States with the Most Vulnerable Populations to Coronavirus

During the coronavirus pandemic, the news often focuses on the medically vulnerable – people who risk the most serious symptoms if they contract the disease, such as the elderly or people with pre-existing medical conditions. However, two other at-risk populations are just as crucial to protect – those who lack adequate living conditions and those without enough monetary resources to weather the pandemic.

In order to find out which states have the highest concentrations of vulnerable people across all three categories, WalletHub compared the 50 states and the District of Columbia across 28 key metrics. Our data set ranges from the share of the population aged 65 and older to the share of the homeless population that is unsheltered and the share of the entire population living in poverty. Read on for the state ranking, additional insight from a panel of experts and a full description of our methodology.

Main Findings

States with the Most Vulnerable Populations to COVID-19

Ask the Experts

Protecting the vulnerable is a crucial task in which both the government and individual citizens must participate. For more guidance, WalletHub turned to a panel of experts. Click on the experts below to read their bios and responses to the following key questions:

1. Considering the White House guidelines to reopening the economy, are the measures taken to protect the vulnerable population sufficient?
2. What are the most important steps a person vulnerable to COVID-19 complications can take to remain safe amid easing of social distancing measures?
3. What are the best means local authorities can provide to better protect high risk groups of population?

Ask the Experts

Sherry A. Maykrantz
Ph.D., CHES – Assistant Professor of Community Health | School of Health Sciences, Salisbury University
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Mordecai Lee
Ph.D. – Professor Emeritus, University of Wisconsin-Milwaukee
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Ruth McDermott-Levy
Ph.D., MPH, RN, FAAN – Associate Professor and Director, Center for Global and Public Health, Villanova University, Fitzpatrick College of Nursing
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Marcia G. Ory
Ph.D., MPH, RN, FAAN – Regents and Distinguished Professor, Associate Vice President of Strategic Partnerships and Initiatives, Texas A&M University Health Science Center, Founding Director – Texas A&M Center for Population Health and Aging, HSC Director – Texas A&M Healthy Texas Initiative
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Harvey Brenner
Ph.D. – Professor, Department of Health Behavior and Health Systems, University of North Texas Health Science Center
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Methodology

In order to identify the states that have the most vulnerable populations during the COVID-19 pandemic, WalletHub compared the 50 states and the District of Columbia across three key dimensions, “Medical Vulnerability,” Housing Vulnerability and “Financial Vulnerability.”

We evaluated those dimensions using 28 relevant metrics, which are listed below with their corresponding weights. Each metric was graded on a 100-point scale, with a score of 100 representing the most vulnerable.

We then determined the weighted average across all metrics to calculate an overall score for each state and used the resulting scores to rank-order our sample.

Medical Vulnerability – Total Points: 60

• Share of Adults Diagnosed with Chronic Kidney Disease: Double Weight (~7.50 Points)
• Share of Adults Diagnosed with Cardiovascular Disease: Double Weight (~7.50 Points)
• Share of Adults Diagnosed with Diabetes: Double Weight (~7.50 Points)
• Share of Adults Diagnosed with Chronic Obstructive Pulmonary Disease (COPD): Full Weight (~3.75 Points)
• Share of Adults Currently Diagnosed with Asthma: Full Weight (~3.75 Points)
• Share of Adults Diagnosed with Hypertension: Full Weight (~3.75 Points)
• Projected Cancer Incidence Change (2019-2020): Full Weight (~3.75 Points)
• Rate of HIV Infections Diagnoses per 100,000 Population: Full Weight (~3.75 Points)
• Share of Obese Adults: Double Weight (~7.50 Points)
• Share of Population Aged 65 & Older: Double Weight (~7.50 Points)
• Nursing Facility Occupancy Rate: Full Weight (~3.75 Points)

Housing Vulnerability – Total Points: 15

• Share of Unsheltered Homeless Population: Triple Weight (~6.43 Points)
  Note: An unsheltered homeless person resides in a place not meant for human habitation, such as cars, parks, sidewalks, abandoned buildings (on the street).
• Share of Homes Lacking Access to Basic Hygienic Facilities: Double Weight (~4.29 Points)
  Note: This composite metric measures both the share of homes with inadequate plumbing, and the share of homes with inadequate kitchen facilities.
• Medically Underserved Areas – Share of Need Met: Full Weight (~2.14 Points)
  Note: The percent of need met is calculated by dividing the number of primary care physicians available to serve the population of the area by the number of primary care physicians that would be necessary to reduce the population to provider ratio below the threshold for designation so that it would eliminate the designation as a primary care Health Professional Shortage Area (HPSA). Health Professional Shortage Area (HPSA) designations are used to identify areas and population groups within the United States that are experiencing a shortage of health professionals.
• Average Minutes to Quickest Available Hospital: Full Weight (~2.14 Points)

Financial Vulnerability – Total Points: 25

• Share of Population That Saved for Unexpected Expenses in Past 12 Months: Double Weight (~3.70 Points)
• Share of Population Who Fell Behind on Bills in Past 12 Months: Full Weight (~1.85 Points)
• Share of Population Delinquent on Their Debt: Full Weight (~1.85 Points)
• Share of Population That Had a Bankruptcy in the Past 12 Months: Half Weight (~0.93 Points)
• States with Biggest Increases in Unemployment Due to COVID-19 Score: Double Weight (~3.70 Points)
  Note: This metric is based on WalletHub’s “States with the Biggest Increases in Unemployment Due to COVID-19” ranking.
• Unemployment Insurance Recipiency Rate: Full Weight (~1.85 Points)
  Note: The Recipiency Rate represents the insured unemployed in regular programs as a percentage of the total unemployed.
• Ratio of Average Weekly Wage Covered by Unemployment Benefit: Full Weight (~1.85 Points)
  Note: The Replacement Rate is the ratio of the claimants'weekly benefit amount (WBA) to the claimants' average weekly wage.
• Average Unemployment Weekly Benefit: Full Weight (~1.85 Points)
  Note: Average Weekly Benefit for weeks of total unemployment. This metric was adjusted for the cost of living.
• Median Annual Household Income: Full Weight (~1.85 Points)
  Note: This metric was adjusted for the cost of living.
• Share of Population Living in Poverty: Full Weight (~1.85 Points)
• Share of Uninsured Population: Full Weight (~1.85 Points)
• Share of Households in Poverty Not Receiving Food Stamps: Half Weight (~0.93 Points)
• Share of Low-Income Renters Paying 50% or More of Their Income on Housing: Half Weight (~0.93 Points)

Sources: Data used to create this ranking were collected from the U.S. Census Bureau, Centers for Disease Control and Prevention, American Cancer Society, Kaiser Family Foundation, U.S. Department of Housing and Urban Development, Health Resources & Services Administration, The Journal of Regional Analysis and Policy, Federal Deposit Insurance Corporation, TransUnion, U.S. Department of Labor, Council for Community and Economic Research, Center on Budget and Policy Priorities, and WalletHub research.

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