27 factors that make you vulnerable to COVID-19

- Total senior population (adults 65+): 49.2 million (15.2% of U.S. population)

People over 65 years old make up 15.2% of the population of the United States, yet this group accounts for 80% of known COVID-19 deaths in the United States. This is due to the fact that older people often have weaker immune systems, as well as the reality that they are more likely to live in nursing homes, which make up around 40% of the country’s known death rate. Nursing homes were some of the first places to experience outbreaks and often lacked sufficient testing, protective gear, and protocols.

States with the largest populations:

#1. Florida: 19.7% of state population (26.6% above national average)

#2. Maine: 19.4% (24.7% above national average)

#3. West Virginia: 18.8% (20.8% above national average)

#4. Vermont: 18.2% (17.0% above national average)

#5. Delaware: 17.6% (13.1% above national average)

Of the states with the largest percentage of seniors, Florida has made headlines for its overall lax handling of the virus and quarantine measures. In Florida, as of October 2020 82.3% of known COVID-19 deaths were among people 65 and older. However, Florida’s numbers do not take visitors and “snowbirds” into account—people, often seniors, who spend a few months in Florida over the winter before returning to their home states.

- Total disabled population: 39.9 million (12.4% of U.S. population)

Having a disability is another risk factor for increased complications from COVID-19. According to the CDC, “Adults with disabilities are three times more likely than adults without disabilities to have heart disease, stroke, diabetes, or cancer than adults without disabilities.” These diseases make people more vulnerable to COVID-19.

States with the largest populations:

#1. West Virginia: 19.5% of state population (48.7% above national average)

#2. Kentucky: 17.3% (32.2% above national average)

#3. Arkansas: 17.2% (30.8% above national average)

#4. Alabama: 16.3% (24.1% above national average)

#5. Mississippi: 16.3% (24.1% above national average)

The five states with the largest populations of people with disabilities are all located in the Southern United States. In addition, two of these states—Alabama and Mississippi—did not adopt Medicaid expansion, meaning people with disabilities might have less access to health care. And when states were discussing rationing care because there were not enough ventilators, Alabama’s state policy (since updated) said that people with “severe mental retardation … may be poor candidates” for a ventilator.

- Total Black or African American population: 40.9 million (12.7% of U.S. population)

Black and African American people make up 12.7% of the United States population, but as of December 2020, they made up roughly 20% of COVID-19 deaths. Overall, Black and African American people have a COVID-19 mortality rate that is 2.8 times higher than the rate for white people.

States with the largest populations:

#1. District of Columbia: 46.9% of state population (316.2% above national average)

#2. Mississippi: 37.7% (234.6% above national average)

#3. Louisiana: 32.2% (185.7% above national average)

#4. Georgia: 31.5% (179.5% above national average)

#5. Maryland: 29.8% (164.5% above national average)

Washington D.C. has the largest percentage of Black and African American residents. Even though this demographic makes up 46.9% of the district’s population, as of May 20 they made up 76.9% of its COVID-19 deaths, a rate six times higher than Washington D.C.’s white population.

- Total Hispanic or Latino population: 57.5 million (17.8% of U.S. population)

Hispanic or Latinx people are at increased risk of being exposed to COVID-19 in the United States. This is because they tend to be disproportionately represented in low-wage jobs that do not allow them to social distance.

States with the largest populations:

#1. New Mexico: 48.5% of state population (313.6% above national average)

#2. Texas: 39.2% (234.3% above national average)

#3. California: 38.9% (231.7% above national average)

#4. Arizona: 31.1% (165.2% above national average)

#5. Nevada: 28.5% (143.0% above national average)

California has the third-highest percentage of Hispanic or Latinx people in the United States. In San Francisco’s Mission District, a heavily Latinx neighborhood, one researcher in May 2020 tested 4,160 individuals and found that 2% tested positive for the coronavirus—but that 95% of that 2% were Latinx.

- Total Native American or Alaska Native population: 2.7 million (0.8% of U.S. population)

Long before the COVID-19 pandemic, indigenous communities experienced health, income, and education disparities, putting these communities in particular danger once the coronavirus did show up. Now that COVID-19 has spread quickly through the United States, Native American communities are experiencing especially harsh impacts as has been documented within the Navajo Nation among several others.

States with the largest populations:

#1. Alaska: 14.4% of state population (791.3% above national average)

#2. New Mexico: 9.6% (494.2% above national average)

#3. South Dakota: 8.7% (438.5% above national average)

#4. Oklahoma: 7.5% (364.2% above national average)

#5. Montana: 6.5% (302.3% above national average)

New Mexico has the second-largest population of Native Americans in the United States, due in large part to the Navajo Nation and Zia Pueblo and San Felipe tribes. Altogether, Native Americans as of December 2020 made up around 16.9% of the state's COVID-19 cases.

- Total rural population: 57.2 million (17.7% of U.S. population)

The earliest cases of COVID-19 were reported from urban areas, but rural areas are at a unique risk for complications from COVID-19. These regions tend to have older populations, younger people with pre-existing health conditions, and fewer hospital ICU beds per capita.

States with the largest populations:

#1. Alaska: 87.2% of state population (208.5% above national average)

#2. Vermont: 71.2% (152.0% above national average)

#3. Wyoming: 69.4% (145.3% above national average)

#4. Montana: 67.5% (138.8% above national average)

#5. South Dakota: 58.5% (106.8% above national average)

South Dakota, a state that is 58.5% rural, has seen disproportionate suffering from COVID-19. The first major outbreak in the state was in part due to the kind of industry prevalent there: meatpacking plants.

- Total multigenerational households: 4.6 million (1.4% of total households)

Older people are more at risk for COVID-19 complications, which makes limiting their exposure important. This can be hard to do in multigenerational households, where seniors live with their children and grandchildren, making exposure to the virus through one of their family members more likely.

States with the largest populations:

#1. Hawaii: 7.9% of state population (137.0% above national average)

#2. California: 5.9% (74.7% above national average)

#3. Texas: 4.9% (45.7% above national average)

#4. Mississippi: 4.7% (40.4% above national average)

#5. Maryland: 4.6% (37.9% above national average)

The number of multigenerational households has risen since the Great Recession in 2008, mostly for financial reasons. In order to help these families navigate COVID-19, Generations United created a fact sheet for families living together, as well as to help families stay connected when they are physically apart.

- Total multiunit housing: 18.3 million (5.7% of all housing units)

Large apartment buildings could be places where COVID-19 might spread more easily. Research from 2017 found that pathogens such as a coronavirus can travel through a building's airflow used to move its plumbing system when that system is not working correctly. However, it is not known whether COVID-19 has spread significantly in this way.

States with the largest populations:

#1. District of Columbia: 46.2% of state population (292.1% above national average)

#2. New York: 28.0% (137.6% above national average)

#3. Hawaii: 24.5% (107.9% above national average)

#4. North Dakota: 19.9% (69.0% above national average)

#5. Florida: 19.3% (63.7% above national average)

Washington D.C. and New York have the highest proportion of multiunit housing, which isn’t surprising as Washington D.C. is itself a city, and New York State is home to the country’s largest city. While it has not been shown that either of these metropolises has experienced COVID-19 due to multiunit housing specifically, both experienced high rates of the virus.

- Total nursing home population: 1.3 million (0.4% of U.S. population)

Nursing homes are risky places for COVID-19 not only because they generally have residents who are senior citizens, but also because of the way the U.S. health care system is designed and how it has handled COVID-19. Following a COVID-19 outbreak in Seattle nursing homes, health officials did not prioritize residents in these facilities for testing and equipment.

States with the largest populations:

#1. Iowa: 0.8% of state population (74.3% above national average)

#2. Rhode Island: 0.7% (70.9% above national average)

#3. North Dakota: 0.7% (69.8% above national average)

#4. South Dakota: 0.7% (59.9% above national average)

#5. Ohio: 0.6% (46.5% above national average)

As of late October 2020, half of all COVID-19 deaths in Iowa were in nursing homes. One nursing home administrator there said he reported four confirmed coronavirus cases among its residents on May 8, but that it took state officials almost three weeks to publicize the outbreak.

- Total incarcerated population: 1.2 million (0.4% of U.S. population)

More than 1 million people in the United States are in prison, or 0.4% of the population. In fact, the United States has more people in prison than any other country in the world. Prisons are places without much personal space, and as the prison population has gotten older—155,000 incarcerated people were 55 or older in 2016, the most recent year with data—prisons are especially risky for COVID-19 transmission and complications. As of May Dec. 7, 2020, there were at least 227,333 confirmed cases of COVID-19 in prisons.

States with the largest populations:

#1. Montana: 1.7% of state population (330.3% above national average)

#2. Louisiana: 0.7% (75.1% above national average)

#3. Alaska: 0.7% (74.8% above national average)

#4. Mississippi: 0.6% (61.3% above national average)

#5. Oklahoma: 0.6% (60.9% above national average)

As COVID-19 began to move through the United States, some states began releasing high-risk prisoners incarcerated for nonviolent crimes. However, the impact of the coronavirus in United States jails has been called a "death sentence," and testing has been lacking.

- Total homeless population: 562,184 (0.2% of U.S. population)

A big piece of keeping down the spread and impact of COVID-19 is staying home, something that’s very hard to do for people who do not have one. The CDC did publish some guidelines on protecting homeless populations, but even homeless shelters, places that are supposed to help people stay off the streets, are places where COVID-19 has spread.

States with the largest populations:

#1. District of Columbia: 1.0% of state population (505.6% above national average)

#2. New York: 0.5% (198.4% above national average)

#3. Hawaii: 0.5% (186.6% above national average)

#4. Oregon: 0.4% (147.2% above national average)

#5. California: 0.4% (145.6% above national average)

There were an estimated 567,715 homeless people living in the United States in 2019. In New York City, the homeless population is 198.4% more than the national average. The coronavirus has been hard for this group. By the end of May, there were 926 confirmed COVID-19 cases reported at 179 shelter locations.

- Total population without health insurance: 32.5 million (10.1% of U.S. population)

There are currently 32.5 million people without health insurance in the United States, even though the Affordable Care Act was supposed to make coverage accessible to everyone. People without health insurance have less access to testing and treatment and are also more likely to have jobs with increased possibility of exposure. And because in the United States health insurance is often linked to employment, as people are losing their jobs due to the pandemic, an estimated additional 27 million people may be losing their insurance.

States with the largest populations:

#1. Texas: 20.2% of state population (118.0% above national average)

#2. Oklahoma: 16.3% (75.8% above national average)

#3. Georgia: 15.6% (67.9% above national average)

#4. Mississippi: 14.7% (58.8% above national average)

#5. Florida: 14.5% (56.0% above national average)

The five states with the largest populations of uninsured people, all located in the South, did not accept the Medicaid expansion that was part of the Affordable Care Act. In Texas and Florida, there have been many calls for this expansion but no political movement.

- Total population below poverty line: 44.3 million (13.7% of U.S. population)

44.3 million people live below the poverty threshold in the United States, which for one person under the age of 65 in 2019 was $13,300 per year. People in poverty often work jobs that cannot have social distance, meaning that people in poverty are more likely to come into contact with the virus and less likely to have good access to health care.

States with the largest populations:

#1. Mississippi: 20.8% of state population (52.3% above national average)

#2. New Mexico: 20.0% (46.5% above national average)

#3. Louisiana: 19.4% (42.1% above national average)

#4. Kentucky: 17.9% (31.1% above national average)

#5. West Virginia: 17.8% (30.4% above national average)

The states with the largest populations of people living in poverty are in the southern United States. Louisiana, which has 19.4% of its population living below the threshold, has had 2,801 COVID-19 deaths as of June 3. As of May 20, 54.4% of the state’s deaths were Black or African American residents, who are more likely to experience poverty in the state.

- Total health care workers: 15.2 million (4.7% of U.S. population)

By the end of September 2020, more than 1,700 health care workers had died from COVID-19, according to National Nurses United. That number includes more than 200 nurses.

States with the largest populations:

#1. District of Columbia: 7.2% of state population (50.1% above national average)

#2. Minnesota: 6.4% (33.9% above national average)

#3. Massachusetts: 6.3% (32.0% above national average)

#4. New York: 6.0% (25.4% above national average)

#5. North Dakota: 6.0% (25.0% above national average)

Health care workers are on the front lines, up close and personal with COVID-19 patients. New York State has 25.4% more health care workers than the national average, and more than half of the nurses in the New York State union reported in May 2020 that they still did not have enough personal protective equipment such as masks and gowns. Health care workers want to be more included in decision-making as states reopen.

- National unemployment rate (November 2020): 6.7%
- Total jobless claims: 10.3 million (3.2% of U.S. population)

Numbers of unemployment claims have dropped since March and April, close to 12 million people who lost their jobs during the pandemic owed on average $5,850 in back rent heading into the new year. Many workers who become unemployed lose health insurance, putting them at greater risk for greater health and financial strain if they contract the coronavirus.

States with the highest rates:
#1. Hawaii: 10.1% (50.7% above national rate)
#2. Nevada: 9.9% (47.8% above national rate)
#3. New Jersey: 9.9% (47.8% above national rate)
#4. Alaska: 8.1% (20.9% above national rate)
#4. Louisiana: 8.1% (20.9% above national rate)
#4. New York: 8.1% (20.9% above national rate)

Nevada's unemployment rate soared to almost 30% in May 2020. This was the highest unemployment for any state since 1976, which is when the Bureau of Labor Statistics began tracking this data. Nevada has a large service economy, and many of these businesses were forced to close during COVID-19.

- Total food-service workers: 13.5 million (4.2% of U.S. population)

Food-service workers make up 4.2% of the United States population and are disproportionately impacted by COVID-19, due to the fact that they are often “essential” workers and on the front lines. In addition, because in some places they tend to have lower income and/or are from immigrant communities, they live further from the city center, meaning more time on public transit and more vulnerability. They are also less able to take time off, even if they feel sick.

States with the largest populations:

#1. District of Columbia: 8.8% of state population (103.2% above national average)

#2. Nevada: 6.5% (49.3% above national average)

#3. Hawaii: 6.0% (38.6% above national average)

#4. Montana: 5.0% (14.3% above national average)

#5. South Dakota: 4.8% (11.1% above national average)

In Washington D.C., which has the highest proportion of food-service workers in the country, 103.2% above the national average, that group is notable for testing positive for COVID-19. The Restaurant Association Metropolitan Washington, which has over 1,000 food-service members in the Washington D.C. area, said in May 2020 are no protocols for what restaurants should do when an employee gets sick.

- Total population in areas with heavy air pollution: 186.8 million (57.9% of U.S. population)

A Harvard study has shown that increased air pollution is associated with an increase in COVID-19 deaths. Over half of the United States population, 57.9%, live in areas with heavy air pollution. This disproportionately impacts people of color, especially African Americans, who tend to live in places with more air pollution due to generations of redlining and housing segregation.

States with the largest populations:

#1. District of Columbia: 100.0% of state population (630.3% above national average)

#2. Georgia: 59.2% (332.5% above national average)

#3. Delaware: 58.5% (327.0% above national average)

#4. Indiana: 53.5% (290.8% above national average)

#5. Illinois: 48.0% (250.6% above national average)

Unlike other risk factors, data for air pollution is shown using county-level data and based on the 16-year average of PM2.5 pollution in each county. Gray areas on the map do not have available data. This data shows that 100% of Washington D.C.’s population lives in areas with heavy air pollution, which is unsurprising as the entire district is a city. This is especially important because 46.9% of its population is African American or Black. Since the COVID-19 shutdown, Washington D.C.’s air pollution has gone down; it currently has the cleanest air it’s had in the last 25 years.

- Total major cardiovascular disease diagnosis: 27.2 million (8.4% of U.S. population)

Major cardiovascular disease is a risk factor for COVID-19 complications and death. In one case study of 21 COVID-19 patients, congestive heart failure was the second most common comorbidity baseline with 42.9%.

States with the largest populations:

#1. West Virginia: 14.2% of state population (64.6% above national average)

#2. Arkansas: 12.6% (46.1% above national average)

#3. Kentucky: 12.6% (46.1% above national average)

#4. Alabama: 12.1% (40.3% above national average)

#5. Tennessee: 11.5% (33.3% above national average)

The states with the highest rates of major cardiovascular disease are all located in the South. According to a 2016 CDC report, heart disease kills more Southerners than any other disease. This is not just a geographic problem but also a racial one: In 2017, Black and African American people were 20% more likely to die from heart disease than people who identify as white.

- Total hypertension diagnosis: 104.7 million (32.4% of U.S. population)

According to the CDC, hypertension could also increase a person’s risk of COVID-19 complications. Hypertension is also known as high blood pressure and is present in nearly one-third of the United States population. However, while the CDC highlights hypertension as a possible risk factor, there is no current scientific confirmation to support the theory that people with hypertension will experience worse symptoms if they contract COVID-19.

States with the largest populations:

#1. West Virginia: 43.5% of state population (32.9% above national average)

#2. Alabama: 41.9% (28.0% above national average)

#3. Arkansas: 41.3% (26.1% above national average)

#4. Mississippi: 40.8% (24.6% above national average)

#5. Kentucky: 39.4% (20.3% above national average)

The states with the highest rates of hypertension are almost the same as the states with the highest rates of heart disease, and these five are also all located in the South. Hypertension is also more common among older people, who are already at higher risk for COVID-19 complications.

- Total diabetes diagnosis: 36.7 million (11.4% of U.S. population)

The CDC has warned about the risk that COVID-19 poses to people with diabetes, and a new study seems to further confirm that fact. A study from the journal Diabetologia found that of 1,317 COVID-19 patients with diabetes who were hospitalized in France, one in 10 had died by the end of the first week.

States with the largest populations:

#1. West Virginia: 16.2% of state population (45.8% above national average)

#2. Alabama: 14.5% (30.5% above national average)

#3. Mississippi: 14.3% (28.7% above national average)

#4. Louisiana: 14.1% (26.9% above national average)

#5. Arkansas: 13.9% (25.1% above national average)

In the United States, the states with the highest rates of diabetes are located in the South, with West Virginia as the state with the highest rate: 16.2% of its population. West Virginia's health care system has been decimated over the last few years, so it was already unprepared for a pandemic even without the added issue of diabetes.

- Total asthma diagnosis: 29.8 million (9.2% of U.S. population)

While the CDC lists asthma as a risk factor for COVID-19 complications, early data has shown that asthma does not increase the likelihood of COVID-19 complications. This data, which came from New York, found that of known COVID-19 deaths, only 5% were people who were known to have asthma.

States with the largest populations:

#1. Maine: 12.3% of state population (27.2% above national average)

#2. West Virginia: 12.3% (27.2% above national average)

#3. Vermont: 12.0% (24.1% above national average)

#4. Rhode Island: 11.9% (23.0% above national average)

#5. New Hampshire: 11.8% (22.0% above national average)

Four of the five states with the highest rates of asthma are located in New England. West Virginia also has high rates of asthma, along with many other chronic illnesses.

- Total smokers: 50.1 million (15.5% of U.S. population)

The risk that smoking poses to people regarding COVID-19 is complicated and still unsettled. One meta-analysis of studies that comprised 11,590 COVID-19 patients found that the risk of disease progression among those who smoked was nearly double that of nonsmokers. It also found that when the disease gets worse, current or former smokers experienced more acute conditions and death. However, a French study found that smokers might be less likely to fall ill with COVID-19 in the first place.

States with the largest populations:

#1. West Virginia: 25.2% of state population (51.9% above national average)

#2. Kentucky: 23.4% (41.0% above national average)

#3. Arkansas: 22.7% (36.8% above national average)

#4. Indiana: 21.1% (27.2% above national average)

#5. Tennessee: 20.7% (24.8% above national average)

In line with the health conditions highlighted previously, states like West Virginia, Kentucky, and Arkansas have the nation’s highest rates of smokers. Smoking can increase the likelihood of developing hypertension and heart disease.

- Total chronic lung disease diagnosis: 22.1 million (6.9% of U.S. population)

As COVID-19 is a disease that heavily impacts the lungs, chronic lung disease is thought to be a risk factor for complications. So far, there have been no definitive studies, but groups like the Cystic Fibrosis Foundation recommends that people with cystic fibrosis consider themselves at risk and stay home.

States with the largest populations:

#1. West Virginia: 15.3% of state population (116.3% above national average)

#2. Kentucky: 12.1% (71.1% above national average)

#3. Tennessee: 10.6% (49.9% above national average)

#4. Alabama: 10.3% (45.6% above national average)

#5. Louisiana: 9.9% (40.0% above national average)

Once again, many of the same Southern states have the highest rates of chronic lung disease. In addition, it is the people with the lowest incomes in cities across the entire country who have higher rates of illnesses such as chronic pulmonary disease.

- Total obese population: 99.9 million (30.9% of U.S. population)

Obesity is another condition linked to worse outcomes when it comes to COVID-19. In addition, while COVID-19 has had the worst impacts on older populations, young adults with obesity are more likely to be hospitalized if they have COVID-19, even if they have no other preexisting health conditions.

States with the largest populations:

#1. Mississippi: 39.5% of state population (26.2% above national average)

#2. West Virginia: 39.5% (26.2% above national average)

#3. Arkansas: 37.1% (18.5% above national average)

#4. Louisiana: 36.8% (17.6% above national average)

#5. Kentucky: 36.6% (16.9% above national average)

The five states with the highest rate of obesity in the United States are all located in the South, with Mississippi and West Virginia tied for having the largest percentage of people with obesity in their states. April data from from the Mississippi Department of Health showed that obesity was present in 67.8% of confirmed COVID-19 deaths and that nearly half of those deaths comprised African Americans.

- Total chronic kidney disease diagnosis: 10.0 million (3.1% of U.S. population)

Chronic kidney disease puts people at higher risk of getting COVID-19 and experiencing complications. This is especially true for people on dialysis, who might have weaker immune systems, or those with a kidney transplant, who need to take anti-rejection medicines that weaken the immune system.

States with the largest populations:

#1. West Virginia: 4.6% of state population (53.1% above national average)

#2. Kentucky: 4.2% (39.8% above national average)

#3. Alabama: 4.0% (33.2% above national average)

#3. Nevada: 4.0% (33.2% above national average)

#5. Tennessee: 3.9% (29.8% above national average)

Four of the five states with the highest rates of chronic kidney disease are in the South. West Virginia once again has the highest rate of any state, with 53.1% above the national average. West Virginia's high rate of multiple chronic illnesses makes it especially vulnerable overall for adverse COVID-19 outcomes.

- Total cancer diagnosis: 1.6 million (0.5% of U.S. population)

For the 0.5% of the United States population with cancer, two new studies showing that current and former cancer patients with COVID-19 are much more likely to die within a month than people without it is disheartening news. In one of the studies, half of 928 former and current cancer patients with COVID-19 were hospitalized and 13% died, which is much higher than rates reported among the general population.

States with the largest populations:

#1. Maine: 0.6% of state population (24.6% above national average)

#2. West Virginia: 0.6% (20.6% above national average)

#3. Delaware: 0.6% (18.1% above national average)

#4. Pennsylvania: 0.6% (17.5% above national average)

#5. New Hampshire: 0.6% (16.7% above national average)

In addition to cancer making COVID-19 more dangerous, quarantine measures and full hospitals have also delayed cancer treatment and screenings. In Maine, which has the highest rate of cancer in the United States, a retiree in Hampden had her cancer treatment put on hold as the virus broke out in her state.

- Total HIV diagnosis: 1.0 million (0.3% of U.S. population)

There is currently no definitive information on the impact of HIV status on COVID-19 risk. However, people who are immunocompromised are at greater risk for contracting COVID-19 and experiencing complications. HIV patients with a low CD4 cell count and those not on HIV treatment are at greatest risk.

States with the largest populations:

#1. District of Columbia: 2.4% of state population (673.7% above national average)

#2. New York: 0.8% (145.2% above national average)

#3. Maryland: 0.6% (106.7% above national average)

#4. Florida: 0.6% (97.5% above national average)

#5. Georgia: 0.6% (96.4% above national average)

Some health experts fear that the COVID-19 lockdowns may actually increase new HIV cases. While it would seem that separating people should keep those cases down, a dearth of health resources has made it harder for some men to get tested, according to an epidemiologist at Emory University. In Washington D.C., which has the nation’s highest rate of HIV, the Whitman-Walker clinic had to stop its daily walk-in STD tests, which included HIV.