Poor city dwellers run greatest coronavirus risk

by Sophie Davies | @sophiedaviesed | Thomson Reuters Foundation
Thursday, 9 April 2020 08:47 GMT

People queue to enter into a Medical Center, as medical staff check them, during an outbreak of coronavirus disease (COVID-19) in Barcelona, Spain, March 18, 2020. REUTERS/ Albert Gea

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Pandemic maps show urban poor are worst hit by COVID-19 - can the world's cities learn future lessons from today's crisis?

By Sophie Davies

BARCELONA, April 9 (Thomson Reuters Foundation) - In working-class Roquetes, life looks good: the Mediterranean glitters on the horizon and sun dapples the green hills behind. But in the coronavirus crisis, this modest Barcelona neighbourhood faces grave risk.

Residents are seven times more likely to get COVID-19 than people in wealthier districts of Spain's second city, according to an interactive map published by regional authorities.

The rate of infection in Roquetes, among the Nou Barris - or 'New Districts' - of Barcelona, is 533 per 100,000 inhabitants, according to the map, which tracked COVID-19 across Catalonia.

About 6 km away, in the upmarket area of Sant Gervasi, the rate of infection is just 77.

Spain is among the worst hit nations in the global crisis, with some 150,000 cases and its big cities suffering most.

Nor is the Roquetes district an inner-city exception.

In El Prat de Llobregat and Sant Quirze del Vallès – working-class satellite towns just outside Barcelona – the rate of infection is even higher, at 604 and 701 per 100,000 inhabitants respectively.

These stark urban inequalities are mirrored in busy cities across the world, showing just what money can buy.

Health experts hope the Barcelona map, along with a slew of others tracking the spread of the new coronavirus, helps the world to recalibrate in COVID-19's aftermath and better protect those city dwellers most at risk from disease.

Socio-economic status is the biggest factor in determining whether someone in Barcelona will contract the virus or not, said Mark Nieuwenhuijsen, a professor of environmental epidemiology at the Barcelona Institute for Global Health.

"In places like Nou Barris, where you see the highest risk, there is less education around, people are probably less aware of these kinds of things but also need to travel more for jobs," he told the Thomson Reuters Foundation by phone.

"Poorer people often do jobs that mean they have to get around - like working in shops or running public transport systems," he said, while the wealthy can often work from home and so are less likely to come into contact with the virus.

POVERTY

Urban health experts say busy western hubs share many similarities with Asian cities, whose crowded neighbourhoods and slums are particularly vulnerable to disease outbreaks.

"Refugee and minority populations live in poor quality, densely occupied accommodation with insecure working conditions," said Carolyn Stephens, a professor of global health at University College London.

Aside from the ease of contagion in dense neighbourhoods, a poor standard of living carries wider risks, said Herbert Gans, a sociology professor at Columbia University.

"Poverty has an almost endless number of bad effects, beginning with poor health, a weak immunity system and low resistance, insufficient medical care, unhealthy housing, and so on," Gans told the Thomson Reuters Foundation.

In New York, for instance, the rate of people who have tested positive in Queens and the Bronx far outstrips that of people living in the wealthier borough of Manhattan, according to data released by New York City's Health Department.

"Urban density may play a role, as with this you tend to have more human contact, but I don't think it's the determining factor," Nieuwenhuijsen concurred.

"Where you see higher density, you see higher public transport use and that's where you can pick things up."

The risk falls when people walk or cycle to work, he said.

HEALTH

Crowded inner-city living can in fact sometimes be an advantage when it comes to healthcare, said Nieuwenhuijsen, as there might be more and better facilities available.

But it doesn't mean everyone gets it, said Stephens.

"Real access is unequal through differences in health protection and insurance; unwillingness to attend; and lack of trust by marginalised groups," said Stephens.

The pandemic, she said, highlights "structural inequalities in health that we see in cities all over the world".

In the U.S. city of Chicago, the number of confirmed cases in some boroughs on the traditionally poor south side, where healthcare is more sparse, is 10 times higher than in some districts with better facilities, according to a map released by the Illinois health department.

Beyond helping stem the pandemic, the maps could help authorities plan for future such crises, health experts say.

"It's always helpful to know where coronavirus actually is and where to target your measures," said Nieuwenhuijsen.

The coronavirus crisis presents an opportunity to "rethink the way we live," said Stephens.

"This is really true in cities and towns - where we have a chance to make sure that we name our societal structural challenges…and make sure that it is the most vulnerable and disenfranchised who are the most protected."

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(Reporting by Sophie Davies, Editing by Lyndsay Griffiths. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live freely or fairly. Visit http://news.trust.org)

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