Philadelphians who live in higher-income neighborhoods have gotten tested for the coronavirus six times more frequently than those in lower-income areas.
Epidemiologist Usama Bilal of Drexel University’s Dornsife School of Public Health made the discovery using data from the Philadelphia Department of Public Health.
“What it shows is social inequality,” Bilal said. “This needs to change.”
Bilal stressed that he measured whether people received tests only, not whether residents had the coronavirus.
But, he added, data from New York and Barcelona, Spain, indicate “the number of positives tends to be higher in poorer areas.”
Using zip codes to track testing, Bilal learned that Center City west of Broad Street was the neighborhood with the highest rate of residents getting tested — 16 per 1,000. The zip code, 19102, has a median household income of more than $90,000, U.S. Census figures show.
In contrast, testing rates in North Philadelphia’s 19120 zip code were the city’s lowest, at just 2.7 per 1,000 residents. The median household income there is around $37,000.
Bilal said the health department had reported 11,000 tests as of last Thursday.
One of the most predictive factors of who gets tested is health insurance, Bilal said: Those who have it get tested more frequently than those who don’t.
He hastened to point out that a person doesn’t need to have health insurance to get a coronavirus test. But, he added, the indication seems to be that “people who have been left out of the health system overall” don’t appear to be getting tested.
It’s possible, he said, that testing rates are higher in upper-income areas because health-care workers who must be tested because of their work live in such places.
“These numbers are deeply disturbing, but not surprising,” said sociologist Judith Levine, director of the Public Policy Lab at Temple University.
"It’s hard for anyone to get a test. You need positive symptoms. But even though insurance isn’t needed, people with health insurance likely have a relationship with a primary physician they can talk to, who knows where the tests are, and can cut through the red tape for you to get the test.
“That gives higher-income people more access to testing.”
It’s also possible that, at the beginning of the pandemic, higher-income people had been traveling and possibly were exposed to the virus, Levine said. But, she added, the United States has had travel restrictions in place for quite some time, and far fewer people are on planes, and no one is booking cruises.
Because low-income people are preoccupied with keeping their jobs at a time of soaring high unemployment, Bilal said, it’s possible they’re not thinking about testing. Also, many low-income Philadelphians work at jobs that don’t offer sick pay, and they might not be able to afford to miss work for a test.
Ultimately, Bilal said, “lots of people are asymptomatic and opt to work over getting tested. The fatality rate of the virus is not as high as the 100% fatality rate of not eating.”
In Fairhill, among the poorest places in the city, where the testing rate is just 3.9 per 1,000, many residents simply “are not taking coronavirus seriously,” said Asteria Vives, a neighborhood activist.
“I don’t know why,” she added. “It’s getting to be really frustrating, but people aren’t staying away from each other. Imagine if this spread so broadly here in North Philadelphia. It’s a ticking time bomb.”
Vives, who founded Home Quarters, a nonprofit that helps low-income families, went on to say that there aren’t many cases in her area, and that she’s never heard of anyone being denied a test because of income.
In Kensington, another low-income community, the Rev. Adan Mairena, who runs the West Kensington Ministry, said he knows of no one who’s gotten tested or sick.
“A lot of folks might not be getting tested because they aren’t online,” he said. People don’t hear much about the virus. And, he added, “the seniors who would be more susceptible are secluded.”
But, like Vives, Mairena looks around the area and worries that coronavirus could sweep through like a fire.
“We are such a dense neighborhood,” he said. “If the virus came, we’d be like the Walking Dead up here.”
In North Philadelphia, people aren’t getting tested because “they have a false sense of security,” said Gary Robbins, director of New Jerusalem Now, a residential addiction-recovery community that includes a food pantry and urban farm.
“It’s not like they’re watching the news around here. There’s not enough being done to get the message across. People have to understand this is serious.”
Robbins begs people to stand six feet from one another and to wear masks and gloves. “But they stand near each other, shooting the breeze.”
Robbins believes many wouldn’t get tested even if they had symptoms. “Folks are saying this disease won’t touch them,” he said. “I don’t know what to do about that.”