Health Map Details Greatest Health Needs Across U.S.

An interdisciplinary team of researchers at Yale and Columbia universities today unveiled an interactive map that guides policy makers and the public in deploying health care workers to communities most affected by the COVID-19 pandemic.

The online map, Mapping the New Politics of Care, uses a wide array of up-to-date data. It shows that decisions about caring for those affected by the pandemic depend not just on surging or falling infection rates but instead on taking into account a range of pre-existing vulnerabilities in U.S. society.

The map reveals that the areas that appear most at risk within each state shift depending on how vulnerability is measured: from COVID-19 cases to unemployment rates, from COVID-19 deaths to formal metrics of health vulnerability such as Years of Potential Life Lost and the Centers for Disease Control and Prevention’s Social Vulnerability Index.

“The COVID19 pandemic in the United States has exposed a crisis of care across the country,” said Yale Law Professor Amy Kapczynski of the Yale Global Health Justice Partnership (GHJP) of Yale Law School and Yale School of Public Health. “The failure of the federal response to the pandemic has demonstrated the stark inability of political leaders to rise to the basic challenge of protecting those living in the U.S. from a new and deadly virus. Yet, the long-standing vulnerabilities in our communities, the patchwork nature of our health system, the historic disinvestment in public health and the weakness of our safety net programs made the U.S. uniquely susceptible to a crisis just like this.”

The interactive map was created by a team from the Center for Spatial Research (CSR) at the Columbia University’s Graduate School of Architecture, Planning and Preservation (GSAPP) and the GHJP.

The researchers describe Mapping the New Politics of Care as a visual journey through the inequities and vulnerabilities that define the American landscape, using different definitions to describe communities at risk, down to the county level.

They propose a New Deal for Public Health, a national program to address acute needs of the pandemic response but also makes a larger national commitment to protecting and improving the public’s health, and confronts the legacy of vulnerabilities that existed before the emergence of SARS-CoV-2.

Central to this new project is the establishment of a Community Health Corps — a national investment in one million community health workers to be deployed across the country to face off with the COVID-19 pandemic while also starting to address decades of health inequity across the country.

"Mapping the New Politics of Care lets visitors to the site make those choices explicitly to see how the number of community health workers across a state shifts depending on what kinds of vulnerability matters to them,” said Laura Kurgan, Professor of Architecture and Director of CSR at Columbia. “It also shows the trade-offs in community health worker allocation between pairs of choices in defining vulnerability. It was important to us to show how vulnerability shapes the country we live in. COVID-19 is only the most current crisis facing cities and towns across the country; here we can show you where vulnerabilities existed long before the pandemic hit.”

Currently, the pandemic tracks certain kinds of pre-existing vulnerabilities and not others. Despite the absence of data to allow for allocations of community health workers in the U.S. based on lives or dollars saved, choices can still be made based on short-term needs of the pandemic or longer standing vulnerabilities.

“This new collaboration between the CSR and GHJP shows how public health, spatial data analysis, data visualization, design, and policy can be used to highlight, expose the social and economic vulnerabilities in America and the health outcomes that follow in their wake,” said Assistant Professor at the Yale School of Public Health and Associate Professor (Adjunct) of Law Gregg Gonsalves of Yale’s GHJP. “As we confront the COVID-19 pandemic, we have to target the places that are hurting now, but those that have been no stranger to disease and ill health for generations in the U.S.”

The Mapping the New Politics of Care project team consists of Laura Kurgan, Dare Brawley, Jia Zhang of the CSR (all bios here) and Gregg Gonsalves, Suzan Iloglu and Tommy Thornhill of the GHJP and Yale School of Public Health. The project builds on a series of essays by GHJP co-directors Kapczynski and Gonsalves on a new politics of care.

The Center for Spatial Research was established in 2015 as a hub for urban research that links design, architecture, urbanism, the humanities and data science. It sponsors research and curricular activities built around new technologies of mapping, data visualization, data collection, and data analysis. CSR focuses on data literacy as well as interrogating the world of ‘big data,’ working to open up new areas of research and inquiry with advanced design tools to help scholars, students as well as our collaborators and audiences, to understand cities worldwide –– past present and future.

The Global Health Justice Partnership (GHJP), hosted by Yale Law School (YLS) and Yale School of Public Health (YSPH), was established in 2012 to promote interdisciplinary, innovative, and effective responses to global health disparities. It is a transformative collaboration that integrates different fields in order to make critical policy interventions. Building on Yale’s institutional assets, the GHJP trains students in law, public health, global affairs, and other fields to undertake collaborative, real-world research and advocacy to promote health justice. It also organizes path-breaking conferences and events, builds partnerships with local NGOs around the world to move research into action, and nurtures a truly interdisciplinary brain trust dedicated to effecting social change.