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Cornell Program on Applied Demographics

Demographic and Health-Related Vulnerability for NYS Counties

There is substantial variation across New York State’s counties in the vulnerability of their populations to a localized COVID-19 outbreak. The risk factors associated with COVID-related complications and hospitalizations are numerous and include demographic factors like age and living arrangements and the prevalence of underlying health conditions among county residents. These risks do not necessarily accelerate COVID-19 case trajectories, but have the potential to compromise the capacity of local health and social service infrastructures at peak transmission.

Drawing on data from the U.S. Census Bureau and the Expanded Behavioral Risk Factor Surveillance System, Cornell demographers have generated indices of COVID-related vulnerability for each of NYS’s 62 counties. The interactive maps below display our Demographic and Health Vulnerability Scores; corresponding tabular data is shown at the bottom in sortable tables that include data on component risks.

A mapping application is developed in conjuction with this document. This mapping application allows us to analyse spatial patterns in each of the measures and also contains up-to-date data on Covid-19 testing and positive cases.


Several key takeaways are evident from the data:

  1. While the Metro NYC area has borne the brunt of NYS’s crisis, the parts of the state that are likely to be most vulnerable are in rural Upstate, particularly in the Adirondack and Chautauqua-Allegheny regions.
  2. While the overlap between demographic and health vulnerability is not strong (Pearson’s r of .42), there are several counties that rank in the riskiest-quartile on both measures, including Allegany, Chenango, Clinton, Orleans and Seneca.
  3. By contrast, several counties rank relatively low on both indices, with Kings, Lewis, New York, Orange, Putnam, Richmond, Rockland, Tompkins, and Westchester counties ranking in the bottom-quartile on both measures.

Demographic Vulnerability

Demographic related risk is determined as a summary score of four items: the percent of the population 80 years or older, the percent living in group quarters facilities (including nursing homes, jails/prisons, or student dormitories), the percent of households that span three generations (including both grandchildren and grandparents), and the percent of the population with a disability. The index is expressed as summed z-scores for each demographic risk factor. The data are sourced from the Census Bureau’s 2018 Population Estimates (age) and 2014-2018 American Community Survey (group quarters, triple-generation households, and disability).

Table 1: Demographic Vulnerability (click on column headers to sort)

Health Vulnerability

Health-related risk is similarly calculated as a summary score of several health risks known to complicate COVID, including the percent of a county’s adult population that has asthma, cardiovascular disease, diabetes (Type I or II), or high blood pressure, along with the adult obesity and smoking rates. Like with the demographic index, item-specific z-scores are summed to generate the health-related index. These data are sourced from the 2016 Expanded Behavioral Risk Factor Surveillance System, which supplements the annual BFRSS data for New York State in order to generate county-specific estimates of community health.

Table 2: Health Vulnerability (click on column headers to sort)