VCU news

By Olivia Trani

The Northern Virginia suburbs of Washington are known for their affluence and high quality of life. However, these broad generalizations mask stark disparities in health outcomes across the region, according to a new report conducted by the Center on Society and Health at Virginia Commonwealth University and commissioned by the Northern Virginia Health Foundation.

By analyzing death data from across the region between 2015 and 2021, the report’s authors found that a person’s chances of reaching age 75 in Northern Virginia depended largely on their race, ethnicity and neighborhood. During the COVID-19 pandemic, these factors had an even greater impact on whether people lived or died. 

“By looking at mortality data on such a granular level, we identified neighborhoods, often largely represented by minority and immigrant populations, that are experiencing conditions typically found in developing nations­­ — this in an area that's known for being wealthy and healthy,” said Steven Woolf, M.D., director emeritus of the VCU Center on Society and Health and lead author of the new report.

“It provides evidence that structural racism is continuing to claim lives,” noted Derek Chapman, Ph.D., interim director of the center and co-author of the report. “Confronting and dismantling the structures in our society that are putting minority populations at risk is a key factor for addressing such health disparities.”

The impact in marginalized communities

In the years before the pandemic, the likelihood that residents in Northern Virginia would die before age 75 was far below the statewide average. However, a closer look into the data revealed that death rates varied dramatically among counties, legislative districts and census tracts. 

The report found that premature death rates at the census-tract level varied more than six-fold across the region. For example, rates were as low as 73.1 premature deaths per 100,000 in the South Run area of Fairfax County but as high as 573.3 deaths per 100,000 in the Dumfries area of Prince William County.

Census tracts with the highest premature death rates were clustered in Manassas and southern Prince William County; Leesburg and Sterling in Loudoun County; Annandale/Springfield, Herndon/Centreville, Seven Corners/Bailey’s Crossroads and Route 1 areas of Fairfax County; the Shirley Highway (Interstate 395) corridor; southern Arlington County; and downtown Alexandria.

“Within these neighborhoods, residents often face adverse conditions that affect health, such as inadequate access to affordable housing, food, health care and transportation,” Chapman said.

Death rates in Northern Virginia also varied by race and ethnicity. Across the region, Black residents were 44% more likely to die before age 75 than their white counterparts, and in some jurisdictions, this disparity was more pronounced. In Arlington County and Alexandria, for instance, Black populations were 116% and 117% more likely to die before age 75.

The data revealed that nearly two-thirds of all premature deaths in Northern Virginia between 2015 and 2019 were avoidable. This includes deaths from certain cancers, heart disease, injuries, alcohol and drugs, and diabetes.

“Such deaths could be averted through lifestyle changes, screenings, immunizations or better medical treatments. Preventive services can keep a person from getting sick in the first place,” said Woolf, a professor in the Department of Family Medicine and Population Health at the VCU School of Medicine.

Health inequities made worse by COVID-19

Existing health inequities in Northern Virginia widened during the pandemic, according to the report. Death rates from COVID-19 were much higher in Hispanic and Black populations (99.3 and 66.1 deaths per 100,000, respectively) than in Asian and white populations (40.4 and 36.6 deaths per 100,000, respectively). 

The report further revealed that the threat of COVID-19 was shaped not only by racial-ethnic background but by the circumstances in which people lived and worked. COVID-19 death rates across Northern Virginia varied as much as two-fold within the same racial-ethnic group, depending on where people lived. 

People of color residing in vulnerable neighborhoods were even more dramatically impacted by the pandemic. Hispanic residents of Prince William County were almost six times more likely to die from COVID-19 (164.5 deaths per 100,000) compared with white residents of Alexandria (28.5 deaths per 100,000). 

“We found that at-risk neighborhoods in Northern Virginia became ‘hot spots’ for COVID–19. Populations of color experienced higher rates of viral exposure, infection, hospitalization, complications and death,” Woolf said.

“Low- and moderate-income families faced even more economic burdens through lockdowns, job and wage losses, food and housing insecurity, and emotional stress,” Chapman added.

Rates of premature death from liver disease, drug overdoses, diabetes, heart disease and stroke also increased significantly during the pandemic — likely due to disruptions in access to health care services. 

Taking action for a healthier, more equitable future  

By identifying precise census tracts that are most threatened by health issues and premature death, the researchers hope the new report raises awareness of health inequities in Northern Virginia and helps policymakers, health departments and community partners better target their investments in neighborhoods. 

“A big emphasis of this report is that health is about much more than health care. There are several social and economic conditions that can either promote or endanger our health,” Woolf said. “Efforts such as improving access to health care, education, affordable housing, well-paying jobs and public transportation play a significant role in enabling everyone to live longer, healthier lives and enhancing their resilience to future public health threats.”