A Parkland Health & Hospital System report last year found high rates of health disparities in certain ZIP codes in southeast Dallas. The report's co-author says those health disparities alone — along with bigger social distancing and job challenges — put those areas at high risk for coronavirus.
"There were communities who suffered higher mortality rates associated with hypertension, diabetes, cancer," said Mike Malaise, Parkland's Senior Vice President of Communications and External Relations.
He talked with us about what's happened in those areas since coronavirus showed up in North Texas, how local officials have responded to the coronavirus outbreak, the health and social issues that existed before, and what lies ahead.
On COVID-19 in Southeast Dallas:
You saw in it urban areas like Dallas. But back East, coronavirus was killing minority patients at a much higher rate than it was killing the population at large. We have not seen that in Dallas County. If you look at the latest numbers from the county, the mortality rates — 36% white, 31% Hispanic, 23% African American — and the rates of infection are not incredibly out of line with each ethnicity group's percentage of the overall population.
But that's not by accident. That was because there was a concerted effort to do testing and outreach into those underserved communities.
On the risk of COVID-19 in underserved areas:
They definitely are at higher risk: people in hourly jobs who don't live at homes where family members can spread out. They don't have an alternative site to send people for social distancing. They have a harder time following the guidelines to avoid infection. That is why it is so important to stay vigilant in these areas, within the communities where the work is not done.
It is too early to take a victory lap in addressing the disparity with COVID-19 and Dallas.
On a second or third wave of COVID-19:
I think that the second round of widespread infection may actually be a third wave. The second wave of COVID-19 is economic devastation. The two of those are interrelated. So if you have people who go to an hourly job, they can't pay the car note or for childcare. So many may lose their job altogether. And if they lose their job altogether, they can't pay the rent. If they can't pay the rent, they become homeless.
Those at the lower end of the socioeconomic ladder just don't have the social support to weather the storm, in many cases, the way some of us do.
On the efforts to stop the spread of coronavirus in those targeted zip codes in Southeast Dallas:
- We send out a massive amount of communication to organizations that interact with community centers and homeless shelters on a weekly basis — both clinical information and socioeconomic information on how to weather the economic impact.
- We are doing robocalls into these targeted communities with information on how they can stay safe and where they can get tested.
- Telehealth has been a huge part of our response to COVID. We have converted a lot of the clinic appointments that otherwise we just would have canceled because he can't have folks coming into the clinics right now, if it's not necessary.
- Our community health worker program has executed around 1,500 encounters with targeted high-risk patients in these zip codes.
- The report (PDF): Dallas County Community Health Needs Assessment by Parkland Hospital and Dallas Count Health and Human Services
- Dallas County testing sites
This reading version of the interview answers have been edited for clarity.