Perth Amboy Mayor Wilda Diaz has never seen so many people die in her city in such a short time.

As the coronavirus swept the state, Perth Amboy was among the hardest hit communities in New Jersey. In just four months, the deaths of 268 of its residents were recorded — nearly triple the number the city typically tallies from March through June.

Perth Amboy is in Middlesex County, south of the New York commuter communities that were the epicenter of an outbreak that exploded last spring. Yet Perth Amboy was one of the cities and towns that saw the greatest increases in deaths amid a public health crisis unlike any other.

To Diaz, that underlines a cold truth that health officials have acknowledged throughout the contagion: Communities of color and poverty are seeing the worst of coronavirus as the disease exposes longtime social disparities.

“We proved those statistics,” said Diaz, whose city is 80% Hispanic and has a poverty rate of 18%. “If they ever did a case study, I think Perth Amboy would prove that is a reality.”

Nor is Perth Amboy alone, according to an analysis by NJ Advance Media of newly released town-by-town mortality data, which captures deaths regardless of their cause. Municipalities with the greatest increases of deaths this year were often those with the highest Black, Hispanic and Asian populations, which have all seen disproportionate impacts from coronavirus.

The trends the data shows aren’t surprising. But it’s the first full look at deaths in the state down to the town level.

To examine mortality, NJ Advance Media compared overall deaths in March through June with the same time period in 2018 and 2019, using figures from the state Department of Health that offer new details into coronavirus' reach. In total, the state had about 16,900 more deaths this year over those four months, a nearly 70% increase from each of the two prior years.

Is the map not displaying correctly? Click here.

The analysis suggested just how much race and ethnicity played a factor: Statistically, about 21% of the difference in deaths town by town could be attributed to the prevalence of racial disparities. Put another way, every percentage increase in a town’s non-white population was associated with an additional 1.4 deaths on average.

That is a prism with which to understand a disease that has altered the life of each and every resident of New Jersey. And that isn’t to say that other factors weren’t also in play.

‘Each of them hurts’

Deaths during the outbreak were regional, with the state’s heavily populated northeastern tier the hardest hit, and its southern end, which is less populated and more white, less so. A single troubled nursing home could cause a given community’s death totals to rise harrowingly. And some of the largest spikes were seen in those cities that are the most densely populated, where social distancing and isolation were more difficult than in the suburbs or the countryside.

That includes a few of the most tightly packed communities in the United States: Union City, West New York and Passaic, all of which had deaths more than triple in the months in which the pandemic was at its worst.

“Each of them hurts,” Passaic Mayor Hector Lora said of the loss of life. “Each of them impacted our city.”

Passaic is 74% Hispanic and 8% Black and nearly a third of its residents live in poverty. It also has many nursing homes, Lora said.

Though the city was deeply impacted, it could have been even worse, he said.

“I’ve seen individuals respond extremely responsibly," Lora said. “I’ve seen children wearing masks. I’ve seen teenagers wearing masks.”

Is the graphic not displaying correctly? Click here.

Veronica Altamirano and her family are among those in Passaic trying to make the best of a bad situation. Altamirano, a 36-year-old undocumented immigrant from Mexico, said she is still recovering from the aftereffects of a bout with coronavirus in April that left her bedridden for 15 days with fevers and trouble breathing. Months later, Altamirano said, she still has chest pain and gets tired easily.

Her husband was the first in the family of seven to be sickened, Altamirano said in Spanish in an interview interpreted by Rosa Lopez, an organizer for Make The Road New Jersey, an immigrant advocacy group. Altamirano said her husband may have contracted the disease at his job in construction, or on the bus coming to and from home.

“Her entire body hurt so bad, so she wasn’t capable of standing up from her bed,” Lopez said for Altamirano.

The couple and their five children — ages 19 to 4 — share a two-bedroom, one-bathroom apartment that made it difficult to stay apart, Altamirano said. Everyone got sick, though she said she was the most severely affected.

At the same time, the family is dealing with other hardship: Until recently, her husband was out of work, and they were not eligible for state or federal assistance because of their immigration status. Even now, with her husband hired part-time, the family has to decide which bills to pay each month, and whether the need for groceries wins out, she said.

Still, Altamirano fared better than some others. She said she knew two factory workers who died in the outbreak after going to jobs where protective equipment like masks and hand sanitizers were in short supply.

Existing inequality

By sheer increase, the state’s four largest cities — Newark, Jersey City, Paterson and Elizabeth — saw the greatest number of excess deaths, with 2,352 more deaths than typical, nearly 15% of the state’s increase from March through June.

But adjusting for size, some communities saw even greater rises, including Perth Amboy, Passaic, West New York, Union City and Dover in Morris County.

Andover Township, a small, largely white community in Sussex County, saw deaths leap nearly 400%. There were 150 deaths from March through June, compared to the 31 averaged over that time period in 2018 to 2019.

The township is the site of the state’s largest nursing home, the troubled Andover Subacute and Rehabilitation, where 17 bodies were discovered on Easter Sunday in a makeshift morgue. The facility has been slapped with $220,235 in fines and penalties by federal regulators who found failures in its infection control practices. In total at its two buildings, 83 residents and two staff members succumbed to COVID-19, according to Sussex County.

“All of our deaths really occurred inside Andover Subacute,” said Michael Lensak, the township’s mayor. “It’s 100% the long-term care facility."

New Jersey’s official coronavirus death toll exceeds 16,000 people, and about 45% of those deaths have been attributed to long-term care facilities. The Department of Health also partially tracks the racial breakdown of deaths in the outbreak, and has found that mortality rates among Blacks, Hispanics and Asians all outpace those of whites.

In August, an analysis by the Associated Press and the Marshall Project found that nationally and in New Jersey, Hispanics, Blacks and Asian Americans have all seen dramatic and disproportionate increases in deaths. In the state, deaths were up 124% among Hispanics through July compared with the average over the past five years. Deaths among Asian Americans rose 107% in New Jersey, and they increased 68% among Blacks. Among whites, deaths were up 28%.

Is the graphic not displaying correctly? Click here.

Gov. Phil Murphy has expressed concern over racial disparities in New Jersey, as have public health experts and social justice advocates, who note that longstanding inequities leave those communities more vulnerable to COVID-19.

In general, people of color are more likely to have lower incomes, less access to health care and to suffer more frequently from chronic illnesses such as diabetes, obesity or lung ailments — secondary health problems that coronavirus exploits. They were also more likely to work labor-intensive, blue-collar jobs that could not be replicated at home, raising their risk of exposure as they went out into the workforce.

“Who are the easiest targets?” asked Christopher Hayes, a historian at Rutgers University whose work focuses on race and urban life. “People who are in close contact with other people. People who are already unhealthy. People who are interacting with lots of other people.”

The outbreak, Hayes said, merely underscored existing inequality.

“If you take away the disease, nothing else is new. All the problems that make Black and Latinx people get sick and die have been there,” Hayes said.

Back in Perth Amboy, Mayor Diaz attributed her city’s high number of deaths to the realities of its workforce, who often work in warehouses or stocking shelves in supermarkets. They then brought the disease home with them, passing it on to their families who lacked the space or the means to socially distance, she said.

Given those circumstances, Diaz said, “it spread like wildfire.”

Our journalism needs your support. Please subscribe today to NJ.com.

Riley Yates may be reached at ryates@njadvancemedia.com. Arjun Kakkar may be reached at akakkar@njadvancemedia.com