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How we reported on COVID-19 risk in multigenerational households Date: 05/03/21

By April Simpson, Susan Ferriss and Mc Nelly Torre

April Simpson

Susan Ferriss

Mc Nelly Torres

Multigenerational households, which can span grandparents down to grandchildren, are common in communities of color, immigrant communities and low-income families. Millions of people in these households face a higher risk of contracting the coronavirus because they often include not only the elderly but also essential workers who can’t work from home. Once COVID-19 enters a larger household, it routinely and quickly infects everyone in it.

These issues received a lot of attention in the earlier stages of the pandemic last year. Many media outlets published stories about several generations living under the same roof and the potential dangers of contracting the coronavirus. A good number in these homes contain essential workers with jobs that put them at risk of infection. But as the vaccine rollout began, most states didn’t adopt policies that prioritized these households. Our story explored this gap as we analyzed county-by-county data showing that people of color — who are at greater risk of contracting the virus — are more likely to live in the same home with older relatives. This became the foundation of this story. We tried to answer this question: did state officials consider the family structures and population health issues common among people of color?

We began our reporting with Washington state after we learned that it was the first to put multigenerational households near the top of its priority list for COVID-19 vaccinations. We talked to public health officials, advocates and residents to understand the significance of the state’s decision. During our reporting, we learned that other states, including Alaska, had followed Washington’s example. We also reported on various federal committees that influenced the Centers for Disease Control and Prevention’s recommendations as they created and defined vaccine priority groups.

We already knew that people living in multigenerational households were at higher risk of contracting the virus. But we needed data to help us with the story. Pratheek Rebala, a news developer at Public Integrity, began analyzing IPUMS/American Community Survey census data to help us understand how common multigenerational households are across the country. As with many complicated data analyses and stories, we all had to be in agreement — a team of two reporters, two data reporters and an editor — on how to define multigenerational households. For this story, we decided that a multigenerational household had to include at least two generations, such as parents and adult children or grandparents raising grandchildren. Applying this definition, Rebala’s data analysis found that 18% of U.S. households are multigenerational. But because of cultural traditions and financial reasons, the percentages are far higher among people of color: 30% among Latinos, 25% among Asians and 24% among Black families, compared to 15% for non-Latino white households.

This finding was significant because experts have found that virus spread within these households has contributed to COVID-19 racial disparities. Yet states largely prioritized people for vaccinations based on age and occupation. For the most part at the time, states followed CDC guidance to prioritize healthcare workers and residents of long-term care facilities where outbreaks had been so deadly. The CDC then recommended that people ages 75 and up and frontline essential workers should follow as a priority.

But built into the 75-and-up age group is another racial disparity: roughly 80% are white. One major reason: Blacks and Latinos typically die younger than white people because of a disproportionate lack of access to health care. In addition, people of color, but especially Asians and Latinos, often care for their elders at home. While these elders were vulnerable to COVID-19 infection, they were often outside of vaccine priority groups because they often don’t live in long-term care facilities and may have been too young to meet states’ requirements for age eligibility.

Once the vaccine supply increased, some states quickly lowered their age thresholds to 65 and up, a group that accounts for eight out of 10 COVID-19 deaths. But younger people of color still face disproportionate risks when compared with white peers. For example, among people ages 55 to 64, COVID-19 deaths rates among Blacks and Latinos are at least five times higher than for white people.

Rebala’s data analysis found that counties with especially large concentrations of multigenerational households also have been ravaged by COVID-19. With this in mind, we focused our reporting on those counties, such as majority-Latino Imperial County in California, which has a large farmworker population.

Data fellow Taylor Johnston created an interactive map that allows readers to click on any U.S. county to see the proportion of multigenerational households broken down by race. We made the map and its associated data freely available for other publications to pull and use to report local stories.

The South, for example, is home to large proportions of Black multigenerational households. In Bolivar County in the Mississippi Delta, at least 1 in 6 residents have contracted COVID-19. Our data analysis found that 22% of households across races in the county are multigenerational. We used these statistics to ground a local version of the story that the Mississippi Center for Investigative Journalism published online.

Here are three tips for reporters:

  • These are complex issues. Be sure to understand the data and talk to as many people as possible.

  • Define your data at the outset and make sure everyone on your team agrees on the criteria. Multiple variables can change the data and outcomes.

  • Don’t be afraid to go back to health officials and ask the same question again. And again. How health officials design, plan and execute the vaccine rollout is complicated. We need to understand their reasoning and whether their decisions are based on scientific evidence.

April Simpson joined the Center for Public Integrity in October 2020 as a senior reporter covering racial equity. Susan Ferriss, a prize-winning former foreign correspondent, joined the Center in 2011, where she has covered immigration, criminal justice and education. Mc Nelly Torres, an award-winning investigative journalist with more than two decades of experience, joined the center as an editor in January 2021.