COVID-19’s Community Impacts: The Human Development Lens
Human Development measures the ability of human populations to lead long, healthy, and fulfilled lives. A quantitative analysis reveals that the COVID-19 pandemic has had a greater impact on local communities with lower Human Development Index.
Epidemic outbreaks are deep probes of the social and economic networks that make up human societies. Unlike almost any other event, they reveal in a flash the connections between us that are often unseen or taken for granted. Outbreaks test the resilience of individuals and communities, and expose fissures and inequalities between people who are part of the same nations, cities, and neighborhoods.
Over the last few months, the COVID-19 pandemic has affected millions of communities across the world. As the situation continues to develop, it is becoming clear that some communities have greater resources and capabilities to combat the epidemic, while others are more vulnerable and less resilient.
These observed differences are often found to be statistically associated with a community’s economic status or its race and ethnicity demographics. We think that these associations are superficial and often tragically misleading.
There is a better indicator of resilience or vulnerability that speaks much more fundamentally to the process and measurement of human development. This shift in perspective connects today’s crisis in each local community with the nature of human development everywhere. It also points to very different solutions that are more systemic and enduring, but are also equally easy to measure, if we choose to.
The Origins of Measuring Human Development
Human Development is a compelling but elusive term. Its meaning must be approached in spirit, and its measurement must be performed with care and attention. Nevertheless, its main contours are well known; quantitative indicators of human development are also well-tested enough that a lot can be said and brought to bear in the current situation.
The main idea behind measuring human development is the concept of capabilities, developed by Amartya Sen and Martha Nussbaum. This refers to our ability to judge the degree to which a society enables its people to lead fulfilled and meaningful lives while recognizing individual differences in preferences, vocations, and needs.
The first thing to know is that measuring human development is different — in spirit and in practice — from measuring economic activity, such as through Gross Domestic Product (GDP). The development of a Human Development Index (HDI) by Pakistani economist Mahbub ul Haq and a team at the UN Development Program (UNDP) had the explicit purpose “to shift the focus of development economics from national income accounting to people-centered policies”.
Since its first uses in the late 1980s, the HDI has become the single most important quantity assessing national development. It is measured annually by UNDP and discussed in context in their Human Development Reports starting in 1990. As a quantity, the Human Development Index is the geometric mean of three components, each measuring the extent to which people live a long and healthy life, their knowledge, and whether they achieve a decent standard of living. These three development dimensions are measured by life expectancy, educational attainment, and Gross National Income (GNI), adjusted for cost of living. Higher HDI values indicate higher levels of development.
The HDI is typically calculated at the national level, to make comparisons between countries. At this level, nations in Western Europe and developed countries in Asia take the top spots today, with the U.S. ranking 15th in the 2018 edition. This is not because the U.S. is not a wealthy nation, but rather due to stark inequalities which relegate much of its populations to lower levels of development associated with relatively mediocre standards of education and health. In this respect, the U.S. (as well as Canada) have been falling down the ranks worldwide as more and more nations find their own faster paths to development.
Criticisms of the HDI are often centered on the issue of inequality, especially tied to the fact that national characterizations of a population hide profound differences at smaller scales.
Localizing the Human Development Index to the Neighborhood Level
To address this problem head on and to better appreciate the effects of inequality, we have decided to calculate the Human Development Index across scales. This allows us to assess the levels of human development of nations, states, cities, and even individual neighborhoods consistently. Doing so enables us, for example, to appreciate that many neighborhoods in a great city like New York offer levels of Human Development that exceed even Norway — the most developed nation in the 2018 national HDI rankings — but that others are more like parts of Latin America or Eastern Europe (see Figure 1). Another way to contextualize the same information is in terms of time lags: Neighborhoods with low HDI, such as Hunts Point in NYC or Englewood in Chicago, have levels of development comparable to the U.S. average a generation ago, around 1985. Several decades of progress are missing.
Calculating and mapping the HDI at the ZIP code level for Chicago and NYC reveal wide variations across communities. In Chicago, high HDI ZIP codes are found primarily in the central business district (“The Loop”) and the North Side. Lower HDI values are found on the South and West sides of the city, which have faced economic and demographic decline for at least a generation as well as high levels of violent crime. In New York, the highest HDI ZIP codes are clustered in Lower Manhattan (with the exception of the Lower East Side), whereas low HDI communities are found primarily in the Bronx and parts of Brooklyn.
But what about the impacts of the COVID-19 pandemic? What do they have to do with human development?
COVID-19 and the Human Development Index
Recently, the UNDP released a report titled “COVID-19 and Human Development: Exploring Global Preparedness and Vulnerability”, which showed that countries with low HDI values were more vulnerable to the negative effects of the COVID-19 pandemic.
Is this true at the local level? Has the COVID-19 pandemic affected communities with low HDI more than communities with high HDI values?
Our analysis finds that this is indeed the case.
Using COVID case data from both NYC (reported through April 30th) and Chicago (reported through April 25th), we can see that on average, ZIP codes with lower HDI values have a higher reported COVID case count than those of higher HDI ZIP codes. Overall, the pandemic has had a greater impact on vulnerable communities, such as Norwood in NYC and North Lawndale and West Lawn in Chicago.
Interestingly, there are some communities with low HDI values that do not have a high COVID case count. For example, in Chicago both the Hegewisch and Riverdale communities have relatively low HDI values, yet they also have relatively low numbers of COVID cases. Both communities are located on the far South Side of Chicago, are manufacturing and industrial hubs, and are relatively low-density compared to communities that have a higher number of cases. A similar pattern is found in NYC — Hunt’s Point in the Bronx, which has a low HDI and a relatively low number of COVID cases, is an Industrial Business Zone with a small residential area.
While confirmed cases are a good estimate of the COVID-19 pandemic’s impact on a community, the measure can vary based on testing capabilities. Given current data, a more accurate measure is cumulative COVID-related deaths in a community.
Concerningly, similar to cases, COVID-related deaths are higher on average in low HDI ZIP codes in Chicago. Some low HDI communities, such as South Shore and Auburn Gresham, have relatively high population rates of diabetes and obesity, pre-existing health conditions that can put people at higher risk for severe illness and poor outcomes from COVID-19.
An exception to this trend is the relatively affluent community of Lincoln Park, which also reported a high number of deaths. This is due to a cluster of severe cases at a particular nursing home in the neighborhood. Other high density, high HDI neighborhoods with large elderly populations such as the Near North side didn’t report as many deaths over the same time period — underscoring how nursing homes continue to be high risk areas during the pandemic. According to the Chicago Sun-Times, nursing homes account for 48% of COVID-related deaths in Illinois.
Overall, these figures reveal that the COVID-19 pandemic is not a singular event, and that like any other health challenge, it has a greater impact on communities with low human development and thus lower life expectancy. Both cases and deaths are higher on average in low-value HDI communities, indicating that these communities may have had underlying vulnerabilities to begin with that were exacerbated by the onset of SARS-CoV-2 viral spread.
Responses in times of crisis stress immediate needs related to morbidity and mortality, such as hospital beds and medical equipment. The impacts of the current situation suggest, however, that the best preparation is systemic. It hinges critically on promoting higher levels of local human development before crises hit, so that our resilience in hard times has a solid foundation at all times.
Many nations around the world, regardless of their specific political system or economic model, are building their own fast, successful approaches to the challenges related to human development.
It is surely possible to do the same — or even better — within our great cities.
Suraj (Neil) Sheth is an MD-PhD Candidate at the University of Chicago’s Pritzker School of Medicine in the Interdisciplinary Scientist Training Program. He is also a Doctoral Fellow in Biomedical Informatics, Precision Medicine and Global Health at the Mansueto Institute for Urban Innovation at the University of Chicago. His current research focuses on developing scalable multidimensional indices that can be used to localize the United Nations Sustainable Development Goals, particularly in the arena of global health and precision medicine, with a focus on underserved populations. More information about his work can be found at voices.uchicago.edu/neilsheth, and he can be reached at neilsheth@uchicago.edu.
Luis M. A. Bettencourt is the Inaugural Director of the Mansueto Institute for Urban Innovation and a Professor of Ecology and Evolution and Sociology at the University of Chicago. His work studies cities and processes of urbanization as systemic complex systems, synthesizing classical concepts and developing new ones with empirical evidence from around the world.
