RALEIGH — In some ways, the daily routine at Crystal Jones’ house in southeast Raleigh isn’t so unlike what it was a year ago.
By the time the sun rises, her husband has already left for his job as a welder. Later in the day, her daughter drives to Garner for her shift as a cashier at a soul food restaurant. Her son heads to Food Lion to stock the shelves, and on weekends joins his sister for the afternoon shift at the same restaurant.
On most days, traffic slows their commute as crowded buses make their halting trips down Rock Quarry Road.
“At the beginning (of the pandemic) the traffic kind of slowed, I didn’t see as many cars go by,” said Jones, who now does her job managing retirement accounts at a bank from home. “But maybe after that first month or whatever you saw that traffic in the neighborhood still moving — because everybody still had to go to work.”
It was sometime in late July, Jones suspects, that someone in the family brought COVID-19 home with them. It could have been her husband. There have been outbreaks at the manufacturing plant where he works. But it could just as easily have been her daughter, who is face to face with customers all day. Or her son, who works in crowded grocery store aisles.
Her daughter and husband tested positive, too, but Jones, who has sickle-cell anemia, was hit much harder by the virus.
“At one point it got kind of scary for me, but I didn’t want to let (my family) know that I was scared,” she said. “I did not have to go to the hospital, but it got really close.”
For weeks, she could barely get out of bed, forcing her to take a leave of absence from her job.
Jones is one of over 7,000 people who have contracted COVID-19 in her ZIP code — 27610 — which has had more cases than any other ZIP code in the state.
As the pandemic spread, Jones and her neighbors found themselves at the center of a storm of risk factors for contracting and becoming seriously ill from COVID-19. In Jones’ ZIP code, 15% are uninsured, according to U.S. Census estimates, nearly double the countywide rate.
Nearly half are low income, with many working low wage, front-line jobs.
And 5% of households are overcrowded, with more than one person per room compared with about 2.3% of households statewide.
It took three months for Jones to finally feel well enough to get back to work. But then in January, she developed cold-like symptoms. She tested positive again. She couldn’t believe it. Throughout the pandemic, she’d only left the house for occasional errands. For months, her husband and kids had immediately thrown their clothes into the laundry and gotten into the shower after work. On Sundays, instead of making their usual drive down Rock Quarry Road to Macedonia New Life Church, they’d crowded around their computer to watch the live-streamed service.
But with her family having no choice but to continue going to work, the biggest risks remained beyond their control.
“It’s fairly impossible to have a tight, close-knit pod for your family when you have essential workers in your household,” said Keisha Bentley-Edwards, a professor of medicine at Duke University. She says that as the pandemic has worn on, the multiple risks associated with low-wage work have become clear for families that it “wreaks havoc on their home life but also on their health.”
Like many ZIP codes across the country that share this litany of what public health experts call “social determinants of health,” 27610 is majority Black: 64% according to 2019 census estimates.
“They have not stopped going and going. It’s like, you don’t work, you don’t pay bills,” Jones said.
The same is true for many of her neighbors, whom Jones sees embark on their regular commute every day. Adding to the risk, she guesses that many essential workers in her area go to work even if they’re sick.
“They can’t afford to be off for 10 to 14 days,” she said, “so they may be going in hoping that it’s not that.”
As the first cases of COVID-19 appeared in 27610, the Rev. Dr. Joe Stevenson kept doing what he’s done for 15 years as pastor at Macedonia New Life Church: identify the gaps in government services where people in his community fall through and try to patch them up.
For years, the church had already served dozens of families at monthly food distributions. With the pandemic, Stevenson’s job became figuring out how to serve as many people as possible as demand skyrocketed and donations fell, and managing COVID-19 testing at the church, where Jones had received her two positive tests.
The stark impact of the pandemic on 27610 is devastating, Stevenson said, but — given the preexisting hardship — not surprising.
The economic struggles that have led many members of the church and their family to continue working high-risk jobs, often without health care, also force them to live in high-risk housing situations.
“Because of the disparities, people are living together, perhaps one, two, three generations deep,” Stevenson said. “Nothing threatens or challenges the health and well-being of any particular people worse than economic disparity.”
County public health officials were also quick to identify the compounding risk factors in the area. They targeted the area for testing sites and in the last couple of months for vaccination sites.
But to community leaders like Stevenson, such initiatives seem to address the symptom, rather than the root cause.
“It’s difficult to catch up with anything with a reactive paradigm,” he said. “You already know that there’s a health disparity in our community. You already know that there’s economic disparity. You already know that people are going hungry ... So fix the issues now. Because it’s not a matter of if there’s another pandemic, it’s a matter of when.”