Long before Prince George’s County reported the highest number of coronavirus cases in Maryland, the conditions that would make the majority-Black suburb vulnerable to the virus were present, according to a report released Tuesday.
The nonprofit think tank — hired by the Prince George’s County Council two years ago to assess the health of county residents and make recommendations about how to improve it — also found that the county historically has invested less than neighboring jurisdictions in health and human services, and it recommended that the government study how it allocates such funding.
County Council Chair Todd M. Turner (D-District 4) said lawmakers are committed to using the findings to move toward a “health in all policies” approach that would lead every county agency — from the school system to the police — to consider ways to improve residents’ health.
“It provides us a strong foundation moving forward,” Turner said in an interview. “The biggest hurdle is going to be what fiscal opportunity we have in light of covid-19.”
The novel coronavirus has severely affected Prince George’s, where 61 percent of residents are Black, 19 percent are Hispanic and 12 percent are White. The county far surpasses the rest of Maryland when it comes to reported cases, with 29,416 infections as of Tuesday, and has reported the second-highest number of deaths in the state, after the more populous Montgomery County.
Within the county, the Zip code with the highest number of coronavirus cases is 20783, which includes Hyattsville, parts of College Park, Langley Park, Beltsville and Adelphi. More than 50 percent of those residents are Hispanic, and 35 percent are noncitizen immigrants.
That mirrors trends throughout the region and the country showing that Latinos have contracted the coronavirus at alarmingly high rates, although their fatality rate remains lower than for Black Americans. Experts say Latinos appear especially vulnerable because they are more likely to work in service industries and live in intergenerational homes.
The Rand report homed in on housing, noting that overcrowded housing conditions are associated with a variety of medical issues, including respiratory problems and trouble sleeping. During the pandemic, it also means that if one family member contracts the coronavirus, the infection is likely to rapidly spread within the household.
The report found that rates of overcrowding were particularly high in Council District 2, which includes Mount Rainier, Hyattsville and Langley Park. Sixteen percent of households were considered overcrowded, compared with 5 percent throughout the county and a statewide average of 2.8 percent.
The report’s authors found that shortages of primary-care physicians and a lack of county spending on health and human services are compounding the health problems of its residents. Prince George’s has 1.33 pediatricians per 100,000 residents, compared with 4.55 in Montgomery County, 5.33 in Howard County and 2.5 in Baltimore County.
The county invests $39 per person on health and human services — compared with $91 in Anne Arundel, $224 in Montgomery and $45 in Baltimore County — and relies heavily on grants, which are typically short-term and come with restrictions, which can hurt programming and staff recruitment and retention.
During a council meeting Tuesday, council member Dannielle M. Glaros (D-District 3), who in recent years has called for more funding for the Health Department, described the report as a “call to action.”
“I really hope we see movement,” Glaros said. “I do not feel we spend enough money on our budget in this arena. . . . It’s going to mean us re-prioritizing and making some difficult decisions this spring.”
Council member Derrick Leon Davis (D-District 6) said that especially for a majority-minority jurisdiction, it was frightening to see how few dollars were being spent on the health of residents. “That is absolutely heart-wrenching,” he said of the lack of funding relative to other jurisdictions.
Anita Chandra, a senior policy researcher at Rand and one of the authors of the report, said the coronavirus has shown the extent to which health policy intersects with housing, public safety and other government policies. She said the disruption caused by the virus will give officials in Prince George’s and across the country new opportunities to think about how they are allocating funding.
“It’s a health pandemic, but it’s also a social and economic pandemic,” Chandra said in an interview. “It got overlaid on an already fragile social fabric.”
The percentage of uninsured Prince George’s residents dropped from 15 percent in 2009, when Rand conducted its last comprehensive report on the county, to 11 percent in 2018. But Prince George’s continues to have the highest percentage of uninsured residents in the state.
In District 2, 26 percent of residents are uninsured, which researchers said could be because undocumented residents are not eligible for health insurance or might not try to get it, because of fears of deportation.
Health literacy, which refers to the extent to which people understand basic health information, is dramatically lower in poorer Prince George’s County communities, mostly inside the Beltway, than in the wealthier neighborhoods outside it.
But the chronic health conditions that can make covid-19 especially dangerous, including heart disease, hypertension and diabetes, are prevalent throughout the county, according to the report. Black and Hispanic residents reported higher rates of hypertension and diabetes than White residents.
And Black residents are more likely to use hospital emergency rooms for the treatment of non-urgent issues including heart disease, diabetes and hypertension, which the report’s authors described as an inefficient use of resources that shows the difficulty residents face navigating the primary-care system.