Overcrowding and exposure to secondhand smoke increase risk for COVID-19 infection among Latinx families in the greater San Francisco Bay Area.

Andrea Decastro Mendez*,Milagro Escobar*,Maria Romero,Janet Wojcicki

doi:10.18332/tid/140827

Abstract

INTRODUCTIONEnvironmental risk factors, including community level pollution burden and exposure to smoking and secondhand smoke, have not been evaluated in relation to risk for infection with COVID-19 in high risk, urban Latinx families.METHODSWe evaluated risk factors for COVID-19 infection in three, preexisting, longitudinal, Latinx family cohorts in the San Francisco Bay Area from May through September 2020 (N=383 households, 1875 people). All households were previously recruited before the pandemic. For the COVID-19 sub-study, participants responded to a telephone interview where we assessed food consumption patterns, housing and employment status, and history of COVID-19 infection. Secondhand smoke exposure was based on previously collected selfreported data, and environmental pollution exposure was determined from census tract residence. Non-parametric tests and multiple logistic regression were used to assess independent predictors of COVID-19 infection.RESULTSLarger household size increased risk for infection (OR=1.58; 95% CI: 1.12–2.23, p<0.01) as did increasing number of children in household (OR=3.79; 95% CI: 1.51–9.56). Any exposure to secondhand smoke was also associated with increased risk for COVID infection (OR 4.69; 95% CI: 1.01–21.85) and having a greater number of family members eating at home was protective against infection (OR=0.10; 95% CI: 0.02–0.52, p<0.01).CONCLUSIONSCrowding, as indicated by larger household size, increases risk for COVID-19 infection in Latinx families, as does exposure to secondhand smoke. Public policy and health interventions need to ensure that multiunit residential complexes do not allow exposure to secondhand smoke between units, that individuals eat in the home environment, and that large households can safely separate individuals exposed to COVID-19.

Highlights

Environmental risk factors, including community level pollution burden and exposure to smoking and secondhand smoke, have not been evaluated in relation to risk for infection with COVID-19 in high risk, urban Latinx families
Hispanic Eating and Nutrition Study (HEN) and LEAD mothers were recruited during pregnancy primarily at Zuckerberg San Francisco General Hospital (ZSFG) with a minority from UCSF Benioff, whereas Telomeres at Birth Study (TAB) participants were recruited in the postpartum unit before hospital discharge
Sociodemographics Larger household size was associated with COVID-19 infection in HEN/LEAD cohorts (6.2±2.7 vs 4.9±1.6, p=0.02; Table 1)

Summary

Introduction

Environmental risk factors, including community level pollution burden and exposure to smoking and secondhand smoke, have not been evaluated in relation to risk for infection with COVID-19 in high risk, urban Latinx families. The novel coronavirus (COVID-19) has infected over 33 million individuals in the US and approximately 589547 have died as of 26 May 20211 (Centers for Disease Control and Prevention, 2021). COVID-19 disease disproportionately affects US racial and ethnic minorities[2,3]. The Latinx community constitutes 18% of the US population, but 28.8% of the confirmed COVID-19 cases. Pediatric COVID-19 infection rates are higher in US racial and ethnic minorities. As of May 2021, there were approximately 3 million reported pediatric cases of COVID-194. In California as of June 2021, Latinx children accounted for 47.9% of the state’s children, yet represented 65.4% of all child COVID-19 cases and 43.5% of deaths[5]. In a study of pediatric COVID-19 cases from 15 states including District of Columbia (but not including California), Hispanic children had a rate of COVID-19

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