A look at new Racial Disparity Numbers in Cambria County

Group	Cambria County	Pennsylvania	U.S.
Overall	75.8	78.1	77.3
White	76.1	78.4	77.6
African American	66.9	73.3	71.8
Hispanic	97.1	82.2	78.8

Two weeks ago I wrote about the new County Health Ranking (CHR) numbers for this year in Cambria County. As before, there was a big discrepancy in life expectancy between African Americans, Whites and Hispanics. The life expectancy estimate for Hispanics may be unreliable as they are a small percentage of the county population. The state life expectancy and racial U.S. life expectancy numbers are are from before the pandemic began.

As before I will go through the other CHR statistics to search for clues for this disparity:

• The percentage of low birthweight babies was 9% for the county and 8% for the state. It was 17% for African Americans, 13% for Hispanics, and 8% for whites.
• The overall child mortality rate was 50/100,000 which was the same as the state rate. It was 160/100,000 for African Americans and 40/100,000 for whites. The African Americans rate was down from 210/100,000 last year and 240/100,000 in 2020.
• The overall infant mortality rate for the county was 7/1,000 live births which was 1% higher than the state rate. For African Americans it was 38/1,000 live births while for whites it was 5/1,000 live births.
• The teen birth rate was 18/1,000 females age 15-19 for the county and 15/1,000 for the state. For African Americans it was 55/1,000, for Hispanics it was 17/1,000 and for whites it was 16/1,000.
• The overall drug overdose mortality rate was 50/100,000 for the county while for the state it was 36/100,000. For African Americans the rate was 117/100,000 while for whites it was 47/100,000. According to overdose free PA, African Americans accounted for 9% of the deaths while they were only 3% of the county population. Whites still accounted for 89% of the overdose deaths.
• The rate of preventable hospital stays was 5,518/100,000 for the county and for the state it was 3,966/100,000. For African Americans it was 7,326/100,000 while for whites it was 5,505/100,000.
• The percentage of female Medicare enrollees receiving a mammogram was 45% for the county and 47% for the state. For Asian Americans it was 23%, it was 38% for African Americans, it was 57% for Hispanics, and it was 45% for whites.
• Forty three percent of the county Medicare enrollees received a flu vaccination while for the state it was 54%. For Asian Americans it was 20%. For African Americans it was 36%. For Hispanics it was 46% and for whites it was 43%.
• The overall child poverty rate for the county was 16% while for the state it was 14%. For Asians it was 15%, for African Americans it was 57%, for Hispanics it was 35% and for whites it was 19%.
• The injury death rate was 133/100,000 for the county while it was 93/100,000 for the state. For African Americans it was 220/100,000 and for whites it was 131/100,000.
• The average 3rd grade reading test level was 3.1 grade for the county which was the same as the state rate. For African Americans it was at the 2.2 grade level and at the 3.2 grade level.
• The average math test level for 3rd graders was also at the 3.1 grade level which was also the same as the state rate. For African Americans it was at the 2.0 grade level while for whites it was at the 3.2 grade level.
• Median household income for the county was $48,700 while for the state it was $64,900. For Asian Americans it was $100,100, for African Americans it was $28,500, for Hispanics it was $40,200, and for whites it was $48,900.
• The homicide rate for the county was 5/100,000 while for the state it was 6/100,000. For African Americans it was 48/100,000 and for whites it was 3/100,000.
• Eighty one percent of the county drives alone to work while for the state it was 74%. For African Americans it was 59%, for Hispanics it was 62% and for whites it was 83%.

Each year CHR provides more detailed information to explain the racial disparities in the health of the area. The next step is to take action to remedy these disparities. 

Coronavirus numbers for the cases and deaths county were not broken down by race at the county level. However, case rates are provided at the zip code level. The vast majority of African Americans in the county live in and around the city of Johnstown. Case rates are higher outside of Johnstown than in the city and its suburbs (zip codes 15901 to 15909) as can be seen in the graph below.

 

**Related Posts**

Why do African Americans live to be 64.8 years in Cambria County?

Some Clues for Racial Disparities for Cambria County

African Americans Still Lag Behind in Life Expectancy in Cambria County

African Americans Still Lag Behind in Life Expectancy in Cambria County

Group	Cambria County	Pennsylvania	U.S.
Overall	76.1	78.4	78.7
Caucasian	76.4	78.9*	78.6
African American	67.3	73.4*	74.7
Hispanic	91.3	85.3*	81.8

*Pennsylvania life expectancy by race numbers are from 2010 (Measure of America, 2013) 

In my book, Wuthering Depths in Johnstown: By the Numbers.  I wrote extensively on the 2020 County Health Rankings for Cambria County (where Johnstown is located).  The number that jumped out at me most was racial disparities in mortality data in Cambria county where African Americans had a life expectancy of 65.6 years, Caucasians 76.2 years, and Hispanics 89.0 years.  

This year's life expectancy numbers from the 2021 County Health Rankings are displayed above in the table above for the years 2017-2019 (corona virus deaths are not included).  Cambria County's overall life expectancy increased from 75.6 to 76.1 years (63rd in PA).  Among counties with life expectancies by race, African American life expectancy increased by 1.7 years to 67.3 (the lowest in PA).  Caucasians increased by 0.2 years to 76.4 (3rd lowest ).  Hispanics increased the most by 2.3 years to 91.3 (5th highest in the state).  

Counties with miniscule racial/ethnic minority populations do not have a breakdown for life expectancy by race.  African Americans comprise 3.5% (10.9% of PA) of the county and Hispanics make up 1.8% (7.8% of PA).  Caucasians comprise 92.6% of the county (75.7% of the state).  Approximately 59% of the African Americans in the county live inside the city of Johnstown

Overall the county is 2.6 years behind the US life expectancy.  Caucasians are 2.2 years behind, African Americans are 7.4 years behind, and Hispanics are 9.5 years ahead of the US rate.  Life expectancy is not included in the overall County Health Rankings for Health Outcomes.  Mortality Measured as Years of Potential Life Lost is factored into the rankings which is a measure related to life expectancy.

Years of potential life lost (YPLL) is the number of years lost if someone dies before age 75.  For example, if someone dies at age 25, they have 50 years for potential life lost.  The overall YPLL rate is 9,700 years per 100,000 for the county.  It is 19,900 years per 100,000 for African Americans and 9,400 years per 100,000 for Caucasians.  

The premature age adjusted death rate for the county is the number of deaths under age 75 per 100,000 for the years 2017-2019.  For Cambria it is 440 deaths/100,000.  For African Americans it is 840 deaths/100,000 and for Caucasians it is 430 deaths/100,000.  For Pennsylvania, the overall rate is 350 deaths/100,000.  This measure is provided by County Health Rankings but not factored into the rankings.

The most shocking mortality rate is the child mortality rate which is the number of deaths under the age of 18 per 100,000 for the years 2016-2019.  For Cambria the rate is 50 deaths/100,000 which is the same as PA's rate.  For African Americans in the county, it is 210 deaths/100,000 (the highest in PA) while for Caucasians it is 40 deaths/100,000.  The rate is more than 5 times higher for African Americans. 

The health factors data for the county provides some clues for this discrepancy.  I will discus it in my next post.

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A Look at Positive COVID-19 Testing Rates in Cambria, PA, and the US

There have been recent media reports about positive testing rates increasing in Pennsylvania.  I thought I would take a closer look at positive test rates since they were reported by the state on April 17. The positive testing rate is simply the number of positive tests divided by the total number of tests.  The graph above shows the cumulative positive test rates for the US (orange line), PA (red line), and Cambria County (blue dotted line).  The black line shows the daily positive testing rate for Cambria County.  

The positive rate for the state has been consistently higher than the US and county rates.  Both rates have been decreasing as testing has become more readily available.  Cambria's positivity rate has been consistently lower than the state and US rates.  The daily testing rate for the county on April 13 was high because on that day there were three positive tests out of 16 total tests (18.25%).  

Since June 24, the cumulative positive test rate increased from 1.02% to 1.28% as of today.  This rise may not sound like much but the solid black line shows positive rates that were consistently at or above the cumulative rates for this period with one day being higher than 5% on July 11.  

The graph above is from the Johns-Hopkins Univeristy site tracking the Corona Virus Pandemic.  It shows the trend in testing for the US during the pandemic.  The blue line shows the seven day average of positive test % with a steady decrease from early April (21.9%) until the middle of June (4.4%) with an increase to 8.7% today.

This graph shows the trend in testing for the state of Pennsylvania for the same period.  Here, we see that there was a corresponding peak in mid April in the positive rate at 27.8% to 3.4% around June 21.  This decrease was followed by an increase to 5.5% as of today.  We can see that testing has risen at a slower rate in the state than in the US as a whole.

The black line in the graph at the top was replaced with the 7 day moving average in testing which does show a rise in positive tests after June 24.  I did not have the same access to 

testing data that Johns-Hopkins had.  I used publicly available data that the PA health department provided beginning on April 17.  

The graph below shows the comparison of the positive testing rate (in the red line) to the testing rate as a percentage of the population for six Johnstown zip codes, the overall rates for Greater Johnstown, Cambria County, Pennsylvania, and the US. These rates are cumulative.  The numbers at the top of each bar are the cumulative testing rates as a percentage of the population.  It's interesting that the state has a higher cumulative positive rate (10.08%) than its testing rate (7.57%).  Johns-Hopkins testing tracker has the state ranked 47th in the testing rates over the last two weeks (1.1 per 1,000) while it ranks 37th in the two week average positive testing rate (5.5%).  At the bottom is a summary of testing data for Pennsylvania.  How one frames the statistics makes all the difference.

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Corona Numbers from the WHO and JHU

A Second Wave of COVID-19 Cases in Cambria and Allegheny Counties?

Cambria County has experienced 22 new cases of COVID-19 in the last 7 days to give a total of 83 cases.  In the previous 37 days, the county had a net increase of 7 cases.  The best fit line is now a fifth order polynomial with an R-square of 99%.  In the graph below, a second order polynomial provided the best fit for the cumulative case curve for the months of March and April with an R-square of 97%.

The map above shows the distribution of the 83 cases in Cambria County by zip code.  The lightest blue zip codes have zero confirmed or probable cases.  The next darker color blue zip codes have between 1 and 4 cases.  The next darker blue colored zip codes have between 5 and 10 cases.  The zip code with the most confirmed cases is 15904 with 7 cases. This zip code covers Richland Township followed by 15931 (Ebensburg) at 6, the Johnstown zip codes of 15905 and 15902 and the Portage zipcode 15946 with 5 each.  The most tested zip code in Johnstown is 15901 with enough tests to cover 12.32% of it's population.  The image below is a screenshot of the distribution of cases on April 26 showing all of the light blue zip codes with the number of cases between 1 and 4.

So far there hasn't been an increase in the number of deaths which tend to follow an increase in cases.  Allegheny County has been showing a similar rise in cases, over 400 in the last five days.  So far they have not had a corresponding increase in deaths.  The bars have been closed down in Allegheny County but not in Cambria County so far.  WEAR A Mask!!!!

**UPDATE**

WTAE in Pittsburgh reports that it is now mandatory to wear masks in public.  Below is a graph showing the trend in testing and cases in the county since March.

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Update on Johnstown Zip Code Testing

Last week I reported that my most viewed post on COVID-19 was on zip code testing in Johnstown zip codes compared to the county, state and the U.S.  I reported that the testing rates for the zip code for downtown Johnstown (15901) was nearly identical to the U.S. rates while the rates for the other zip codes and the county lagged behind the state and the U.S. rates.  I reposted the chart from that post above. 

 

As I was tracking the testing rates I noticed that the pattern was changing in the testing rates.  You can see that pattern in the bar chart above from the Google Sheets I put together for the county.  The rate for 15901 is still the highest in the city but it is falling behind the U.S. rate. The 15902 zip code has been inching upwards while the 15909 zip code lags behind the others and the county.  

I updated the line chart at the top of the post with the trend in testing up to the current date.  I got rid of the data table to make it more readable. In the chart we see that the testing rate for 15901 started to fall behind the U.S. rate on May 29. The post for the chart at the top was on May 17.  

The 15902 zip code (red dotted line) testing rate has nudged ahead of the state rate (solid black line.  Finally we see that the 15909 zip code has fallen further behind the other zip codes and the state and county overall in the testing rates on May 26.  

The number of COVID-19 cases in the county on May 17 was 54.  Today (27 days later) it is 61.  The 15902 zip code (Hornerstown and Moxham) now has a cluster of five confirmed cases and between 1 and 4 probable cases (the exact number is not released for privacy concerns) while 15901 has between 1 and 4 confirmed cases according to the PA Department of Health.  

Does the lag in testing account for the decrease in the number of new cases for the county?  I suppose only God knows for sure.  The COVID cast website shows a decrease in the indicators that they use to forecast the future cases from may 17 to May 31.  These indicators include doctor visits with COVID-19 symptoms, google search data, and Facebook search data.  After May 31 the indicators has leveled off which suggests that a surge in cases is not imminent.  Dr. Fauci has warned that a surge could happen as the states have been reopening.  So far it has yet to materialize in Cambria County.  Time will tell.

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COVID-19 and CSI without Dead Bodies

Since March 14, thirteen out of the last 14 posts on the blog have been on the Coronavirus pandemic.  One was on the new hate group numbers from the Southern Poverty law center.  With states starting to reopen after the I thought I would take a look at how the pandemic has affected traffic on this site according to Google Analytics.  I compared the traffic from March 14 to today (June 7) to the previous period (Dec 19,2019 to March 13, 2020).

Overall, the site has received 20.4% more traffic for the current period to the previous (1,133 to 941).  The average number of page views per session increased by 18.23% (1.47 pages/session for this period to 1.24 pages/session for the last period).  However, the average time spent on a page was 30.5% lower for the current period (0:26) compared to the previous (0:38).

Although the overall number of users on this site was up by 20.4%, the number of users from the U.S. was down by 12.46% (752 to 859).  There was number of users was up from China (49 to 2), India (19 to 3), the U.K. (18 to 10), Hong Kong (15 to 0), Germany (13 to 3), Japan (11 to 3) Mexico (11 to 5) and Canada (8 to 5).  Overall the number of users for this site from outside the U.S. was higher for this site with 381 for this period to 82 from outside the U.S.  This gives an increase of 365% from outside the U.S.

The ratio of new users to returning users for this period was 93.7% (1,103) new to 6.3% (74) returning for this period to 89.4% (897) to 10.6% (106) for the previous.  For those users that have their gender identified by Google the ratio of males to females was 51.01% (177) females to 48.99% (170) males for this period.  For the previous period it was 29.89% (55) for females versus 70.11% (129) for males.

For those users whose age is identified by google, the largest increase in users was in the 35-44 age group with a 180% increase (70 to 25) followed by the 65+ age group at 173.68% (52 to 19), and the 25-34 age group at 126.67% (102 to 45).  There were increases for all the age groups.  

The results here appear to be mixed.  There are more users for this site for the pandemic posts.  According to the graph in the image at the top of the post, the largest spike in number of users between the period occurred in the week from May 17 to May 23.  The post for this period was the one on COVID-19 testing in zip-codes in Johnstown.  The traffic for this post was almost exclusively from the U.S.  More specifically, it was mostly from Johnstown and the surrounding areas.  Without this post, the gap in users between the US and the rest of the world would be even greater.

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A Comparison of State Mortality Rates: Pennsylvania is 6th Highest, Michigan is Highest

In my last post I spoke of how Pennsylvania's case mortality rate (7.16%) was greater than the U.S. rate (5.91%).  At the time I was unsure how the state compared to the other states in the case mortality rate.  To do this I looked at the cases reported on Johns-Hopkins Coronavirus Dashboard.  The numbers that they report for Pennsylvania (74,045 cases, 5,373 deaths) are different than reported by the state department of health (70,042 cases, 5,373 deaths).  This is due to Johns-Hopkins relying on media reports of cases as well as government reports.  Deaths from the disease are easier to track than cases.

The case mortality rate is the number of deaths divided by the number of reported cases.  The numbers for each state as of yesterday are displayed at the table below.  Johns-Hopkins reports cases and deaths on the U.S. flagged Grand Princess and Diamond Princess cruise ships are included in the total.  Michigan has the highest case mortality rate at 9.59% followed by Connecticut at 9.21%, the U.S. Virgin Islands at 8.70%, New York at 8.08%, New Jersey at 7.24%, and Pennsylvania at 7.16%.  The high rate for Michigan is troubling given all of the protests against the coronavirus lockdown there.

Looking at the population adjusted mortality rate as deaths per 100,000 population, not surprisingly, New York has the highest rate at 151.56/100,000 followed by New Jersey at 127.66/100,000, Connecticut at 106.67/100,000, Massachusetts at 93.91/100,000, and the District of Columbia at 63.05/100,000.  Pennsylvania is 9th on this measure (41.13/100,000) and is right behind Michigan which is at 53.41/100,000.

New York is also first in coronavirus cases at 1,876.08/100,000 followed by New Jersey at 1763.39/100,000, Massachusetts at 1359.35/100,000, Rhode Island at 1354.87/100,000, and the District of Columbia at 1191.08/100,000.  Pennsylvania is 13th on this measure at 574.57/100,000 which is just ahead of Michigan which is at 556.84/100,000.  The U.S rate on this measure is 514.95/100,000.  

The graph above shows the state case mortality rate by population (the two cruise ships are excluded).  There is no linear association between the state's population and their case mortality rate.  The line crossing the graph just below 6% is the U.S. case mortality rate.  

The population rates indicate the prevalence in the population of coronavirus cases and deaths.  The case mortality rates are an indication of the strain that the disease has placed on the health care systems in that state.  Michigan Pennsylvania, and the Virgin Islands with low population adjusted mortality rates but high case mortality rates suggest additional strain.

State	cases	deaths	Case Mortality	case mortality rank	Population	Deaths per 100,000	Cases per 100,000
Michigan	55611	5334	9.59%	1	9,986,857	53.41	556.84
Connecticut	41288	3803	9.21%	2	3,565,287	106.67	1158.06
Virgin Islands	69	6	8.70%	3	104,901	5.72	65.78
New York	364965	29484	8.08%	4	19,453,561	151.56	1876.08
New Jersey	156628	11339	7.24%	5	8,882,190	127.66	1763.39
Pennsylvania	73557	5265	7.16%	6	12,801,989	41.13	574.57
Louisiana	38497	2723	7.07%	7	4,648,794	58.57	828.11
Massachusetts	93693	6473	6.91%	8	6,892,503	93.91	1359.35
Indiana	32437	2030	6.26%	9	6,732,219	30.15	481.82
Ohio	33439	2044	6.11%	10	11,689,100	17.49	286.07
Colorado	24754	1392	5.62%	11	5,758,736	24.17	429.85
Vermont	971	54	5.56%	12	623,989	8.65	155.61
Missouri	12798	688	5.38%	13	6,137,428	11.21	208.52
Washington	20181	1078	5.34%	14	7,614,893	14.16	265.02
DC	8406	445	5.29%	15	705,749	63.05	1191.08
Oklahoma	6229	322	5.17%	16	3,956,971	8.14	157.42
New Hampshire	4231	214	5.06%	17	1,359,711	15.74	311.17
Maryland	48423	2392	4.94%	18	6,045,680	39.57	800.95
Nevada	8113	396	4.88%	19	3,080,156	12.86	263.40
Arizona	17277	834	4.83%	20	7,278,717	11.46	237.36
Mississippi	14044	670	4.77%	21	2,976,149	22.51	471.88
Rhode Island	14353	655	4.56%	22	1,059,361	61.83	1354.87
New Mexico	7252	329	4.54%	23	2,096,829	15.69	345.86
Illinois	114306	5083	4.45%	24	12,671,821	40.11	902.05
Kentucky	9077	400	4.41%	25	4,467,673	8.95	203.17
Florida	52634	2319	4.41%	26	21,477,737	10.80	245.06
South Carolina	10623	466	4.39%	27	5,148,714	9.05	206.32
Georgia	44445	1908	4.29%	28	10,617,423	17.97	418.60
Minnesota	22464	942	4.19%	29	5,639,632	16.70	398.32
West Virginia	1899	74	3.90%	30	1,792,147	4.13	105.96
California	101032	3895	3.86%	31	39,512,223	9.86	255.70
Puerto Rico	3397	129	3.80%	32	3,193,694	4.04	106.37
Maine	2137	81	3.79%	33	1,344,212	6.03	158.98
Delaware	9096	344	3.78%	34	973,764	35.33	934.11
Alabama	15843	583	3.68%	35	4,903,185	11.89	323.12
Oregon	4038	148	3.67%	36	4,217,737	3.51	95.74
Montana	481	17	3.53%	37	1,068,778	1.59	45.00
North Carolina	24896	838	3.37%	38	10,488,084	7.99	237.37
Wisconsin	16462	539	3.27%	39	5,822,434	9.26	282.73
Virginia	40249	1281	3.18%	40	8,535,519	15.01	471.55
Idaho	2699	81	3.00%	41	1,787,065	4.53	151.03
Guam	170	5	2.94%	42	165,768	3.02	102.55
Grand Princess	103	3	2.91%	43
Texas	58537	1581	2.70%	44	28,995,881	5.45	201.88
Iowa	18360	493	2.69%	45	3,155,070	15.63	581.92
Hawaii	644	17	2.64%	46	1,415,872	1.20	45.48
Alaska	411	10	2.43%	47	731,545	1.37	56.18
North Dakota	2439	56	2.30%	48	762,062	7.35	320.05
Kansas	9270	212	2.29%	49	2,913,314	7.28	318.19
Arkansas	6277	120	1.91%	50	3,017,804	3.98	208.00
Tennessee	21288	353	1.66%	51	6,829,174	5.17	311.72
Wyoming	860	14	1.63%	52	578,759	2.42	148.59
Nebraska	12619	153	1.21%	53	1,934,408	7.91	652.34
Utah	8706	105	1.21%	54	3,205,958	3.28	271.56
South Dakota	4710	54	1.15%	55	884,659	6.10	532.41
Diamond Princess	49	0	0.00%	57
N Mariana	22	0	0.00%	57	56,882	0.00	38.68
Total	1697459	100274	5.91%		329,637,350	30.42	514.95

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