Finding Innovation and Resilience During the COVID-19 Pandemic:
Areas of Fulton County with a higher proportion of Black residents have more COVID-19 infections and COVID-19-related deaths. These racial disparities follow a pattern seen at the national and state levels both for COVID-19, other leading causes of death, and for socioeconomic factors known to affect health.
Studies of health disparities within counties are rare. Georgia Health Policy Center researchers examined racial disparities for COVID-19 within Fulton County, Ga., a designated urban county that contains most of the city limits of Atlanta, with some suburban and rural subregions.
Demographics of Fulton County
For this analysis, North Fulton, Atlanta, and South Fulton geographic boundaries were approximated by aggregating Atlanta ZIP codes first for Atlanta, then all ZIP codes north and south of Atlanta, respectively, (a method the Fulton County Board of Health.)
Fulton County is roughly evenly split between Black and white residents (45.5% versus 46.8%, respectively) with Asian individuals and Hispanic individuals (of any race) accounting for 7.6% and 7.4% of the population, respectively. However, Black and white residents are not evenly distributed across the county, with North Fulton predominantly white and South Fulton predominantly Black.
COVID-19 in Fulton County
Overall Deaths per Cases
At the end of 2020, cumulatively, 4.9% of the Fulton County population had a known COVID-19 infection and Fulton County experienced 732 COVID-19-related deaths. Areas within Fulton County with higher proportion of Black residents have higher percentages of the population testing positive for COVID-19 and have a higher percentage of deaths per positive cases.
Other Racial Disparities in Fulton County
% Adults without HS Diploma
This pattern is not unique to COVID-19. In Fulton County, pre-COVID, there were higher rates of deaths from chronic conditions (e.g., diabetes, heart disease, and high blood pressure) among Black residents. A difference of as little as 3.5 miles can translate to a 23.6-year difference in life expectancy.
The underlying causes of health disparities are complex but are known to include social determinants of health such as economic and educational opportunity, access to quality health care, and opportunities to practice healthy behaviors. South Fulton and Atlanta, areas of Fulton County with a higher proportion of Black residents, show lower rates of well-being as measured by socioeconomic drivers of health (e.g., less access to health care, and lower rates of high school graduation and employment, and higher levels of poverty), compared to North Fulton.
Policy Approaches to Address Inequities
The pandemic illustrates how structural barriers to achieving health and economic opportunity, combined with existing health disparities, make certain populations more vulnerable to COVID-19. By shining a light on COVID-19 disparities and their underlying causes, the pandemic provides an opportunity to address health inequity.
There are several best-practice approaches to narrowing equity gaps, and examples of efforts occurring in cities and counties around the country. These strategies include: engaging residents most directly impacted by inequities; building and supporting resident leadership; changing policies, systems, and structures; and addressing equity in the COVID-19 vaccine rollout.
Read the full brief, Health Equity and COVID-19: The Impact Within a Single Metro Atlanta County, here.