Neighborhood disparities in COVID-19 outcomes in New York city over the first two waves of the outbreak.
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ABSTRACT: Purpose
To assess the association of neighborhood demographic and socioeconomic characteristics with COVID-19 incidence and mortality in New York City (NYC) over the first two waves of outbreak.Methods
This retrospective study used neighborhood-level data from 177 modified ZIP code tabulation areas in NYC between March 01, 2020 and April 30, 2021.Results
Neighborhoods that were most severely impacted in wave 1 were also more affected in wave 2. Neighborhoods with a higher percentage of seniors (≥75 years), males, Black and Hispanic population, and large-size households had higher incidence rates of COVID-19 in wave 1 but not in wave 2. Neighborhoods with higher percentage of Black and Hispanic population and lower insurance coverage had higher death rate per capita and case fatality ratio in wave 1, and neighborhoods with higher percentage of Black and Asian population had elevated case fatality ratio in wave 2. Median household income was negatively associated with incidence rate and death rate per capita but not associated with case fatality ratio in both waves. Neighborhoods with more seniors had higher death rate and case fatality ratio in both waves.Conclusions
Neighborhood disparities in COVID-19 incidence and mortality across NYC neighborhoods were dynamic during the first two waves of outbreak.
SUBMITTER: Zhong X
PROVIDER: S-EPMC9042413 | biostudies-literature | 2022 Jun
REPOSITORIES: biostudies-literature
Publications
Neighborhood disparities in COVID-19 outcomes in New York city over the first two waves of the outbreak.
Zhong Xiaobo X Zhou Ziqi Z Li Guohua G Kwizera Muhire H MH Muennig Peter P Chen Qixuan Q
Annals of epidemiology 20220427
<h4>Purpose</h4>To assess the association of neighborhood demographic and socioeconomic characteristics with COVID-19 incidence and mortality in New York City (NYC) over the first two waves of outbreak.<h4>Methods</h4>This retrospective study used neighborhood-level data from 177 modified ZIP code tabulation areas in NYC between March 01, 2020 and April 30, 2021.<h4>Results</h4>Neighborhoods that were most severely impacted in wave 1 were also more affected in wave 2. Neighborhoods with a higher ...[more]
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Project description:IntroductionExisting socioeconomic and racial disparities in healthcare access in New York City have likely impacted the public health response to COVID-19. An ecological study was performed to determine the spatial distribution of COVID-19 testing by ZIP code Tabulation Area and investigate if testing was associated with race or SES.MethodsData were obtained from the New York City coronavirus data repository and 2018 American Community Survey 5-year estimates. A combined index of SES was created using principal component analysis and incorporated household income, gross rent, poverty, education, working class status, unemployment, and occupants per room. Multivariable Poisson regressions were performed to predict the number of total tests and the ratio of positive tests to total tests performed, using the SES index, racial composition, and Hispanic composition as predictors.ResultsThe number of total tests significantly increased with the increasing proportion of white residents (β=0.004, SE=0.001, p=0.0032) but not with increasing Hispanic composition or SES index score. The ratio of positive tests to total tests significantly decreased with the increasing proportion of white residents in the ZIP code Tabulation Area (β= -0.003, SE=0.000 6, p<0.001) and with increasing SES index score (β= -0.001 6, SE=0.0007, p=0.0159).ConclusionsIn New York City, COVID-19 testing has not been proportional to need; existing socioeconomic and racial disparities in healthcare access have likely impacted public health response. There is urgent need for widespread testing and public health outreach for the most vulnerable communities in New York City.
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