The Environmental and Social Determinants of Health Matter in a Pandemic: Predictors of COVID-19 Case and Death Rates in New York City.

Maria De Jesus,Aquilah Daughtery,Shalini S Ramachandra,Benjamin Shapiro,William C Howell,Imani Maliti,Zoe Jafflin,Monica C Jackson

doi:10.3390/ijerph18168416

Abstract

Our research objective was to determine which environmental and social factors were predictive of coronavirus disease 2019 (COVID-19) case and death rates in New York City (NYC), the original epicenter of the pandemic in the US, and any differential impacts among the boroughs. Data from various sources on the demographic, health, and environmental characteristics for NYC zip codes, neighborhoods, and boroughs were analyzed along with NYC government’s reported case and death rates by zip code. At the time of analysis, the Bronx had the highest COVID-19 case and death rates, while Manhattan had the lowest rates. Significant predictors of a higher COVID-19 case rate were determined to be proportion of residents aged 65 years plus; proportion of residents under 65 years with a disability; proportion of White residents; proportion of residents without health insurance; number of grocery stores; and a higher ozone level. For COVID-19 death rates, predictors include proportion of residents aged 65 years plus; proportion of residents who are not US citizens; proportion on food stamps; proportion of White residents; proportion of residents under 65 years without health insurance; and a higher level of ozone. Results across boroughs were mixed, which highlights the unique demographic, socioeconomic, and community characteristics of each borough. To reduce COVID-19 inequities, it is vital that the NYC government center the environmental and social determinants of health in policies and community-engaged interventions adapted to each borough.

Highlights

Introduction19 months into the coronavirus disease 2019 (COVID-19) ongoing pandemic, the death toll amounts to approximately 607,000 individuals in the United
It is important to note that Manhattan and the Bronx have the highest number of per capita hospital beds, and Manhattan has the highest population density, which suggests that other factors, such as underlying comorbid illnesses, occupational exposures, and socioeconomic and racial/ethnic-based structural inequities explain the differential outcomes among the boroughs
We aimed to shed light on the related underlying environmental and social determinants of health related to COVID-19 case and death rates as well as how the local government can focus its COVID-19 response efforts towards the most impactful factors in order to reduce the case and death rates in the city and its boroughs

Summary

Introduction

19 months into the coronavirus disease 2019 (COVID-19) ongoing pandemic, the death toll amounts to approximately 607,000 individuals in the United. States (US) alone and 4.26 million individuals globally [1,2]. Since the beginning of the pandemic in January 2020, the cumulative number of confirmed cases in the US at the end of July 2021 is 34.53 million and 194.72 million worldwide [3]. It is increasingly clear that social and health inequities are profoundly, and unevenly, impacting COVID-19 4.0/).

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