RALEIGH, N.C. (WNCN) — Rural counties in North Carolina averaged over 100 more per capita cases of COVID-19 over the past two weeks than urban or suburban ones, a CBS17.com data analysis found.
The state’s 82 rural counties averaged 343 cases per 100,000 people, compared to 283 cases for the 12 suburban counties and 226 for the six urban ones.
CBS17.com compared the North Carolina Department of Health and Human Services’ breakdown by county of case counts for the past 14 days to the Rural Center’s classification of the state’s 100 counties.
That timeframe is significant because the state’s seven-day rolling average of daily new cases increased by 15 percent from Oct. 15 to Wednesday, when it reached an all-time high of 2,221.
“I think it is making sure that we know that this virus is not just something that is happening in our urban areas of the state,” DHHS Secretary Dr. Mandy Cohen said. “It is happening in our rural communities.”
The rural county with the most cases during that time period (Greene County, with 821) has three times as many cases as the urban county with the most cases (Forsyth, 267) and almost twice as many as the suburban county with the most (Gaston, 510).
The Rural Center defines a county as rural if its average population density is at or below 250 people per square mile. The 12 regional city and suburban counties have population densities between 250 and 750 people per square mile, while that figure exceeds 750 for the six urban counties.
Both Gov. Roy Cooper and Cohen brought up the increase in cases in the state’s rural communities as a cause for concern Wednesday during a COVID-19 task force media briefing, with the governor saying hospitals in those areas are “a little bit thinner and more difficult for them to be able to accept a lot of patients.”
While those rural counties account for just under half the state’s population of 10.6 million, hospitals in those counties have just 38 percent of the total general beds in the state. Seventeen rural counties don’t have a hospital while only six counties have two of them.
Guidance from the Centers for Disease Control and Prevention point to “long-standing systemic health and social inequities” that have put rural residents at “increased risk” of a COVID-19 infection, with higher rates of other health problems — high blood pressure and obesity, for example — and are less likely to have health insurance.
“We do know that older populations face a higher risk of hospitalization and symptoms from COVID,” said Debbie Lai of Covid Act Now, a group that tracks and analyzes coronavirus-related data.
There could also be a political component at play, with mask-wearing and other social distancing measures at times being viewed as partisan acts. Lt. Gov. Dan Forest, the Republican candidate for governor, has expressed doubt about the effectiveness of masks.
“A mask is not political,” Cooper said. “It’s patriotic.”
The data analysis found that of the 50 counties with the most cases over the past two weeks, 44 were carried by Republican Donald Trump in the 2016 presidential election to just six for Democratic nominee Hillary Clinton.
At the other end, 18 of the 50 counties with the fewest cases during that time period were blue four years ago and 32 were red.
In 2016, Trump won 76 of the state’s 100 counties to 24 for Clinton.
Another litmus test — the general election — is coming next week.
“Once we get past this election, that can help us,” Cooper said. “We’ll find people not using the political excuse but be willing to follow the science to slow the spread.”