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The COVID-19 pandemic has devastated the world as a stark reminder that emerging infectious pathogens are still a perpetual challenge to human society and an important global public health problem (Ciotti et al., 2020; M. L. Cohen, 2000; Anthony S Fauci, Lane, & Redfield, 2020; Anthony S. Fauci & Morens, 2012; Khanna, Cicinelli, Gilbert, Honavar, & Murthy, 2020; Morens & Fauci, 2013; Van Bavel et al., 2020). The pandemic unfolds differently in specific locales as they have different social, economic, demographic, and political settings, and many specific interventions and mitigation decisions are often made at the local level by local administrations. This study investigates how the prevalence of COVID-19 varies by age, race/ethnicity, over time, and in different neighborhoods in Milwaukee, and how social vulnerability can contribute to the understanding of COVID-19’s prevalence in Milwaukee County. Milwaukee is the most populous county in the State of Wisconsin with nearly a million residents in the central city and surrounding suburbs. For decades, Milwaukee has been one of the most segregated metropolitan areas in the United States in terms of black vs. white residential segregation (Frey & Myers, 2005; Iceland, Weinberg, & Steinmetz, 2002), and it is now home to a growing Hispanic minority. Residential segregation is among the factors that could affect exposure to infection by COVID-19.
Although biomedical advances have greatly thwarted infectious diseases’ threat to human society, the emerging human pathogens continue to impact disproportionately populations deprived of social resources (J. M. Cohen, Wilson, & Aiello, 2007). Studies on the early stage of the COVID-19 pandemic have found that it has disproportionate impact on socially vulnerable populations, e.g., people of minority or old age (Adhikari et al., 2020; Alsan, Stantcheva, Yang, & Cutler, 2020; Gaynor & Wilson, 2020; Pierce et al., 2021; Poulson et al., 2021; Yang, Kim, Zhao, & Choi, 2021). Racial or ethnic minorities may have a greater risk of infection/death due to comorbidities, living in dense neighborhoods of lower socio-economic status, which may have closer physical contact between individuals, less equitable health care access and lower rates of testing, and working in the essential workforce (Dasgupta et al., 2020; Shah, Sachdeva, & Dodiuk-Gad, 2020; Wang et al., 2021). Some early studies have shown that social vulnerability is associated with higher COVID-19 fatality across U.S. counties and high social vulnerability coexists with high fatality rate in more than 1 in 4 U.S. counties (Khazanchi et al., 2020; Kim & Bostwick, 2020; Nayak et al., 2020). A recent study shows that at census tract level high social vulnerability is linked with more COVID-19 incidents (Biggs, Maloney, Rung, Peters, & Robinson, 2021).