They're Dying in the Suburbs: COVID-19 Cases and Deaths by Geography in Louisiana (USA)

The national COVID-19 conversation in the US has mostly focused on urban areas, without sufficient examination of another geography with large vulnerable populations: the suburbs. While suburbs are often thought of as areas of uniform affluence and racial homogeneity, over the past 20 years, poverty and diversity have increased substantially in the suburbs. In this study, we compare geographic and temporal trends in COVID-19 cases and deaths in Louisiana, one of the few states with high rates of COVID-19 during both the spring and summer. We find that incidence and mortality rates were initially highest in New Orleans. By the second peak, trends reversed: suburban areas experienced higher rates than New Orleans and similar rates to other urban and rural areas. We also find that increased social vulnerability was associated with increased positivity and incidence during the first peak. During the second peak, these associations reversed in New Orleans while persisting in other urban, suburban, and rural areas. The work draws attention to the high rates of COVID-19 cases and deaths in suburban areas and the importance of metropolitan-wide actions to address COVID-19. RegistrationN/A Funding sourceNIH (DP5OD26429) and RWJF (77644) Code and data availabilityCode for replication along with data is available here: https://github.com/alinasmahl1/COVID_Louisiana_Suburban/.