York City Borough Research Articles

I Like Feminism and Feminism Likes Me

Abstract When high-end block buster venues are the primary focus of curatorial reflections, even for feminist writers, what does the poor feminist curator have to say? What does curatorial “care work” look like from a different place? One semester the gallery budget was slashed so brutally, we had to give up the insurance. So, I co-wrote a two act play about Joseph Beuys’s first trip to the US, in 1974, when he asked to meet with “American feminists.” I Like Feminism and Feminism Likes Me (2020) was part slapstick, part exaggerated amateur dramatics, part allegorical attack on male charisma in the New York City borough that elected Trump (Staten Island), and part feminist revenge tragedy. In this paper I reanimate the project through the affective scrim of my experience of the Covid-19 pandemic. It is an experiment in teaching and writing art history through the body: mine, theirs, maybe yours as well.

Insights into missing populations: Exploring characteristics of unscreened patients with cancer in psychosocial distress and social drivers of health screening in an ambulatory setting.

174 Background: Psychosocial distress is common among patients with cancer and distress screening is required for American College of Surgeons Commission on Cancer accreditation. Screenings proactively identify needs, connect patients to services, reduce distress and improve cancer outcomes. We implemented a dynamic 17-question electronic screening tool that includes: assessment for psychosocial distress, social drivers of health (SDH) and spiritual care, and evaluated differences in patient characteristics among those who did and did not complete the survey. Methods: The survey was developed through an interdisciplinary review of evidence-based questions to proactively address supportive care needs for patients. It is available in English and Spanish and sent to patients via the patient portal 7 days before the second oncology appointment with a reminder 3 days before the appointment. It was implemented across 5 Mount Sinai Health System ambulatory facilities, spanning 3 New York City boroughs between June 2022 and February 2024. We used descriptive statistics to compare demographic and clinical characteristics of patients who did and did not complete the survey. Results: A total of 11,199 patients were assigned surveys; (42%) did not complete it. Patients who did not complete the survey were more likely to be Asian and Hispanic, older age, to speak a language other than English, reside in Queens or Brooklyn, and were less likely to have Commercial insurance compared to those who completed the survey (p<0.001 for all). There was no difference in sex (p=0.93) among the groups. Conclusions: There are significant disparities in the completion rates of electronic psychosocial distress and SDH screenings among patients with cancer, revealing that certain groups are less likely to engage with the tool. Targeted strategies are needed to increase screening completion rates among these populations. Future efforts should focus on addressing language barriers, enhancing technological accessibility, and developing culturally sensitive approaches to ensure all patients benefit from these screenings so we can better identify and address the supportive care needs of all cancer patients. Characteristics of patients who did and did not complete the survey. Characteristic Did Not Complete4654 (42%) Completed6545 (58%) p-value Race <0.001 Black 978 (21) 1538 (23) Asian 642 (14) 698 (11) Unknown 225 (5) 258 (4) Other/Patient Declined 1298 (28) 1461 (22) White 1511 (32) 2590 (40) Age (mean (SD)) 64 (14) 61 (15) <0.001 Non English Language 1167 (25) 956 (15) <0.001

Spatiotemporal Exploration of Ridesharing Services Ridership through Geovisualization: A Case Study of the New York City Region

App-based ridesharing services (RSSs), exemplified by platforms like Uber, play a pivotal role in modern transportation by offering convenient and on-demand services. The exploration of RSSs necessitates a comprehensive consideration of the inherent spatiotemporal variability within the data. Prior research, however, has tended to analyze the spatial and temporal dimensions separately, with many studies omitting the temporal aspect. This study addresses the gap by using geovisualization techniques to illustrate emerging hot spot analysis in New York City in 2022, derived from space–time data mining. Overall, despite temporal variations in overall RSSs ridership, certain taxi zones maintain distinct ridership patterns. Across the five New York City boroughs (Manhattan, Bronx, Queens, Brooklyn, and Staten Island), Midtown Manhattan and the Brooklyn areas adjacent to Queens exhibit saturated intensifying hot spots, signaling a notable increase in RSSs ridership throughout 2022, surrounded by sporadic hot spots. Conversely, peripheral areas of New York City reveal diminishing cold spots, indicating a decrease in their intensity as cold spots. Furthermore, the study conducts separate spatial and temporal profiling. By presenting the spatiotemporal trends of RSSs, this research complements existing literature and provides valuable insights for more informed interventions. The study also highlights certain limitations that could be addressed in future endeavors.

Unraveling energy justice in NYC urban buildings through social media sentiment analysis and transformer deep learning

This study explores the intricate relationship between human sentiment on social media data, herein tweet posts on X platform, urban building characteristics, and the socio-spatial dynamics of New York City (NYC) boroughs. Leveraging Natural Language Processing (NLP) techniques, particularly sentiment analysis, augmented by the capabilities of transformer deep learning models, RoBERTa, the study places particular emphasis on the term ‘Stay-at-Home’ to encapsulate the pronounced shift in building occupancy during the pandemic's inaugural year. This focus intertwines with pivotal terms like ‘Energy Bill’ and ‘HVAC’, shedding light on their interconnected implications. The sentiment analysis leverages data from New York City's PLUTO and the Department of Energy's LEAD databases to emotional disparities connected to urban building characteristics as well as demographic and socioeconomic factors. This analytical approach unravels prevailing public emotions and extends the discussion to include energy justice concerns, viewing them through the lens of the city's built infrastructure. The research uncovers profound disparities in the built environment and the allocation of resources in NYC, highlighting the critical need to embrace a spatial justice framework for a sustainable future. This research can aid designers, planners, and policymakers in their efforts to promote equitable and inclusive urban development.

Estimates of loneliness among racially and ethnically diverse adults with serious mental illness in New York City boroughs: Manhattan, Bronx, and Brooklyn.

Estimates of loneliness among racially and ethnically diverse adults with serious mental illness in New York City boroughs: Manhattan, Bronx, and Brooklyn.

Resource selection by New York City deer reveals the effective interface between wildlife, zoonotic hazards and humans.

Although the role of host movement in shaping infectious disease dynamics is widely acknowledged, methodological separation between animal movement and disease ecology has prevented researchers from leveraging empirical insights from movement data to advance landscape scale understanding of infectious disease risk. To address this knowledge gap, we examine how movement behaviour and resource utilization by white-tailed deer (Odocoileus virginianus) determines blacklegged tick (Ixodes scapularis) distribution, which depend on deer for dispersal in a highly fragmented New York City borough. Multi-scale hierarchical resource selection analysis and movement modelling provide insight into how deer's movements contribute to the risk landscape for human exposure to the Lyme disease vector-I. scapularis. We find deer select highly vegetated and accessible residential properties which support blacklegged tick survival. We conclude the distribution of tick-borne disease risk results from the individual resource selection by deer across spatial scales in response to habitat fragmentation and anthropogenic disturbances.

Assessment of Electronic Health Literacy among Patients in an Urban, Academic Radiation Therapy Department

The COVID-19 pandemic dramatically affected health outcomes and healthcare access, especially with the abrupt transition to virtual care. Cancer patients in the New York City borough of the Bronx, a potentially marginalized community with high rates of poverty and non-English speakers, may be particularly vulnerable to healthcare disparities, given their advanced age and possible difficulty navigating telemedicine appointments due to decreased electronic health literacy (EHL). We investigated EHL levels using both subjective and objective measures and associated predictors of EHL in patients within an academic, urban radiation oncology department. We conducted a prospective IRB-approved study of patients aged ≥18 presenting for care in our department. Patients' internet access and established habits were surveyed via Health Information National Trends Survey (HINTS). Subjective EHL, self-reported comfort using the internet for health information, was assessed via the eHealth Literacy Scale (eHEALS), which calculates a score by adding participants' answers for 8 questions (each on a 1 to 5-point Likert scale). Subjective EHL was categorized as low (8-23), moderate (24-31), or good (32-40). Objective EHL was determined by the eHealth Literacy Objective Scale (eHeLiOS), which tests responses to 9 common scenarios on gathering and assessing electronic health information via multiple-choice questions. The numbers of correct answers were totaled and categorized into low (1-4), moderate (5-7), or good (8-9) EHL. Patients were enrolled between December 2020 and December 2022. 56 patients completed the subjective eHEALS assessment, while 49 completed the eHeLiOS objective test. 52% and 27% of patients identified as Black and Hispanic, respectively; 66% were male, and the median age was 67 (range 28-86). 76% reported accessing the internet regularly, of which 92% reported doing so via broadband network. The prevalence of good EHL was 10% using objective and 29% using subjective surveys. Using a proportional odds logistic model, only age was associated with EHL. For every increased year of age, there was an 11% decrease in objective (OR 0.89, p = 0.02) and 5% decrease in subjective (OR 0.95, p = 0.08) EHL odds, respectively. Gender, race/ethnicity, income, insurance, and employment status were not significantly associated with EHL. Few study patients, who represent an older and potentially marginalized population, showed good EHL levels; more perceived good EHL via subjective testing than we observed using our objective measure. These data suggest implementation of an objective EHL assessment would aid in identifying patients who may benefit from learning activities to improve EHL and support to navigate telehealth visits effectively. Further research is needed to optimize telemedicine strategies for older cancer patients with low EHL.

Multinomial Estimations of Predictive Risk Factors for Traumatic Brain Injuries.

Introduction Traumatic brain injuries (TBIs) affect millions of patients each year, with more than 220,000 hospitalizations in 2019 and 64,000 deaths in 2020 alone. TBIs span a plethora of injuries including cerebral contusions and lacerations, axonal injuries, optic pathway disruptions, and skull fractures. Previous research has established that characteristics such as sex, mechanism of injury (MOI), and blood-thinning agents have some causal connections to a variety of cranial traumas. Methods This paper sought to analyze aggravating risk factors for various TBIs in the New York City borough of Staten Island. Data on eight predictive risk variables were collected at a level 1 trauma center from January 1, 2022, to December 31, 2022: MOI, seizure history, anticoagulant/antiplatelet therapy, alcoholism, age, biological sex, tested alcohol level, and body mass index (BMI). A multinomial logistic regression was estimated to generate risk ratios (RRs), and chi-squared tests were carried out to determine univariate associations. Results It was found that blood thinner use and sex were both significant predictors of various types of TBIs. Additionally, those not tested for alcohol, including pediatric patients, were less likely to suffer most forms of TBI, while BMI had a negligible relationship with any TBI class. The use of blood-thinning agents put patients at an increased risk of concussions (relative risk ratio [RRR]: 1.82; 95% confidence interval [CI]: 1.10-3.02) and undiagnosed intracranial injuries (RRR: 1.90; 95% CI: 1.08-3.34). Men were at higher risk of multiple cranial injuries than women (RRR: 3.62; 95% CI: 1.38-9.48), as well as physical traumas such as brain lacerations and hemorrhages (RRR: 2.81, 95% CI: 1.28-6.18). BMI was weakly correlated with undiagnosed cranial injuries (RRR: 1.04; 95% CI: 1.00-1.08) and slightly uncorrelated with physical traumas (RRR: 0.94; 95% CI: 0.88-1.00). Those not tested for alcohol were at far less risk of multiple TBIs (RRR: 0.08; 95% CI: 0.01-0.66), concussions (RRR: 0.27; 95% CI: 0.11-0.71), and physical brain traumas (RRR: 0.33; 95% CI: 0.13-0.84). No parameter exhibited any statistical significance with skull fractures. Conclusion Particular risk factors for TBIs include biological sex and blood thinner use. Injury prevention efforts should be based on the category of TBI, with a particular focus on blood thinner users becoming concussive post-trauma. Attention should also be paid to men who engage in risky behavior such as binge drinking and crime sustaining more than one brain trauma or isolated brain bleeds. Therefore, improved hospital outreach for fall precautions in nursing homes and targeted interventions for at-risk men are vital for future projects.

Noise Complaints and Land Rezoning as a Predictor of Hate Crimes in a New York City Borough.

Hate crimes generally have severe victim outcomes compared to other crimes, and therefore warrant further investigation. These types of crimes can often happen in neighborhoods where people from various cultures, socioeconomic backgrounds, religions, etc. meet. Understanding how neighborhood tensions impact the level of hate crimes is important in reducing hate crimes and building community. The current study investigates neighborhood level predictors of hate crimes in a borough of New York City (NYC). Using symbolic threat and defended neighborhoods frameworks, we consider how 311 noise complaints and land use rezoning data can be predictors of hate crimes. We use data from the New York City Police Department (NYPD) and NYC Land Use Tax Output. We find that hate crimes are more likely in the neighborhoods where the noise complaints and land use rezoning are higher than the median. The theoretical implications of these findings are discussed below.

Forum Theater: An Innovative Strategy to Enhance Clinician Communication With Marginalized Trauma Patients.

Marginalized groups experience a higher frequency of traumatic injury and are more likely to report negative experiences in the health care setting. Trauma center staff are prone to compassion fatigue, which impairs patient and clinician interactions for these groups. Forum theater (a form of interactive theater designed for addressing social issues) is proposed as an innovative method of exploring bias and has never been applied in the trauma setting. This article aims to determine the feasibility of implementing forum theater as an adjunct to enhance clinician understanding of bias and its influence on communication between clinicians and trauma populations. This is a descriptive qualitative analysis of adopting forum theater at a Level I trauma center in a New York City borough with a racially and ethnically diverse population. The implementation of a forum theater workshop was described, including our work with a theater company to address bias in the health care setting. Volunteer staff members and theater facilitators participated in an 8-hr workshop leading to a 2-hr multipart performance. Participant experiences were collected in a postsession debrief to understand the utility of forum theater. Debriefing sessions after forum theater performances demonstrated that forum theater is a more engaging and effective method for dialogue surrounding bias than personal past experiences with other educational models. Forum theater was feasible as a tool to enhance cultural competency and bias training. Future research will examine the impact it has on levels of staff empathy and its impact on participants' level of comfort communicating with diverse trauma populations.

Abstract P4-03-05: HER2 + Breast Cancer in Afro-Caribbean Women in New York City

Abstract Background: Human Epidermal Growth Factor receptor 2 (HER2) protein overexpression and/or amplification positive breast cancer accounts for 14% of breast cancer cases in the United States. The use of anti-HER2 targeted therapy in combination with chemotherapy has resulted in better response rates leading to better outcomes in patients with this breast cancer subtype. Few studies directly investigate breast cancer outcomes in Afro-Caribbean women in the U.S, and fewer studies have investigated HER2 positive (HER2+) disease in this patient group. We describe the clinicopathologic characteristics and outcomes of HER2+ breast cancer in this minority patient group. Methods: This is a retrospective study conducted at Kings County Hospital (KCH), a public hospital in Brooklyn, a New York City borough with the highest population of Afro-Caribbeans in the United States, outside of Miami, Florida. Data of patients diagnosed with breast cancer from 2015-2018 was collected from the hospital’s tumor registry. Clinical and pathologic data was collected and analyzed with descriptive statistics and Chi-square testing. Results: A total of 299 women with breast cancer were screened and 18% (54) had HER2+ disease. 63% (34) of these patients were post-menopausal, with median age 56. 78% self-identified as Afro-Caribbean. 19% (11) of patients reported first- or second-degree relatives with a breast cancer diagnosis, 22% (13) reported first-degree relative with non-breast malignancy. Half of the patients younger < 45 years age reported a positive family history of any type of cancer. 74% of patients presented with Nottingham Grade 3 disease, 31% with localized disease, without lymph node involvement, 52% with regional lymph node involvement, and 17% with distant metastasis. 63% of patients were estrogen receptor (ER) positive and 37% were ER negative. Post-menopausal women presented with higher rates of lymph node involvement at 70.4% vs. 50% in pre-menopausal women (p=0.17). 41% (22) of patients received neoadjuvant chemotherapy while 31% received adjuvant therapy with standard chemotherapy and anti-HER2 targeted treatment. Of the 22 patients who received neoadjuvant treatment, 14% had complete pathologic response, 68% had partial response, and 18% had disease progression. Treatment response to neoadjuvant therapy was independent of lymph node status (90.9% in local disease vs. 85.7% in lymph node involvement, p=0.66). The median progression free survival was 48 months, overall survival at 7 years was not reached, and mortality rate was 16.7%. Conclusions: In our analysis, Afro-Caribbean patients with HER2+ breast cancer presented with high grade tumor, high incidence of regional lymph node involvement, and ER positive tumors. Noteworthy was the presence of strong family history of cancers, suggestive of familial or inherited cancers. Pathologic complete response to neoadjuvant chemotherapy was remarkably less than anticipated, and further research is warranted to study tumor biology and responses to standard HER2 systemic therapies in these patients.

Abstract P314: Social Determinants of Cardiovascular Risk Factors Among African Immigrants in New York City

Background: African immigrants (AIs) constitute a highly diverse and rapidly growing population in the US, particularly in New York City. Yet, their cardiovascular health remains understudied. We examined the prevalence of cardiovascular disease (CVD) risk factors and identified predictors of increased CVD risk among AIs residing in the five New York City (NYC) boroughs. Objective: To examine the relationship between social determinants (marital status, education, employment, and health insurance) and CVD risk factors among AIs living in NYC. Methods: This cross-sectional study was conducted among AIs ≥30 years residing in NYC. Outcomes of interest were self-reported CVD risk factors assessed individually (hypertension, diabetes, hyperlipidemia, overweight/obesity, and poor sleep). Using logistic regression analyses, we examined the associations between social determinants and individual CVD risk factors, adjusting for age and sex. Results: Of 215 participants, the mean age was 54 (SD: 11.7) years, and 70% were female. The majority (93%) had ≥1 of the 6 CVD risk factors. Smoking was least prevalent, and overweight/obesity was most prevalent (76%); with 42%, and 18% having a prior diagnosis of hypertension and diabetes, respectively. Those who were employed had ≥ bachelor's education were less likely to have hyperlipidemia (adjusted Odds Ratio [aOR]: 0.35, 95%CI: 0.15-0.86, or overweight/obesity (aOR: 0.31, 95%CI: 1.11-0.88); and twice (aOR: 2.14, 95%CI: 1.11-4.15), more likely to report poor sleep. However, being married and having health insurance were associated with a 3-fold (aOR: 3.08, 95%CI: 1.12-8.50) and 4-fold (aOR: 4.07, 95%CI: 1.12-14.73) higher likelihood of being overweight/obese. Conclusions: The prevalence of CVD risk factors among AIs was particularly high. Culturally-appropriate interventions and policies to reduce CVD risk factors are highly recommended for this population.

Travel Patterns and Street Networks: <i>A Novel Visualization Methodology of City-Level Traffic Flows and Network Usability</i>

Street Networks, knitted in the urban fabric, facilitate spatial movement and control the flow of urbanization. The interrelation between a city’s spatial network and how the residents travel over it has always been of high interest to scholars. Over the years, multifaceted visualization methods have emerged to better express this travel trend from small to large scale. This study proposes a novel approach to 1) visualize city-wide travel patterns with respect to the street network orientation and 2) analyze the discrepancies between travel patterns and streets to evaluate network usability. The visualizations adopt histograms and rose diagrams to provide several insights into network-wide traffic flows. The visualization of four New York City (NYC) boroughs including Queens, Brooklyn, Bronx, and Staten Island was generated for the daily traffic and the average hourly flows in the morning and evening rush hours. Then the contrasts between built-in street network topology and travel orientation were drawn to show where people travel over the network, travel demand, and finally which segments experience high or light traffic, revealing the true picture of network usability. The findings of the study provide an insight into the novel and innovative approach that can help better understand the travel behavior lucidly and assist policymakers in decision making to maintain a balance between urban topology and travel demands. In addition, the study demonstrates how to further investigate city street networks and urbanization from different diverse dimensions.

A Bridge Too Far? The Staten Island/Hudson-Bergen Light Rail Missed Connection

Few urban areas are as economically and socially integrated as the New York City borough of Staten Island and the New Jersey communities of Bayonne and Jersey City just across the Hudson River. These strong links are illustrated by travel patterns across a north-south corridor from Staten Island up into Bayonne. Yet transit planning and development policy and implementation have been radically different in the two areas, with slow and, right now, stunted development of transit in Staten Island, New York City, as contrasted with the muscular and systematic approach taken in Bayonne and Jersey City, New Jersey. This paper analyzes the links between the two areas, describes the different transit policies taken in each, assesses the outcomes of these different policies, and offers suggestions for ways in which transit and development links could be improved, in particular an extension of the Hudson-Bergen Light Rail (HBLR) into Staten Island. The paper also discusses the interim use of buses as a pre-development phase for light rail (LRT) or bus rapid transit (BRT), focusing on the relatively new S89 route in Staten Island that now links directly to the HBLR and which immediately attracted strong ridership.

The Persistent Effect of Violent Trauma on Urban Communities 25 Years After Tupac Shakur's Murder.

The Persistent Effect of Violent Trauma on Urban Communities 25 Years After Tupac Shakur's Murder.

Breast Cancer Survivorship Care During the COVID-19 Pandemic Within an Urban New York Hospital System

Purpose/Objective(s)The COVID-19 pandemic has placed a tremendous burden on healthcare systems and has forced oncology providers and cancer patients to balance pandemic risks with maintaining standard cancer survivorship care. We evaluated adherence to long-term follow-up among early-stage breast cancer patients in an urban, academic cancer center in the New York City borough of The Bronx during the COVID-19 pandemic.Materials/MethodsWe retrospectively reviewed patients with stage I-II breast cancer who underwent resection and adjuvant therapy at our center. Adherence with long-term follow-up was evaluated based on contact with any oncology specialist (surgical, medical, or radiation) at our center between two and five years after breast cancer surgery. Patients were deemed adherent to follow-up during COVID-19 if they attended an oncology follow-up appointment (in-person or telemedicine) between March 1 and December 1, 2020; patients were deemed non-adherent if they attended follow-up during the same date range in 2019, prior to the pandemic, but did not follow-up during the COVID-19 period. Adherence during COVID-19 was compared with pre-COVID rates of follow-up. Clinical and demographic data were evaluated as potential predictors of adherence. Local COVID-19 case rates were estimated from public data by ZIP code during the peak of the pandemic in April 2020. Multivariate logistic regression was performed to identify associations with follow-up non-adherence.ResultsDuring COVID-19, 496 (68%) of 734 patients were adherent to follow-up. Of the adherent group, 40.5% had telemedicine visits. The rate of follow-up adherence during COVID-19 was dramatically lower than historic adherence rates of 89-96%, which varied depending on time since resection. On multivariate analysis, adherence was more likely among patients who had received adjuvant radiation therapy (adjusted Odds Ratio [aOR] 1.4; P = 0.032) and smokers (aOR 1.6; P = 0.041). When patients who live in The Bronx were stratified by ZIP code, there was no association (R2 = 0.01) between local COVID-19 case rates and likelihood of adherence during the COVID-19 pandemic.ConclusionTo our knowledge, this is the first analysis evaluating the potential effect of COVID-19 on cancer survivorship care. We observed a dramatic disruption in long-term follow-up during the COVID-19 period, despite prevalent utilization of telemedicine visits. Overall, if the observed rate of non-adherence persists and patients are not reintegrated into regular follow-up patterns after the COVID-19 period, it has the potential to dramatically affect cancer survival outcomes.

P105 Assessment of Consumption and Nutritional Intake of Food Box Program During COVID-19

<h3>Background</h3> The COVID-19 pandemic has dramatically increased food insecurity in the United States. In response to the growing need, food banks and soup kitchens across New York City have adapted by distributing free food boxes in high-need communities. While program evaluations have largely focused on distribution, no study has assessed the consumption of the contents of these boxes and their impact on increasing nutrition. <h3>Objective</h3> This study aimed to evaluate the consumption and nutritional impact of food boxes provided by World Central Kitchen on recipients in New York City. <h3>Study Design, Setting, Participants</h3> A study of 391 food box recipients was conducted across 4 New York City boroughs from July 13-September 18, 2020. Key informants identified communities with high food insecurity. A phone survey was conducted by WCK staff to participants waiting in line to receive a food box. Boxes contained either fresh fruits and vegetables only or fresh produce and dairy. Contents were included because of their nutritional values. <h3>Measurable Outcome/Analysis</h3> Survey responses were imported into a data frame and analyzed to understand consumption and nutritional impact of food boxes. Variables of interest included: demographics, household size, if they were the primary cook in their home, most and least preferred item(s) in the box, items they wished were included, quantity of the box consumed, and reason for unused items. <h3>Results</h3> Of the 391 survey participants, the contents of the food boxes reached 1,398 individuals. Moreover, 90% of participants consumed all of the box's contents, increasing their nutrition. <h3>Conclusion</h3> The high percentage of WCK food boxes completely consumed suggests that boxes offering fruits and vegetables are an effective intervention in improving nutrition for recipients. These findings have important implications for shaping nutritional guidance of future food box programs.

Perspectives on COVID-19 vaccination among kidney and pancreas transplant recipients living in New York City.

PurposeSolid organ transplant recipients are at increased risk of morbidity and mortality from coronavirus disease 2019 (COVID-19), but limited vaccine access and vaccine hesitancy can complicate efforts for expanded vaccination. We report patient perspectives and outcomes from a vaccine outreach initiative for a vulnerable population of transplant recipients living in New York City.MethodsThis was a retrospective review of qualitative perspectives from a COVID-19 vaccine outreach initiative. In the outreach effort, kidney and pancreas transplant recipients under care at the transplant center at NewYork-Presbyterian Hospital were initially contacted electronically with educational material about vaccination followed by telephone outreach to eligible unvaccinated patients. Calls were used to schedule vaccine appointments for patients who agreed, answer questions, and assess attitudes and concerns for patients not yet ready to be vaccinated, with conversational themes recorded.ResultsOf the 1,078 patients living in the 5 New York City boroughs who had not reported receiving COVID-19 vaccination, 320 eligible patients were contacted by telephone. Of these, 210 patients were scheduled for vaccination at our vaccine site (including 13 who agreed to vaccination after initially declining), while 110 patients were either not ready or not interested in being vaccinated. The total number of patients willing to be vaccinated was 554 when also including those already vaccinated. Unwillingness to be vaccinated was associated with younger age (median age of 47 vs 60 years, P < 0.001), Black race (P = 0.004), and residence in Bronx or Brooklyn counties (P = 0.018) or a zip code with a medium level of poverty (P = 0.044). The most common issues raised by patients who were ambivalent or not interested in vaccination were regarding unknown safety of the vaccines in general, a belief that there was a lack of data about the vaccines in transplant recipients, and a lack of trust in the scientific process underlying vaccine development, with 34% of the patients contacted expressing vaccine hesitancy overall.ConclusionOur qualitative summary identifies determinants of COVID-19 vaccine hesitancy in a diverse transplant patient population, supporting the need for transplant centers to implement tailored interventions to increase vaccine acceptance in this vulnerable population.

An iterative tessellation-based analytical approach to the design and planning of waste management regions

Collection and transportation of solid waste are costly for municipal budgets. This study challenges the use of existing administrative boundaries in waste management applications. By reducing the spread (standard deviation) of parameters (landfills, populated places, and roads), efficient and practical waste management regions are created. A novel alteration to the Centroidal Voronoi Tessellation (CVT) algorithm is proposed where Thiessen polygons are created using the central feature of a subset of data instead of the geometric centroid. The results applying the central feature method are compared to traditional CVT methods. Two Canadian provinces (Saskatchewan and Nova Scotia), the City of Regina, and two New York City boroughs (Manhattan and the Bronx) are investigated. Results suggest that the newly proposed tool can reduce the standard deviation of selected parameters compared to CVT. The spatial distribution of data and the geometry of the input tessellations are important factors in optimization. In Saskatchewan, reductions in parameter standard deviations ranged between 7.0 and 23.8% when comparing the two methods. In Nova Scotia, reductions in standard deviation of 9.64–13.25% were observed. In the City of Regina, wards may be more effective in planning solid waste collection compared to current solid waste collection boundaries. The standard deviation of parameters was minimized by 32.2–55.0% in New York. The proposed method may be able to efficiently create waste management regions in both cities and provinces, helping to reduce waste collection and transportation costs by ensuring an even spread of parameters in each region.

Socioeconomic Disparities in Subway Use and COVID-19 Outcomes in New York City.

Using data from New York City from January 2020 to April 2020, we found an estimated 28-day lag between the onset of reduced subway use and the end of the exponential growth period of severe acute respiratory syndrome coronavirus 2 within New York City boroughs. We also conducted a cross-sectional analysis of the associations between human mobility (i.e., subway ridership) on the week of April 11, 2020, sociodemographic factors, and coronavirus disease 2019 (COVID-19) incidence as of April 26, 2020. Areas with lower median income, a greater percentage of individuals who identify as non-White and/or Hispanic/Latino, a greater percentage of essential workers, and a greater percentage of health-care essential workers had more mobility during the pandemic. When adjusted for the percentage of essential workers, these associations did not remain, suggesting essential work drives human movement in these areas. Increased mobility and all sociodemographic variables (except percentage of people older than 75 years old and percentage of health-care essential workers) were associated with a higher rate of COVID-19 cases per 100,000 people, when adjusted for testing effort. Our study demonstrates that the most socially disadvantaged not only are at an increased risk for COVID-19 infection, they lack the privilege to fully engage in social distancing interventions.