World Mayor 2023

The strengths and weaknesses
of US cities during a pandemic




ON THIS PAGE: Large American cities most vulnerable to CoronaVirus ||| CoronaVirus ranking ||| Health vulnerability ||| Financial vulnerability ||| Economic vulnerability ||| Social vulnerability ||| Sources and Research author |||



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Coronavirus American citiesLarge American cities most
vulnerable to CoronaVirus
April 2020: New York City, San Francisco, Washington DC, Detroit and Miami have been named as the five American cities most vulnerable to a virus epidemic such as the current CoronaVirus (COVID-19) outbreak. New research examined the vulnerability of more than 100 cities based on their economic, financial, social and health strengths. According to the report, larger cities, due to their high population density, global connections and extensive use of public transport, are most exposed to the effects of a pandemic such as COVID-19. For example, 61 per cent of New Yorkers commute using public transport, while virtually every resident in Amarillo (TX), the third-least vulnerable city in the survey, uses private transport.

Potentially, many of America’s most prosperous cities face significant disruptions during an epidemic, which affects large numbers of residents and hinders the normal flow of business. The research, which was conceived and carried out by Clever under the supervision of Francesca Ortegren, shows that eight of the top-ten most vulnerable communities are large cities. New York City, where 61 per cent of commuters travel by public transport, has only three acute hospital beds per 1,000 people. And with almost 11,000 residents per sqkm, the city also suffers from the highest urban population density in the US. The statistics for San Francisco, which is ranked second in the national vulnerability table, show how bad the New York's situation really is. In San Francisco only a third of commuters travel by public transport (NYC 61%), the population density is just under 7,000 people per sqkm (NYC 11,000) and the city has more than five acute hospital beds per 1,000 residents (NYC 3).

Financially, Miami is the most vulnerable US city to a virus epidemic. There, a staggering 30 per cent of the residents have no health insurance, while a third of the city population live in poverty. According to the research, economically, Washington DC is the most vulnerable US city. The city’s debt stands at more than US$8,100 per resident and, a fact that counts against the city, more than three quarters of workers are employed by small companies.

The research also devotes a chapter to social cohesion and placed particular importance to the willingness of residents to participate in activities for ‘the greater good’. According to the survey, in Elizabeth, New Jersey, only seven per cent of residents are civic minded, while in New York, which is placed seventh in this section, almost 40 per cent of citizens indicated a willingness to place the good of the community before any self-interest.


CoronaVirus ranking: Vulnerability of large US cites
(107 US cities were reviewed)
Overall vulnerability
Rank
City
Health vulnerability
Rank
Economic vulnerability
Rank
Financial vulnerability
Rank
Social vulnerability
Rank
1
New York City (NY)
1
6
44
6
2
San Francisco (CA)
2
2
107
88
3
Washington (DC)
4
1
97
46
4
Detroit (MI)
25
11
2
49
5
Miami (FL)
10
86
1
11
6
Philadelphia (PA)
3
55
12
50
7
Los Angeles (CA)
5
65
26
8
11
Denver (CO)
32
3
83
44
12
Baltimore (MD)
17
36
37
23
13
Atlanta (GA)
38
16
42
28
20
Jacksonville (FL)
66
9
46
72
21
Indianapolis (IN)
72
13
38
45
22
Memphis (TN)
74
34
8
77
29
Las Vegas (NV)
19
79
48
26
35
Houston (TX)
62
39
32
64
45
Albuquerque (NM)
27
72
56
56
46
Sacramento (CA)
26
90
50
34
48
Omaha (NE)
67
24
82
32
51
Tulsa (OK)
83
32
59
41
53
San Antonio (TX)
54
61
61
20
59
Seattle (WA)
18
8
106
101
67
Oklahoma City (OK)
87
42
60
43
74
Fort Worth (TX)
69
76
52
52
75
Austin (TX)
68
40
81
79
78
San Diego (CA)
21
74
89
92
79
San Jose (CA)
13
18
90
107
96
Virginia Beach (VA)
51
82
100
22
103
Raleigh (NC)
80
57
87
104
Data: 'Clever research'


Health vulnerability:
The ten most vulnerable US cities

Health vulnerability factors include those that increase the rate of viral transmission, the availability of treatment and the percentage of high-risk citizens.

Research principal Francesca Ortegren says: “We included the percentage of the population who commute via public transport and population density and proportion of the population living in overcrowded housing (i.e. more than 1.5 people per bedroom on average) in each city as measures of rapid spreading. The factors indicate that people are likely to be in close proximity to others and, therefore, are more likely to come into contact with or pass along COVID-19. The availability of treatment was defined as the number of acute care hospital beds available per 1,000 residents. The more beds available per person, the better chance people have at treatment and isolation once they're sick. We also included the percentage of the population who is 65 years old or older and living alone as an indication of accessibility of care. COVID-19 disproportionately impacts older adults, leaving people over 65 more vulnerable.”

Rank
City
Commute by pubic transport
Population density per sqkm
Acute hospital beds (per 1,000 people)
Over 65s living alone
1
New York, NY
61%
10,981
3.0
11%
2
San Francisco, CA
33%
6,955
5.1
10%
3
Philadelphia, PA
26%
4,310
4.8
12%
4
Washington, DC
35%
4,060
6.3
10%
5
Los Angeles, CA
6%
3,196
2.7
8%
6
Laredo, TX
2%
1,036
2.2
6%
7
Alexandria, VA
19%
3,820
2.1
8%
8
Santa Rosa, CA
2%
1,618
3.0
13%
9
Salinas, CA
1%
2,608
2.8
6%
10
Miami, FL
4%
4,307
7.6
12%


Financial vulnerability:
The ten most vulnerable US cities

Financial vulnerability factors include the lack of health insurance, poverty, employment status and proportion of residents spending more than half of their income on rent.

Research principal Francesca Ortegren says: “People's ability to afford care and participate in social distancing are directly tied to their financial stability and characteristics of their employment. Importantly, people who are not employed don't have health insurance, or spend over 50 per cent of their income on rent may not be able to afford hospitalisation or care if they become infected, increasing the likelihood that the virus will spread.”

Rank
City
Population without health insurance
Living in poverty
Non- and unemployed rate
More than half of income spent on rent
1
Miami, FL
30%
33%
18%
35%
2
Detroit, MI
17%
43%
24%
37%
3
Laredo, TX
32%
31%
12%
26%
4
Cleveland, OH
14%
36%
18%
30%
5
Dayton, OH
14%
31%
17%
31%
6
Stockton, CA
15%
20%
26%
33%
7
Elizabeth, NJ
27%
19%
18%
28%
8
Memphis, TN
18%
26%
16%
29%
9
Jackson, MS
17%
25%
15%
31%
10
Syracuse, NY
10%
32%
13%
33%


Economic vulnerability
The ten most vulnerable US cities

Economic factors include city debt and workers relying on small-scale employers.

Research principal Francesca Ortegren says: A city's economic vulnerability to widespread, potentially fatal disease has to do with possible long-term effects on the local economy as a direct result of a recession or measures taken to flatten the curve.”

Rank
City
City debt
per resident
Employed by
small companies
1
Washington, DC
$8,139
76%
2
San Francisco, CA
$8,500
74%
3
Denver, CO
$8,488
63%
4
St. Louis, MO
$4,580
67%
5
Westminster, CO
$1,603
67%
6
New York, NY
$8,346
51%
7
Cleveland, OH
$6,978
53%
8
Seattle, WA
$5,030
56%
9
Jacksonville, FL
$8,694
48%
10
Sioux Falls, SD
$490
64%


Social vulnerability
The ten most vulnerable US cities

Social factors include civic engagement and the ability to innovate.

Research principal Francesca Ortegren says: “We measured people's willingness to participate in activities for the “greater good” to indicate the likelihood that people in a certain city will cooperate with recommendations that reduce the spread of the virus. We also included innovation capabilities (as measured by the number of patents per capita) to estimate the ability for a community to quickly and efficiently help restore the economy.

Rank
City
Civic engagement
Innovation
(Patents per capita)
1
Elizabeth, NJ
7.5%
47.7
2
Laredo, TX
31.0%
1.5
3
Norfolk, VA
37.7%
6.1
4
Salinas, CA
36.6%
17.3
5
El Paso, TX
39.4%
4.1
6
New York, NY
39.7%
10.7
7
Anchorage, AK
41.2%
6.7
8
Los Angeles, CA
37.2%
36.1
9
Savannah, GA
42.3%
10.0
10
Corpus Christi, TX
45.1%
7.4


Sources and author
Sources: Robert Graham Centre - Social Deprivation Index (SDI); University of Notre Dame – Urban Adaption Assessment; Integrity Data; US Census Bureau – Annual community Survey and annual economic surveys.

About Francesca Ortegren, research principal at Clever Real Estate: Francesca earned her PhD in Cognitive Psychology from Texas Tech University, conducted behavioural research on memory, learning, and teaching and taught college-level research methods and statistics courses.