Abstract
BackgroundNew York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection. Little is known about how the presence of chronic risk factors correlates with mortality at the population level. Here we determine the relationship between these factors and COVD-19 mortality in NYC.MethodsA cross-sectional study of mortality data obtained from the NYC Coronavirus data repository (03/02/2020–07/06/2020) and the prevalence of neighborhood-level risk factors for COVID-19 severity was performed. A risk index was created based on the CDC criteria for risk of severe illness and complications from COVID-19, and stepwise linear regression was implemented to predict the COVID-19 mortality rate across NYC zip code tabulation areas (ZCTAs) utilizing the risk index, median age, socioeconomic status index, and the racial and Hispanic composition at the ZCTA-level as predictors.ResultsThe COVID-19 death rate per 100,000 persons significantly decreased with the increasing proportion of white residents (βadj = − 0.91, SE = 0.31, p = 0.0037), while the increasing proportion of Hispanic residents (βadj = 0.90, SE = 0.38, p = 0.0200), median age (βadj = 3.45, SE = 1.74, p = 0.0489), and COVID-19 severity risk index (βadj = 5.84, SE = 0.82, p < 0.001) were statistically significantly positively associated with death rates.ConclusionsDisparities in COVID-19 mortality exist across NYC and these vulnerable areas require increased attention, including repeated and widespread testing, to minimize the threat of serious illness and mortality.
Highlights
New York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection
Of diabetes, asthma, chronic obstructive pulmonary disease (COPD)/emphysema/chronic bronchitis, cancer, angina/coronary heart disease, chronic kidney disease, obesity, and hypertension were extracted from the 500 Cities Project [21], which sourced this data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS) [22]
Risk index Each component of the risk index, as well as the proportion of white and Hispanic residents, median age, Socioeconomic status (SES) index and COVID-19 death rate were analyzed according to quartiles of the risk index (Table 1)
Summary
New York City (NYC) was the epicenter of the COVID-19 pandemic, and is home to underserved populations with higher prevalence of chronic conditions that put them in danger of more serious infection. The mortality count peaked on April 7, where there were 598 reported deaths, 6042 cases and 1578 people hospitalized. Reflecting on this time has highlighted racial and socioeconomic disparities in COVID-19 testing patterns that are indicative of gaps in initial COVID-19 response policy [2,3,4,5]. Analysis of COVID-19 case identification and mortality rates in New York City has underscored variations in the amount of COVID-19 testing performed over time, delays in receiving testing results, and lags in the reporting of death data [6, 7].
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