Kaiser’s at-risk group includes all people over 60 years old and all adults younger than 60 who also have heart disease, cancer, lung disease, or diabetes. In each state, older people are the majority of the people considered to be at risk of complications. But the Deep South and mid-South form a solid bloc of states where younger adults are much more at risk. In Arkansas, Alabama, Kentucky, Tennessee, Louisiana, and Mississippi, relatively young people make up more than a quarter of the vulnerable population. Compare that with the coronavirus’s beachhead in Washington State, where younger adults make up only about 19 percent of the risk group.
…Southerners are more likely to suffer from chronic diseases than other Americans—even as Americans are more likely to suffer from chronic diseases than citizens of other countries with comparable wealth. According to Neuman, these estimates don’t include people with cancer or who are immunocompromised—groups that are also at high risk for serious illness from COVID-19. And cancer mortality rates are highest in southern states.
…These differences are not innate to southerners; they are the result of policy. Health disparities tend to track both race and poverty, and the states in the old domain of Jim Crow have pursued policies that ensure those disparities endure. The South is the poorest region in the country. The poor, black, Latino, or rural residents who make up large shares of southern populations tend to lack access to high-quality doctors and care. According to the State Health Access Data Assistance Center, Mississippi, North Carolina, Texas, Florida, Georgia, and Louisiana all spend less than $25 per person on public health a year, compared with $84 per person in New York. Nine of the 14 states that have refused to expand Medicaid to poor residents under the Affordable Care Act are in the South.
…Advocates have drawn attention to the extreme vulnerability of people in prison to the coronavirus—and the South incarcerates a larger proportion of its population than anywhere else in the United States. …Southern states have some of the lowest ratios of active physicians to patients in the country.