hit everyone equally.
“People with the means to avoid risky situations and to work at home were more successful at avoiding COVID-19, while their less affluent neighbors — literally across the tracks in this case — suffered the brunt of the pandemic,” the institute writes in its report.
Among all the information regularly published about the pandemic’s impacts in the state, the Colorado Health Institute report is unique in that it uses data from a system called the Colorado Health Observation Regional Data Service. This service allows researchers to examine data taken straight from patients’ medical records. The data is aggregated and de-identified, meaning it cannot be used to reveal personal medical information.
The service, known as CHORDS, mostly covers the Denver metro area, with some reporting from Larimer and Weld counties. Overall, it captures information from about a quarter of the population in the areas it covers — so the numbers in the Health Institute’s report should be thought of as a representative sample rather than as a comprehensive accounting, said Joe Hanel, a spokesperson for the Colorado Health Institute.
What’s more, because CHORDS has data only on people who sought treatment for COVID-19, the Health Institute report doesn’t track where all infections occurred, just the ones that resulted in the most serious illnesses.
But the new report aligns with what Denver officials have been reporting for months on their own COVID-19 data dashboard. And it captures persistent inequalities that show up in all kinds of measurements of health and opportunity in the city.
Tracing the “inverted L”
The Colorado Health Institute mapped the findings of its study, revealing a familiar pattern in Denver: One cluster of high coronavirus rates runs up Federal Boulevard; another follows Interstate 70, with the exception of the Central Park neighborhood, formerly known as Stapleton.
This is the “inverted L,” and the neighborhoods that sit within it all tend to be lower-income and more diverse — and also to fare worse in various socio-economic measures, as the news site Denverite has reported. For instance, the L shows up when looking at rates of education or tree cover.
Dr. Judy Shlay, a family physician and the associate director of Denver Public Health, said it would show up if you are looking at diabetes rates or other measures of health. It shows up in life expectancy.
“All sorts of different health outcomes tend to be worse in these areas,” Hanel said. “These are areas where COVID-19 was also a lot more pronounced.”
Westwood, which lies west of Federal Boulevard, is on the inverted L’s path. Platt Park is not.
The Colorado Health Institute study found that people living in Westwood had coronavirus infection rates more than double the average of all the neighborhoods included in the study. Infection rates for residents of Platt Park were about a third of the average.
Similarly, data from Denver Public Health shows that residents of Westwood had one of the highest COVID-19 hospitalization rates in the city, while residents of Platt Park had one of the lowest. The rate in Westwood is 12.7 hospitalizations for every 1,000 residents — more than eight times the rate in Platt Park.
To Shlay, there are a number of reasons why coronavirus might have hit Westwood harder. Faced with an affordable housing crisis, multiple generations of families may live under one roof, creating the kind of high-density settings where coronavirus thrives. People in lower-income areas may be less able to work from home, putting them in the virus’ path out in public.
In communities with higher rates of people who don’t speak English, such as Westwood, language may pose a barrier to accessing health care or getting good information.
“If you don’t have resources in the community and there’s longstanding inequities, when a pandemic comes up, you’re going to see it,” Shlay said.
Hanel said these patterns of inequity don’t just show up in Denver. In the Colorado Health Institute’s analysis, they also were evident in parts of Adams and Weld counties.
Hanel highlighted Greeley. Areas in the eastern half of the city, including the neighborhood where the JBS meatpacking plant is located, saw high rates of COVID-19 cases. More affluent areas in the western half of the city did not.
“A lot of these neighborhoods, these are folks who were exposed at work because they had to go to their job, which was face-to-face,” Hanel said.
Achieving vaccine equity
Worryingly, the inverted L also shows up in Denver data on vaccination rates. But here Shlay is optimistic.
Earlier this year, Denver showed a broad disparity between neighborhoods like Westwood and ones like Platt Park. Today, that disparity still exists, but it is smaller.
According to Denver’s data, 63% of eligible people in Westwood have received at least one dose of a COVID-19 vaccine. In Platt Park, it’s 88%, with several other wealthier Denver neighborhoods at 90% or above.
“While it’s not perfect, we are definitely better than where we were a month ago, two months ago,” Shaly said.
Denver also continues to show a big racial gap in vaccination rates. According to data from the Colorado Immunization Information System, 76% of eligible white Denver residents have received at least one vaccine dose, compared with about 40% of eligible Hispanic residents.
Shlay said part of that gap might actually be a data error — Hispanic residents being classified inaccurately in the immunization system or declining to state their ethnicity. But she acknowledged that there’s a lot more work to be done, even as she said she is proud of all the work the city and other groups have already done.
The biggest challenge, she said, may not be overcoming vaccine skepticism but rather addressing vaccine convenience. People who work long hours with no opportunity to miss work or duck out during the day just may not have had time to get vaccinated, she said.
But, here, there is another challenge in neighborhoods on the inverted L. She described Denver Public Health’s efforts to set up a consistent vaccine clinic in the city’s East Colfax neighborhood, which sits on the city’s border with Aurora. Normally, that would take place at a fire station or a police station, a recreation center or a library. East Colfax has none of those.
The pandemic, she said, has pointed out why that needs to change.
“We need to now use what happened in COVID,” she said, “to really dive in and address those inequities.”