These 5 underlying conditions are the most frequent in Alabamians who died of COVID-19

This story was last updated on May 4, 2020. 

Since Gov. Kay Ivey announced Alabama would begin testing people for COVID-19 on March 5, more than 101,000 tests have been administered and more than 7,800 cases have been confirmed positive.

About 1,050 people have been hospitalized due to the coronavirus pandemic and almost 300 or about 4% have died.

On Tuesday, April 21, a little more than two weeks after Ivey issued a statewide stay-at-home order, the governor said she had no plans to yet reopen “non-essential” businesses or lift the decree, which remains in effect until the April 30, because authorities simply haven’t conducted enough tests.  

Alabama Department of Public Health data captured through the morning of April 21 shows the state has administered 959 tests per 100,000 people — less than 1% of the population. In the Black Belt region those numbers drop by about 6% to 902 tests per 100,000. And in Wiregrass counties by almost 30%, at a rate of 675 tests.  

More:Gov. Kay Ivey sticks with stay-at-home orders for now, no call for reopening businesses

Ivey’s stance now falls in line with public health officials who have cautioned leaders against making hasty decisions fueled by economic woes, suggesting instead a measured approach only after widespread testing has been completed. It's a warning that has sparked protests in a handful of states and even emboldened some in Montgomery to ignore physical distancing guidelines, gathering at the Capitol to call on the governor to "open Alabama."

But just as in many other states, a lack of testing among the asymptomatic who show no indicators of the virus, leaves the frightening possibility of a spark in new cluster outbreaks should social restrictions be eased.  

Most believe that Alabama needs more widespread testing and that certain barriers must be considered, such as geography, finances and access to transportation that could decrease the likelihood that those who need to get tested do so. But doctors say it also means more targeted testing and messaging among populations that have been identified as particularly at-risk: seniors, African Americans and those with underlying medical conditions.  

Though data varies state by state, some trends have emerged that show people suffering from specific illnesses are more likely to die from the virus. These are the most frequent underlying medical conditions found in patients who died of COVID-19 in Alabama.  

More:Alabama data shows majority of coronavirus deaths are African Americans

1. Cardiovascular disease 

About 59% of people who have died from COVID-19 in Alabama had heart disease. It’s the leading cause of death in the state, killing more than 12,000 people each year. While 38% of Alabamians have been diagnosed with high cholesterol, many go undiagnosed or are diagnosed only when they begin to have serious health complications due to a lack of screening or access to health services. Risk of developing the disease increases significantly with age and African Americans are much more likely to have it and to die of disease-related strokes.  

2. Diabetes  

ADPH data shows 38% of COVID-19 patients who died had some form of diabetes. In 2015, Alabama had the fourth highest rate of diabetes in the country. More than 14% of the state’s adults are living with diabetes and according to the state’s health department black Alabamians are significantly more likely to have the disease and die of it — at two times the rate of white Alabamians with diabetes. Risk increases dramatically with age and rural residents are particularly afflicted. Those with diabetes often suffer from other medical issues such as heart disease, stroke and kidney failure. 

3. Chronic Lung Disease 

About 25% of those who died from COVID-19 in Alabama were found to have a chronic lung disease. These are disorders that affect the lungs and other parts of the respiratory system, usually developing slowly and worsening over time. Types of chronic lung disease include asthma, chronic obstructive pulmonary disease and pulmonary fibrosis, among others. A 2015 behavioral risk factor analysis published by the ADPH showed that Alabamians who reported a household income under $15,000 and had less than a high school education were more likely to be diagnosed with COPD, emphysema or chronic bronchitis.  

4. Kidney Disease 

Alabama’s health data shows that about 23% of deceased patients who tested positive for COVID-19 had chronic kidney disease. About 400,000 Alabamians or 1 in 11 have the disease, and in 2017 the state ranked 12th in the country for kidney disease related deaths. The Alabama Kidney Foundation estimates that almost 12,000 people are currently on dialysis, though most people with kidney damage or reduced function are completely unaware. According to the National Kidney Foundation, Black Americans suffer from kidney failure at three times the rate of white Americans and represent 35% of all patients receiving dialysis due to the condition.  

5. Comorbidities 

People suffering from two or more overlapping diseases at once are at an extreme risk to COVID-19, representing almost 53% of confirmed deaths in the state. Many of the diseases listed above go hand in hand. High blood pressure contributes to heart disease as well as increasing a person’s risk of developing chronic kidney disease, which those who have diabetes are also more likely to develop. 

Social determinants of health — where people live and work, what kind of food they have access to or can afford — also play a large role in the development of these diseases. Those who earn lower incomes, have less education and live in rural areas are statistically more likely to be affected, which means these groups need to have a heightened awareness about their health status and do their best to take preventative measures, while officials must develop targeted responses to account for these unique vulnerabilities. 

Contact Montgomery Advertiser reporter Safiya Charles at (334) 240-0121 or SCharles@gannett.com