COVID-19 Racial Disparities Could Be Worsened By Location Of Test Sites : Shots - Health News An NPR investigation shows that black and Latino neighborhoods in four large Texas cities have fewer coronavirus testing sites, leaving communities blind to potential COVID-19 outbreaks.
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In Large Texas Cities, Access To Coronavirus Testing May Depend On Where You Live

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In Large Texas Cities, Access To Coronavirus Testing May Depend On Where You Live

In Large Texas Cities, Access To Coronavirus Testing May Depend On Where You Live

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RACHEL MARTIN, HOST:

Experts have said all along that testing is critical to knowing how and where COVID-19 is spreading and then containing the virus. But across the nation, it's been a struggle to get enough tests and to get them to the right places and in the hands of the right people. NPR and member station KERA in Dallas have dug deep into the data in Texas. They found evidence that in many places, communities of color that have been hardest hit by the coronavirus, these communities don't have as much access to testing as white communities do.

Joining us now to talk about why and what it means are NPR data editor Sean McMinn and Bret Jaspers from KERA in Dallas. Welcome to you both.

SEAN MCMINN, BYLINE: Hello.

BRET JASPERS, BYLINE: Hi.

MARTIN: So Sean, first off, why Texas? Why put your focus there?

MCMINN: Texas was one of the first states to begin reopening, and it has a large number of big cities. That meant we could collect enough testing sites to make a meaningful comparison between different neighborhoods. And what we found was that, in four of the state's largest cities, whiter neighborhoods had many more testing sites than areas with higher concentrations of people of color.

MARTIN: And when you say testing site, what does that mean? Define that.

MCMINN: Yeah, the testing sites we're talking about are places that are open and advertising to the public - think urgent care clinics and drive-through testing sites. It doesn't include places like a doctor's office and some hospitals, where they only test their own patients. It also doesn't include mobile or temporary testing sites that might change locations often.

MARTIN: So you said whiter neighborhoods have more testing sites in these cities. Bret, how big is the disparity, really?

JASPERS: Well, one of the cities with this disparity is Dallas, where I am. And here we found that, in north Dallas, the whiter part of town, there are 20 testing sites. South Dallas has just nine, and a third of those are right next to an interstate that's like a borderline between north and south Dallas.

MCMINN: The other cities in Texas that have this kind of disparity also are Fort Worth, Austin and El Paso.

MARTIN: OK, so that's sort of the big picture about the disparity in testing access and what it could mean. Bret, let's look at the why, the cause of all this. What do local officials say about the geographic distribution of testing locations in Dallas?

JASPERS: First, when you look at the list of Dallas locations that are offering testing to the public, a lot of them are run by the private sector. And that was something Dr. Philip Huang pointed out. He is the director of the Dallas County health department. So north Dallas already has a lot more places to get health care, and this is an extension of that.

PHILIP HUANG: There's a whole lot of hospitals up in that area, where there are more paying, probably insured patients, and that's historically where some of the hospitals are locating. And then if you look in this other southern part, there are fewer.

JASPERS: And Huang says that when the county does have input over where a testing site goes, they do try to target places that are in underserved communities. For example, there are two federally funded drive-through sites that together do a thousand tests a day, one downtown and one in south Dallas. Now, those are drive-through sites, so you need a way to get there.

MARTIN: Are those sites maxing out their capacity?

JASPERS: Huang, the county health department director, said that they do. And those sites are free as well, which makes them more accessible to lower-income people. And now the city of Dallas has a free service that'll come to your house if you can't travel.

But if you're not connected to the health care system to begin with, you might not hear about these things. Political leaders at the state level in Texas have decided not to expand Medicaid, and so the state has the highest uninsured rate in the country at 18%. And if you don't have insurance, you might not have a primary care doctor, and a lot of the advice out there says call your doctor, you know, as a starting point.

MCMINN: And, Rachel, if people are looking to get tested, government websites aren't always up to date with the latest information on where to go. The state of Texas has a website and a map, but we discovered some locations were missing. I talked to a volunteer group called Get Tested COVID-19. They're trying to put together a national database of testing site locations. Their founder, Tarryn Marcus, said they were running into the same problems that we did.

TARRYN MARCUS: There's a lot of missing information - so very much the bare bones is provided and not a lot of kind of in-depth information that would be really useful to kind of get an actual understanding of what's going on in each state.

MARTIN: So, Sean, how does all this play into the state-led efforts to control the spread in Texas? I mean, the state started to reopen on May 1, right?

MCMINN: Right. So if it's harder to get tested in some neighborhoods, it does raise the concern - could local health officials be missing an outbreak until it's too late? If so, that could really affect the people who live in the neighborhoods where the spread is undetected, but it could also affect the rest of the city and the state. Here's Jennifer Nuzzo at Johns Hopkins University.

JENNIFER NUZZO: It misses an opportunity for interventions, like risk communication, the ability to deploy resources to the area to help those people. So there are downstream effects just in terms of the overall outcomes of not knowing where the cases are.

MCMINN: And the places where they're going to know where these cases are first, based on the testing sites that we looked at, are neighborhoods that have high concentrations of people of color.

MARTIN: NPR data editor Sean McMinn and Bret Jaspers of member station KERA in Dallas. You can read more about what they found at npr.org, and they'll be sharing more data and stories in coming days. Thanks to you both.

JASPERS: You're welcome.

MCMINN: You're welcome.

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