How COVID-19 Has Impacted the Southern Border Region

The coronavirus has killed over 200,000Americans and has infected at least 7.6 million people living in the U.S. The virus is indiscriminate in who it affects, but communities that have long-suffered from systemic discrimination, poverty, and limited access to health care have been among the worst affected. Analyses of public health data have shown that there are stark gaps in who is being infected and killed by the virus. According to a recent NPR analysis, for example, Black, Latino and Native Americans are being disproportionately affected by the virus. In the southern border region, which is home to some 20 million people, more than 13,000 people have died due to the coronavirus and about half a million have been infected as of early October, 2020.

Reckless policies by the Trump administration have made life more difficult — amplified by the pandemic — for many southern border residents. The administration has continued to build the deadly border wall, wasting millions of public funding and potentially helping spread the virus among construction workers and community members. Border communities decried the sending of construction workers to Arizona in March, at the beginning of the pandemic, but were ignored by the federal government. Similarly, the vast-network of intrusive border checkpoints has continued to operate in the throes of the virus, potentially limiting people from reaching life-saving medical attention. Some reporting also suggests that Border Patrol has increased their roving patrols, building on their already expansive authority in the 100-mile zone. These actions show a clear disregard for public health, which combined with a long-standing shortage of resources and funding for border communities, have put the lives at risk of many vulnerable residents in the southern border.

Health experts note that people of color run higher risks of getting infected, have a harder time getting tested, and may experience more severe symptoms from the virus. For some border communities, which have higher shares of people of color than the country as a whole, a lack of resources and investment have put them at greater risk for the virus (two-thirds of people living in the southern border region are people of color). And some border counties, particularly those in southern Texas, have among the highest infection and cases per capita in the nation (although it looks like the southwest border was an early covid hotspot, recent reports heading into the fall of 2020 show that the northern-Midwest has emerged as a hotspot area).

Reporting from April noted that people living in the rural Rio Grande Valley of Texas were particularly at risk due to the lack of infrastructure and access to health resources. A 2019 study of the RGV area also found that counties in this area had a strikingly low number of primary care doctors (PCPs) compared to others in the state. Willacy County, for example, only had 8 primary care doctors — compared to 12 in all of Starr County, leading to even more marginal medical care.

Limited access to hospitals and other care facilities — as well as Border Patrol checkpoints that force people to choose between getting healthcare and being deported — have also exacerbated the risk of infection to border residents. The border community of San Ysidro, California, lacks any hospitals and only has health clinics. Testing capacity has also been limited along border states. According to data from John Hopkins University, testing capacity is still lagging for some states in the southwest. What is clear is that border residents are too often under-served, while many work in the frontlines of essential sectors and industries.

Hospital data also shows that on the whole, border communities are severely underserved by hospitals equipped to handle flu-like cases. The map above shows the total number of medical hospitals in counties along the southern border as of October, 2020. The analysis finds that although some border communities have a high number of hospitals and hospital beds (like San Diego, CA or Maricopa County in Arizona), a vast majority of border counties (70%) have one or less hospitals per county. A total of 23 counties — most in South Texas — have no hospitals, according to our analysis of a Definitive Healthcare database of hospitals. (Definitive Healthcare defines a hospital as a facility that provides in-patient care, and psychiatric and non-medical hospitals are not included in this analysis.)

The Coronavirus at the Border

As of early October, at least 14,000 borderlanders have died from the coronavirus and about half a million people (529,000) living in the southern border region have been reported infected, according to a county-by-county analysis of covid data provided by the New York Times.

The interactive map below shows coronavirus infections data for counties that are within 100-miles of the U.S.-Mexico border. In the border region, counties with the largest populations lead with the highest tally of overall cases and deaths. According to the latest data, the top-5 counties by deaths are Maricopa County, AZ; Hidalgo County, TX; Orange County, CA; Riverside County, CA; and Cameron County, TX. However, looking at the cases per 100,000 people (a common demographic technique used to standardize cases by population) shows that counties in South Texas are the hardest hit in the border, and some are among the hardest hit in the nation.

Kenedy County in Texas leads any other county in the southern border region with the highest per-capita deaths. As of October 7, 2020 roughly 500 people have died per 100,000 people due to the coronavirus in this county. More than 300 people-per-capita have died in neighboring Brooks County. In fact, the top-ten counties for deaths-per-capita are all in South Texas. The New York Times recently reported that South Texas is home to the top-5 communities with the highest rates of infection in the country. These areas all border Mexico, and have some of the highest rates of poverty, unemployment, and percentage of population that do not have health insurance, among other markers of the striking inequality in the region.

Poverty, Unemployment and a Lack of Insurance

The coronavirus pandemic has hit the Rio Grande Valley region of Texas particularly hard, where low hospital capacity and low incomes contributed to hospitals being overwhelmed by coronavirus cases. In Zapata County, for instance, about four-in-ten (39%) of county residents are below the poverty line and 28% of people do not have health insurance. In 2018, the unemployment rate was also 11.0% — almost three times higher than the national average at that time. Since the beginning of the pandemic, more than 300 people have been infected with the virus in this rural county.

This is just another example of the rampant inequality that exists among some border communities. The average poverty rate for border counties in 2018 was 20.4% -- significantly higher than the 14.1% national average. In fact, 78% of border counties have a poverty rate above the national average. And 13 counties (all but one in Texas) have a poverty rate that is twice as large as the U.S. average.

The lack of health insurance is another important factor contributing to the disparity in COVID infections and deaths. Among border counties, many have staggeringly high rates of uninsured people. According to data from the 2018 Small Area Health Insurance Estimates, the average rate of uninsured people per county for border communities was about 18.9% — almost twice as high as the U.S. average (10.5%). Communities in South Texas in particular have among the highest rates of uninsured residents in the country. In Hidalgo County, home to McAllen, about one-in-three people (32.1%) do not have any type of health insurance.

The pandemic has also wrought incredible damage to the economy, affecting the livelihoods of millions of people who lost their jobs due to the closing of thousands of restaurants, factories and other businesses to protect public health. Millions of people lost their jobs and the economy is now slowly recovering. An average 8.4% of people in the U.S. were unemployed in August, 2020 — down from a peak of 14.7% in April.

Among communities in the southern border, many are experiencing high unemployment and a lagging recovery, according to the most recent unemployment data from the Bureau of Labor Statistics. In Imperial County in California for instance, roughly two-in-ten (22.9%) people 16 or order are unemployed. Other counties like Luna, NM (17.0%), Yuma, AZ (16.4%), and Starr, TX (15.7%) are similarly experiencing high rates of unemployment.

To explore more demographics about the border region and its people, visit our ‘Region at a Glance’ page.

The table below shows the latest coronavirus case and death data, per county, as well as some relevant factors like poverty and insurance data for ease of analysis and comparison.

Government Waste

At the onset of the pandemic, a severe shortage of life-saving equipment, trained staff, and hospital resources exacerbated the effects of the virus. A lack of personal protective equipment (PPE), like masks or gloves, put the lives of front-line workers at risk and endangered fragile communities. So much so that the U.S. leads every other nation in the world in the total number of deaths and infections for the coronavirus.

The U.S. government — tasked with protecting the safety and wellbeing of its people — has instead wasted billions of dollars that could instead be used for protecting communities. Maybe the most egregious example? The Trump administration continues to pour millions of dollars into the construction of an ever-creeping border wall. Oftentimes, they justify the construction by stating that the wall will stop the spread of the virus — even though that has been shown to be patently false.

The deadly border wall destroys precious environmental resources, sacred indigenous spaces, and tears communities apart. Many border communities suffer from high rates of inequality, ranging from high poverty to stark rates of uninsured residents. Border communities do not need more walls dividing them. Instead, they desperately need continuous support and life-saving resources like hospitals and medical equipment.

On average, one additional mile of border wall costs taxpayers $24.4 million dollars…

Instead of building one more mile of the border wall, the U.S. government could have paid for:

Gustavo López is a Border Research Manager for the Southern Border Communities Coalition (SBCC), a project of Alliance San Diego.


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Southern Border Communities Coalition is a program of Alliance San Diego.


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