How COVID-19 Has Impacted the Southern Border Region

Last Updated: January 7, 2021

The coronavirus has killed over 560,000 Americans and has infected at least 30 million people living in the U.S. as of late April. 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 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 40,000 people have died due to the coronavirus and more than two million infected as of late April.

Reckless policies by the Trump administration made life more difficult — amplified by the pandemic — for many southern border residents. The administration 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 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 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 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.) At the onset of 2021, the virus is so widespread that many hospital systems have become overwhelmed. In Southern California, for example, space has become so limited that some hospitals have been forced to ration care and turn people away from hospitals.



The Coronavirus at the Border

As of late April, more than 40,000 borderlanders have died from the coronavirus and about two million 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; Orange County, CA; Riverside County, CA; San Diego County, CA; and Hidalgo 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.

McMullen County in Texas leads any other county in the southern border region with the highest per-capita deaths. As of late April, roughly 670 people have died per 100,000 people due to the coronavirus in this county. Nearly 600 people-per-capita have also died in nearby Maverick County. In fact, the top-ten counties for deaths-per-capita are all in South Texas besides Sierra County in New Mexico. The New York Times reported last summer that South Texas was 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.



Vaccinations In the Southern Border

The federal government has granted emergency-use authorization for the Pfizer and Moderna two-dose and the one-shot Johnson and Johnson vaccines against the coronavirus. In December, the U.S. began the largest vaccination campaign in history. Since taking office in January, President Joe Biden has accelerated vaccine distribution and administered over 200 million doses before the end of April. According to the latest CDC data analyzed by the New York Times, nearly 140 million people have received one dose and over 90 million people have been fully vaccinated.

The federal government distributes doses to states proportional to their overall populations, and some have been more efficient than others at vaccination rates. California for example, has used 78% of allocated doses and 45% of the population received the first shot. The state of New Mexico, on the other hand, has administered 86% of its allocated doses and one in two residents have received the first dose. Concern about the slow rollout is also growing due to variants of the virus that have appeared in San Diego and other cities along the border.



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, 35% of county residents are below the poverty line and 28% of people do not have health insurance. In November 2020, the unemployment rate was also 14.9% — twice larger than the national average at that time. Since the beginning of the pandemic, more than a thousand 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 2019 was 20.2% -- significantly higher than the 13.4% national average. In fact, 81% of border counties have a poverty rate above the national average. And 15 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 6.7% of people in the U.S. were unemployed in November, 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 Starr County, Texas for instance, roughly two-in-ten (19.0%) people 16 or order are unemployed. Other counties like Zavala, TX (17.8%), and Imperial County, CA (16.4%) 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…

The cost of one mile of border wall could have instead paid for:

36 MILLION
N95 MASKS

244,000
COVID-19 TESTS

976
HOSPITAL-GRADE RESPIRATORS

3,815
PEOPLE'S FULL-BENEFITS MEDICAID INSURANCE

Methodology:

The approximate cost of building an additional mile of border wall is based on a 2019 Office of Management & Budget (OMB) estimate. The estimated number of n95 masks is based on a price estimate released by mask-manufacturer 3M in June, 2020. The price is based on the 1804 surgical model mask. The estimated number of covid tests that could be purchased is based on wide reporting that an average test costs roughly $100. Estimates on the number of ventilators are for lower-end models, priced at approximately $25,000 each, according to the Washington Post. The total number of people that could be enrolled in Medicaid with full-benefits is based on approximate per-person cost estimates for fiscal year 2014 (the latest year that such data is available).

 

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