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Atealla Betancourt speaks with a doctor before getting tested for the coronavirus disease (COVID-19) during its outbreak, in Austin, Texas, U.S., June 28, 2020. REUTERS/Sergio Flores
The Avenue

A roaring Sun Belt surge has inverted the demographics and politics of COVID-19

Editor's Note:

This is an updated version of a post published on June 19, which adds new data for COVID-19 cases through June 28.

Only a few weeks after all 50 states began to reopen from their public health lockdowns, some are taking a second look. A new wave of COVID-19 cases is hitting parts of the nation’s Sun Belt, which had not felt much impact during the pandemic’s early months. Between Memorial Day and the end of June, the Sun Belt surge has led to new rates of high COVID-19 prevalence in many smaller-sized rural counties that are less racially diverse, have more middle-income residents, and lean Republican.

This analysis extends our monitoring of the spread of counties with a high COVID-19 prevalence from April and May. Even more so than in earlier reports, the new surge is hitting parts of the country that national and local leaders thought to be immune to the pandemic just one month ago.

Cases increase in smaller-sized Sun Belt areas

While COVID-19 cases have declined in some parts of the country, they have recently increased sharply in the South and West’s “Sun Belt” region. For the five weeks between Memorial Day (May 25) and June 28, 27 states showed an increase in COVID-19 cases compared to the five previous weeks. Twenty-four of these states are in the Sun Belt, with the greatest increases in Florida, Texas, California, Arizona, North Carolina, and South Carolina. States showing the greatest declines in new cases include the earlier hotspots of New York, New Jersey, Illinois, and Massachusetts.

A notable aspect of the Sun Belt surge is its dispersion into outer suburban, smaller, and nonmetropolitan counties. Figure 1 depicts the contrast in regional shifts over the six-week period between May 17—the week before Memorial Day—and June 28 for new COVID-19 cases per 100,000 population.

Fig1

Not surprisingly, the smaller gains in urban core areas are most represented in Northeast and Midwest counties, along with mixed levels of gains for mature “inner” suburbs, outer suburbs, and small and nonmetropolitan areas.

Sharply countering this pattern is the uptick in COVID-19 cases among counties of all urban categories in the South and West, especially during the last two weeks of June. Over these two weeks, the urban core and inner suburban counties of Houston, Dallas, San Antonio, Phoenix, as well as Orlando, Tampa, and Jacksonville, Fla. registered sizable gains.

A more significant feature of the Sun Belt surge, however, is the increase in COVID-19 cases in outer suburban and smaller-sized counties. Among the 905 counties where cases of COVID-19 increased by more than 100 per 100,000 residents during the June 14 to June 28 period, nearly four out of five are in the Sun Belt—the vast majority of which (650 counties) lie outside urban cores and inner suburbs. Large numbers of the latter counties are in Texas.

A demographic U-turn

This new surge of COVID-19 cases is also noteworthy because of the demographic attributes of residents in newly impacted counties, which are much different than those of earlier months. To examine this shift, we extend our earlier analysis to compare counties which first reached high COVID-19 prevalence between May 25 and June 28 with those that reached high prevalence in April and early May. (We define “high prevalence” as at least 100 cases per 100,000 population, based on case data reported by The New York Times and 2019 population data reported by the U.S. Census Bureau.)

Table1

On March 29, 59 counties—constituting just 8% of the U.S. population—had reached high-prevalence status. These were heavily concentrated in select large metropolitan regions, including New York, Detroit, Seattle, and New Orleans.

During the four-week period between March 29 and April 26, new high-prevalence counties spread further across the country, eventually housing 57% of the population. These included an array of metropolitan areas such as Chicago, Atlanta, Miami, San Francisco, Los Angeles, and Washington, D.C., but also large swaths of counties in the Deep South and Midwest.

The four-week period between April 27 and May 24 saw greater COVID-19 spread into the South and West, dipping into some smaller areas in all regions and extending into Texas, Virginia, and other parts of the interior South. By then, 83% of the nation resided in the nearly 1,700 high-prevalence counties.

Fig2

Table2

The most recent five-week period between May 25 and June 28 saw 732 counties reach high-prevalence status. As noted earlier, they represent a new surge into the South and West, with 474 counties located in those regions and large representations in Texas (105 counties), Kentucky (44), and Tennessee (38). While some of these counties in the West are located in and around larger metro areas such as Sacramento, Calif., Portland, Ore., and Ogden, Utah, the vast majority of newly identified high-prevalence counties lie within smaller areas.

The contrast in demographic profiles between these new high-prevalence counties and those from late March and early April is striking. As Figure 2 indicates, less than 2% of new high-prevalence county residents live in urban core areas, with more than three-fifths in small or nonmetropolitan areas. This differs sharply from the heavily urbanized picture of COVID-19’s impact as of March 29, when four-fifths of the affected population lived in urban cores. Similarly, the newly designated high-prevalence counties are more heavily located in the South and West (77%) than earlier groups of counties.

The contrast is also apparent when looking at counties’ race-ethnicity attributes, foreign-born residents, and household income rates. In high-prevalence counties from the end of March, more than half of residents identified with a racial or ethnic group other than white. Newly designated high-prevalence counties, however, are more than 70% white. Similarly, the new counties show the lowest representation of foreign-born residents (7.3%) and the lowest share of households with incomes above $100,000 (22.3%) out of all the groups of counties previously designated with high COVID-19 prevalence.

From ‘blue’ America to ‘red’

Perhaps the most pronounced difference between the early high-prevalence counties and those reaching high prevalence between May 25 and June 28 is their political orientation. Early high-prevalence counties were strongly Democratic in terms of how their residents voted in the 2016 presidential election, with Hillary Clinton besting Donald Trump by a margin 62 to 34 in those areas (See Figure 2). But among voters in new high-prevalence counties, Trump bested Clinton by a margin of 59 to 35.

One can see COVID-19’s spread to “red America” in the counties that reached high prevalence between April and early May. Among voters in counties designated with high prevalence between March 30 and April 26, Clinton’s lead was reduced to a margin of 53 to 41. Among those in counties designated between April 27 and May 24, Trump took a 50 to 44 lead. This change coincides with shifts of high COVID-19 prevalence to “redder” states and smaller, more Republican-leaning counties within those states.

Table3

When looking at the number of counties designated with high prevalence, Table 3 makes plain that the ratio of Trump counties to Clinton counties increases with each period. In general, Trump counties tend to be smaller, so for each period since late March (even including the March 30 to April 26 period, when Clinton was still besting Trump in the voter margin) there were more Trump counties than Clinton ones among those newly designated with high COVID-19 prevalence.

That ratio increased over time, and among the newest tranche of 732 high-prevalence counties from May 25 to June 28, Trump won all but 56. Over half of these Trump counties are located in the South, with large representations in Texas, Virginia, North Carolina, and Tennessee. Over a third are in the Midwest, with many in Iowa, Kansas, Minnesota, and South Dakota. COVID-19’s spread to more Republican counties should change early assumptions that the pandemic has been confined to largely Democratic states and areas.

COVID-19’s June surge to new areas of the Sun Belt casts a light on where and who the pandemic will impact in the months ahead. The reopenings in many states and communities thought to have overcome exposure are now being reversed. In addition, the early politicization of the pandemic by the president and other public officials (which suggested that “red” parts of America need not be concerned with excessive protections) is looking like bad advice—and could become political fodder for their electoral opponents in November, should the virus continue to spread.

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