Updated 4 weeks ago
Since levels of testing have varied so widely from county to county in Florida, the number of “confirmed cases” in a county may reflect how well a county tests rather than the actual incidence of COVID-19 in the population. In addition, there is no way to count those who’ve been exposed to the disease but are asymptomatic — some estimates reckon that 10 times as many people have actually been exposed to the disease as have tested positive.
The most reliable statistic for the pandemic’s impact on a given county is its mortality rate — the number of deaths compared to the county’s population.
In Florida, COVID-19 death rates per 100,000 population don’t mirror a county’s population. While the state’s largest county, Miami-Dade, with more than 2.7 million people, has the highest COVID-19-related death rate among the state’s largest counties, the third-highest death rate was in Polk County, which ranks ninth among Florida counties in population. Orange County, the state’s fifth-largest county by population, ranks 10th in death rate among the state’s largest counties.
The explanation? The biggest factor by far in a county’s death rate, says Dr. Jason Salemi, an associate professor of epidemiology at the University of South Florida, has to do with its demographic makeup — specifically, the age distribution of the county’s population. Deaths from COVID-19 are concentrated among the portion of the population that’s older than 65. Among the state’s larger counties, the populations of Orange and Duval, for example, are younger overall than that of Pinellas. The higher the percentage of elderly residents, the higher the death rate from COVID-19 tends to be, Salemi says. “Age is by far the biggest factor.”
Adjusting the death rate figures for age produces different results. Sarasota County, for example, has a rate of around 137 COVID-19 deaths per 100,000 population, compared to 98 in Orange County. Factor in how many people over 65 live in the two counties, and the picture changes dramatically, Salemi points out — Sarasota’s death rate per 100,000 population falls to around 88, while Orlando’s ageadjusted rate rises to 126.
Other considerations — though much less important statistically — can include the general health of a county’s population, population density, household size and the presence of prisons. Some small counties in Florida with extremely high COVID-19 death rates (see chart) house large correctional institutions, where the pandemic has spread rapidly. A relatively small number of deaths at a correctional facility or nursing home in a lightly populated county can inflate the county’s death rate.
- 83%— Percentage of total COVID-19 deaths accounted for by people older than 65
- 35%— Percentage of total COVID-19 deaths accounted for by residents and staff of long-term care facilities
Toll on Small Counties
Some of the state’s smallest counties — both geographically and by population — have had among the highest death rates. In most cases, due to the county’s small population, a COVID-19 outbreak in a prison or nursing home that produced a relatively small number of fatalities could skew the county’s overall death rate.
- Among all counties nationally, Miami-Dade County ranked seventh in the number of COVID-19 related deaths. Miami-Dade was the only county in Florida to rank among the top 20 counties nationally in number of deaths.
- Broward County, with more than 194,000 confirmed cases, ranked 16th among all counties nationally in the number of confirmed cases.
Read more in Florida Trend's April issue.
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