Despite a sustained and vocal effort to distribute the coronavirus vaccine equitably among Sonoma County residents without regard to their wealth or race, there are significant gaps in immunization rates among local neighborhoods, forcing the county to make up ground from the start of its campaign to improve health equity during the pandemic.
A Press Democrat analysis of vaccination numbers in 32 ZIP codes that either wholly or partially fall within the county reveal an unmistakable disparity between some of Sonoma County’s wealthier neighborhoods and its more socioeconomically disadvantaged.
It’s a story as old as civilization: Life is healthier for those with resources.
“What makes us believe the systems that lead to inequality in housing, education and health care don’t also apply to COVID-19?” said Pedro Toledo, chief administrative officer of Petaluma Health Center. “I think we need to recommit ourselves to providing access to the vaccine for groups that are disproportionately impacted by COVID, low-income communities in particular.”
Following the state’s lead, the county is charting vaccination rates according to ratings on the Healthy Places Index, or HPI, a measurement of census tracts based on income levels and quality-of-life factors such as access to health care, education and transportation. Tracts with similar ratings are placed into one of four groups, or quartiles, and public health officials and political leaders are using them to evaluate the fairness and effectiveness of the vaccination campaign.
The lowest economic quartile in Sonoma County has received 20% of the doses thus far, a share that climbs to 23%, 26% and 31% for successively better-off populations. Charting the percentage of residents in each quartile who have received at least one vaccine dose shows a similar trajectory.
All of these figures measure rates for everyone 16 and older. They include Sonoma County residents who were vaccinated outside county limits, but exclude out-of-county residents who got their doses here, said Kate Pack, the county’s chief epidemiologist.
The gaps between economic levels is precisely why the state of California added an equity metric to its vaccination campaign on March 4. At that time, the lowest-quartile communities in the state were receiving 16% to 17% of the overall vaccine supply, as opposed to 34% for the highest quartile.
That uneven playing field has ravaged many poorer neighborhoods, where crowded living spaces, prevalence of underlying health conditions and uneven access to medical care creates higher risk of contracting COVID-19. And because so many workers in these areas have essential on-site jobs, including a high concentration in food production, their risk is transferred to the broader community.
To address the problem, the state began setting aside 40% of all vaccine doses for California’s poorest ZIP codes. As of Friday, the gap had narrowed a bit, with 19% of all doses now having gone to the lowest quartile, and 30.7% to the highest.
To make matters confusing, counties divide up tracts by socioeconomic status to create their own quartiles. California does the same, but on a statewide level. And none of the state’s most disadvantaged communities are in Sonoma County. It’s a sore spot for some local community activists, who are quick to point out we are getting no “equity doses” despite pockets of significant poverty in Sonoma County.
Using the state’s quartiles as a guide, though, the vaccine disparity between Sonoma County neighborhoods is clear.
Of the five county ZIP codes in California’s second-lowest HPI, three are among the least-vaccinated ZIPs in the county. Those would be the rugged, coastal-adjacent area around Annapolis (95412, a tract that, as Sonoma County Supervisor Lynda Hopkins pointed out a recent board meeting, includes the home base of the Kashia band of Pomo Indians), where only 20.9% of residents have been immunized; the Roseland neighborhood and other predominantly Latino blocks of southwest Santa Rosa (95407), which has a 23.4% vaccination rate; and the area around Guerneville (95446), which is at 28.8%.
The median for the county’s 32 represented ZIP codes is about 37%.
Acknowledging the need to increase vaccinations in Roseland, DEMA Consulting & Management had been running a county-supported clinic at the library there, but it hasn’t been operating lately.