The media often portrays the coronavirus pandemic as an urban problem. But the North Carolina counties with the highest COVID infection rates actually have more pigs and poultry than people. In these rural communities with large populations of poverty and people of color, there is a little-noticed COVID crisis.
Duplin County is the state’s No. 1 producer of hogs and now also has by far the highest COVID infection rate. There are roughly 2 million pigs and 59,000 people in Duplin. Amazingly, more than one in every 43 residents has tested positive for COVID-19.
More than 1,300 Duplin County residents are COVID-positive. Twenty have died. Duplin County’s Health Department has not yet released demographic data on those infected, but more than 48 percent of Duplin residents are people of color — largely black and Hispanic. About 26 percent of Duplin residents live below the poverty line.
Bordering Duplin, Sampson County has more than 7 million turkeys and 63,000 residents. One in every 70 Sampson County residents has tested positive for COVID-19. About 48 percent of the population is also people of color, and 24 percent live below the poverty line. Sampson County’s Health Department has released some demographic data on COVID infections. Hispanic residents are 20 percent of Sampson County’s population, but they were recently 46 percent of the COVID infections.
Across the entire state, the Hispanic infection disparity is even wider. Hispanics make up 10 percent of North Carolina’s population, but the state Department of Health and Human Services says Hispanics make up 46 percent of COVID infections for which ethnic data exists. About a third of the state’s infection data lacks any information on race or ethnicity. “I will tell you that we have a very disjointed, independent health care system across the state,” Gov. Roy Cooper said at a recent press conference. Cooper vowed to improve race/ethnic reporting data in a recent executive order.
Many of these residents work in agricultural industries deemed essential by the federal government. Duplin County’s five largest private employers all deal in agriculture and/or meat processing. The work inside hog and poultry plants is fast-moving and physical, done in tight quarters, and poorly paid. Many workers don’t get paid sick time. Social distancing is not easy here. Kenneth Sullivan, CEO of Smithfield Foods, admitted as much. “Social distancing is a nicety that makes sense only for people with laptops,” Sullivan wrote to Nebraska’s governor. ProPublica has reported meat packing plants as living in a regulatory limboland and said President Trump’s executive order to keep meat processing plants open has resulted in less corporate cooperation with county health departments.
Meantime, the people in these communities often struggle for health care. Duplin County’s 2018 Community Health Needs Assessment shows one in five residents has no health insurance. Another 27 percent of Duplin residents receive health coverage through Medicaid, the state and federal health program for the poor and disabled. The assessment suggested a staggering 65 percent of Duplin County’s Hispanic population has no health coverage at all. These are grim numbers for a county with the state’s highest COVID-infection rate.
Local data also suggests there is not enough COVID testing happening in some rural counties. The World Health Organization says if more than 10 percent of people test positive for COVID-19, more testing is needed to identify the true scope of virus spread. North Carolina’s positive test rate is 9 percent, but 37 percent are testing positive in Sampson County. Duplin County has not released local testing data.
These numbers show rural communities are in some ways even more vulnerable than big cities to COVID-19. During this pandemic they need more health care access. Medicaid expansion would help. So would passage in Congress of the HEROES Act — another round of federal stimulus funding directly to states, cities and counties to fill budget holes brought on by the pandemic’s recession. It contains a number of healthcare supports, including an increase in Medicaid funding to the states to avert the looming Medicaid cuts.
Bolstering public health and health care programs will help slow the virus spread and reopen more quickly. The U.S. Senate must insert more Medicaid funding in its stimulus package for state and local governments. North Carolina’s rural counties and their COVID infection rates reveal a burning need Congress must meet.