Plain Talk

COVID‑19:  Where’s the Risk?
From The Buxton Co

The COVID‑19 pandemic hit the U.S. hard and fast, leaving organizations in all industries scrambling to assess the risk and take appropriate steps to ensure the safety of their employees and customers.

At Buxton, we’re committed to providing clarity on critical business decisions. Because of our commitment, we immediately took action to develop a COVID‑19 vulnerability assessment for every ZIP code in the United States. This information can be used to help determine areas where additional healthcare surge capacity may be needed, where businesses not faced with mandatory closures may consider voluntary closures, and where government and other organizations may consider concentrating preventative efforts.

In this blog post, we’ll summarize the methodology used in our calculations and share insights on geographic trends observed in the data.

Calculating COVID‑19 Risk: Our Methodology

Buxton classified all U.S. ZIP codes into one of five categories (quintiles) based on level of risk.

1. Lowest Risk (bottom 20% of ZIP codes)



2. Below Average Risk



3. Average Risk



4. Above Average Risk



5. Highest Risk (top 20% of ZIP codes)

The formula we used to calculate each ZIP code’s level of risk is as follows:

(Equally Weighted Average of the calculated heart disease (demand per capita age 65+), diabetes (demand per capita age 65+), lung disease (demand per capita age 65+), and uninsured risk (demand per capita age 65+)) x Percentage of Population Age 65+ = Risk Score

It’s important to note that our calculations should be interpreted as a measure of vulnerability to serious complications or death resulting from the virus, rather than a measurement of overall risk of infection. This highlights the areas where the impact of the virus is likely to be most severe. Additionally, the risk factors noted in the formula risk were indexed against national averages.

COVID‑19 Risk: Are Urban Areas at Higher Risk?

With news headlines focused on many of the major metro areas, it may be tempting to assume that urban areas are inherently more vulnerable. But is that really the case?

Our calculations show that 14.5% of the total U.S. population resides in ZIP codes classified as highest risk. But if we view those results filtered by urban density, 15.7% of the rural population resides in highest risk ZIP codes compared to only 9.6% of the urban population. In other words, rural area populations have higher concentrations of highest risk people and urban area populations have lower concentrations of highest risk people.

This same pattern is observed when we apply an additional filter: age.

According to the data, 21.9% of the total population age 65+ in the U.S. resides in highest risk ZIP codes. When we view those results filtered by urban density, 22.8% of the rural population age 65+ resides in highest risk ZIP codes compared to only 15.8% of the urban population age 65+. Again, rural area populations age 65+ have higher concentrations of highest risk people and urban area populations age 65+ have lower concentrations of highest risk people. This may be driven in part due to less access to medical care in rural communities.

COVID‑19 Risk: Are Certain Regions at Higher Risk?

Next, we examined the data to see if there are any regions that have higher concentrations of high-risk areas. We split the results by U.S. census divisions. The following patterns stood out:

• The West South Central (WSC) census division – home of Arkansas, Louisiana, Oklahoma, and Texas – has 12.3% of total U.S. population but is where only 4.7% of the population living in highest risk ZIP codes resides. This area has fewer high-risk ZIP codes than we would expect.



• The West Mountain (WM) census division is another area of relatively low risk. Our methodology ensured that each risk classification level includes 20% of U.S. ZIP codes, but 38% of WM census division ZIP codes fall into the lowest risk category.



• The New England (NE) census division, on the other hand, has 4.5% of the total U.S. population but is where 11.9.% of the population living in highest risk ZIP codes resides. Stated another way, 20% of all ZIP codes fall into each category of risk, but 49% of ZIP codes in the NE census division are classified as highest risk.



• The South Atlantic (SA) census division is also a higher risk geographic area with 19.8% of the total U.S. population living in this division. It is also where 29.0% of the population living in highest risk ZIP codes resides.

COVID‑19 Risk: Which States Have the Highest and Lowest Risk?

Some states face a higher percentage of the population living in high-risk areas than others. We calculated the concentration of population in highest and lowest risk ZIP codes by state.

While 26.6% of the total U.S. population resides in one of the lowest risk ZIP codes (category 1 in Buxton’s rankings), these top 10 states have even higher concentrations of their population in category 1 areas.

With nearly 91% of its population in a lowest risk ZIP code, Alaska tops the list for the lowest level of risk. Many of the states in the top 10 are in the West or Midwest regions of the United States. Interestingly, despite its large urban centers, Texas ranks #5 for low risk.

On the other hand, 14.5% of the total U.S. population resides in one of the highest risk ZIP codes (category 5 in Buxton’s rankings). These are the top 10 states that exceed that threshold.

Maine tops the list with nearly 72% of its population in a highest risk ZIP code. Other New England states also rank high on the list, confirming the patterns observed at the census division level.

The Bottom Line

The COVID‑19 pandemic may be changing life and business as we know it, but together we can make a difference.

Understanding the risks in your markets empowers you to make better decisions. If your organization needs help answering questions during this crisis or throughout the recovery, we can help. Reach out to us today to start the conversation.

Buxton is the leading customer analytics firm that helps organizations identify who their customers are, where those customers are located, and the value those customers have to the organization.

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