What helps COVID-19 kill Alabamans
Without question, the COVID-19 pandemic affected every walk of life in the last year. Young people caught the virus and suffered. Some of them died. Older people caught the virus. More of them died. But from the beginning, when the World Health organization designated COVID-19 a global pandemic on March 11, 2020, health officials beat the drum that age and certain underlying health conditions posed higher risk factors for getting, suffering, and dying from this mysterious virus. One of those conditions especially affected people in Alabama: obesity.
The Centers for Disease Control say diabetes, respiratory diseases, circulatory diseases, and cancer are among top underlying health conditions putting adults with COVID-19 at risk of serious complications that result in hospitalization or death. This rings true when you look at the underlying causes of death listed on the Alabama death certificates of people who contracted and died of COVID-19.
Of those who died of COVID-19 in Alabama, over 90% had one of the underlying conditions the CDC lists as a risk factor as seen in the chart below.
Since the CDC started keeping track in January 2020, only 1% of death certificates in Alabama list obesity as a contributing cause of death alongside COVID-19. But that smallest red slice of the pie chart above is the number one cause of nearly every other condition on the same chart, including many respiratory diseases, circulatory diseases, diabetes and cancer. It’s also the main contributing factor to chronic kidney disease, chronic obstructive pulmonary disease (COPD), heart disease, and diabetes, all of which are listed on death certificates of COVID-19 patients across Alabama.
Alabama’s counties range in population from nearly 660,000 in Jefferson County, the home of the state’s biggest city of Birmingham, to the least populated Greene County with just a little over 8,000 people. But no matter the population, every county has at least a 30% obesity rate. At the bare minimum, a third of the people living in Alabama are obese. And it only goes up from there. The CDC reports that at least half of the people in Macon and Wilcox counties are living with obesity and all the health problems that it produces.
With such high obesity rates, one would expect COVID-19 infection and death rates to follow. In the chart below, the number of COVID-19 cases trends between half and a quarter of the number of obesity cases in each county.
But some counties buck that trend.
St. Clair County, Birmingham’s northeast neighbor, has a relatively low (by Alabama standards) obesity rate at 37%, but ranks the highest in the state for COVID-19 cases by population. 26% of the nearly 88,000 people living in St. Clair county contracted the virus. 238 of those people died.
Similar circumstances with significantly different results in Shelby County, just to the south of Birmingham. Shelby County’s population is more than double that of St. Clair’s, but it’s obesity rate is just a tick higher at 38%. But Shelby County boasts the lowest COVID-19 infection rate in the state at just 4%.
Then there’s Macon County, directly east of Alabama’s capitol Montgomery. Macon County has the dubious distinction of having the highest percentage of obesity cases by population. 51% of 18,700 living there are obese. However, Macon County saw a relatively low COVID-19 case rate of about 8%. Still, even with that lower case rate, 4% of those who got the virus in Macon County died.
Social distancing, masking and utilizing other protective protocols may explain some of these discrepancies. And as the CDC and ADPH have reported, age is a major contributing factor for complications with a COVID-19 infection. But by looking at the contribution obesity has to all the major underlying conditions that make the COVID-19 virus more deadly, it’s easier to see that Alabama may need to address an epidemic of a different nature once this pandemic has passed.
