York City Borough Research Articles

Social Determinants Predict Outcomes in Data From a Multi-Ethnic Cohort of 20,899 Patients Investigated for COVID-19.

Importance: The COVID-19 pandemic exploits existing inequalities in social determinants of health (SDOH) in disease burden and access to healthcare. Few studies have examined these emerging disparities using indicators of SDOH.Objective: To evaluate predictors of COVID-19 test positivity, morbidity, and mortality and their implications for inequalities in SDOH and for future policies and health care improvements.Design, Setting, and Participants: A cross sectional analysis was performed on all patients tested for COVID-19 on the basis of symptoms with either a history of travel to at risk regions or close contact with a confirmed case, across the Mount Sinai Health System (MSHS) up until April 26th 2020.Main Outcomes and Measures: Primary outcome was death from COVID-19 and secondary outcomes were test positivity, and morbidity (e.g., hospitalization and intubation caused by COVID-19).Results: Of 20,899 tested patients, 8,928 tested positive, 1,701 were hospitalized, 684 were intubated, and 1,179 died from COVID-19. Age, sex, race/ethnicity, New York City borough (derived from first 3 digits of zip-code), and English as preferred language were significant predictors of test positivity, hospitalization, intubation and COVID-19 mortality following multivariable logistic regression analyses.Conclusions and Relevance: People residing in poorer boroughs were more likely to be burdened by and die from COVID-19. Our results highlight the importance of integrating comprehensive SDOH data into healthcare efforts with at-risk patient populations.

Reimagining impact: Storying youth research, arts, and activism

On a Friday afternoon, youth from four New York City boroughs gathered for a Cyphers for Justice (CFJ) after-school session. It was the third weekly session of the 15-week program, in which youth, ...

Gynecologic oncology care during the COVID-19 pandemic at three affiliated New York City hospitals

BackgroundNew York City was among the epicenters during the COVID-19 pandemic. Oncologists must balance plausible risks of COVID-19 infection with the recognized consequences of delaying cancer treatment, keeping in mind the capacity of the health care system. We sought to investigate treatment patterns in gynecologic cancer care during the first two months of the COVID-19 pandemic at three affiliated New York City hospitals located in Brooklyn, Manhattan and Queens. MethodsA prospective registry of patients with active or presumed gynecologic cancers receiving inpatient and/or outpatient care at three affiliated New York City hospitals was maintained between March 1 and April 30, 2020. Clinical and demographic data were abstracted from the electronic medical record with a focus on oncologic treatment. Multivariable logistic regression analysis was explored to evaluate the independent effect of hospital location, race, age, medical comorbidities, cancer status and COVID-19 status on treatment modifications. ResultsAmong 302 patients with gynecologic cancer, 117 (38.7%) experienced a COVID-19-related treatment modification (delay, change or cancellation) during the first two months of the pandemic in New York. Sixty-four patients (67.4% of those scheduled for surgery) had a COVID-19-related modification in their surgical plan, 45 (21.5% of those scheduled for systemic treatment) a modification in systemic treatment and 12 (18.8% of those scheduled for radiation) a modification in radiation. Nineteen patients (6.3%) had positive COVID-19 testing. On univariate analysis, hospital location in Queens or Brooklyn, age ≤65 years, treatment for a new cancer diagnosis versus recurrence and COVID-19 positivity were associated with treatment modifications. On multivariable logistic regression analysis, hospital location in Queens and COVID-19 positive testing were independently associated with treatment modifications. ConclusionsMore than one third of patients with gynecologic cancer at three affiliated New York City hospitals experienced a treatment delay, change or cancellation during the first two months of the COVID-19 pandemic. Among the three New York City boroughs represented in this study, likelihood of gynecologic oncology treatment modifications correlated with the case burden of COVID-19.

Reductions in commuting mobility correlate with geographic differences in SARS-CoV-2 prevalence in New York City

SARS-CoV-2-related mortality and hospitalizations differ substantially between New York City neighborhoods. Mitigation efforts require knowing the extent to which these disparities reflect differences in prevalence and understanding the associated drivers. Here, we report the prevalence of SARS-CoV-2 in New York City boroughs inferred using tests administered to 1,746 pregnant women hospitalized for delivery between March 22nd and May 3rd, 2020. We also assess the relationship between prevalence and commuting-style movements into and out of each borough. Prevalence ranged from 11.3% (95% credible interval [8.9%, 13.9%]) in Manhattan to 26.0% (15.3%, 38.9%) in South Queens, with an estimated city-wide prevalence of 15.6% (13.9%, 17.4%). Prevalence was lowest in boroughs with the greatest reductions in morning movements out of and evening movements into the borough (Pearson R = −0.88 [−0.52, −0.99]). Widespread testing is needed to further specify disparities in prevalence and assess the risk of future outbreaks.

Delivering a Masterpiece

The new Kosciuszko Bridge, also known as the K Bridge, is a twin-span, cable-stayed structure that traverses Newtown Creek, linking the New York City boroughs of Brooklyn and Queens via the Brooklyn–Queens Expressway, which runs east to west. Built in two phases, the eastbound bridge was completed in April 2017, and the westbound bridge was completed in August 2019. Both phases represent the first major bridge in New York City since the Verrazano–Narrows Bridge in 1964, and it is the state's first cable-stayed bridge.

A metagenomic examination of the pathobiome of the invasive tick species, Haemaphysalis longicornis, collected from a New York City borough, USA

Haemaphysalis longicornis, the Asian longhorned tick, is an invasive tick species that has spread rapidly across the northeastern and southeastern regions of the United States in recent years. This invasive pest species, known to transmit several tick-borne pathogens in its native range, is a potential threat to wildlife, livestock, domestic animals, and humans. Questing larval (n = 25), nymph (n = 10), and adult (n = 123), along with host-derived adult (n = 25) H. longicornis ticks were collected from various locations on Staten Island, NY. The pathobiome of each specimen was examined using two different high throughput sequencing approaches, virus enrichment and shotgun metagenomics. An average of 45,828,061 total reads per sample were recovered from the virus enriched samples and an average of 11,381,144 total reads per sample were obtained using shotgun metagenomics. Aside from endogenous viral sequences, no viruses were identified through either approach. Through shotgun metagenomics, Coxiella-like bacteria, Legionella, Sphingomonas, and other bacterial species were recovered. The Coxiella-like agent was ubiquitous and present at high abundances in all samples, suggesting it may be an endosymbiont. The other bacterial agents are not known to be transmitted by ticks. From these analyses, H. longicornis do not appear to host any endemic human tick-borne pathogens in the New York City region.

Variation in COVID-19 Hospitalizations and Deaths Across New York City Boroughs

This study describes demographic characteristics and hospital bed capacities of the 5 New York City boroughs, and evaluates whether differences in testing for coronavirus disease 2019 (COVID-19), hospitalizations, and deaths have emerged as a signal of racial, ethnic, and financial disparities.

Metaphors for Western Thought: Assessing the Rhetoric of One World Freedom Tower

Metaphors for Western Thought: Analyzing the Rhetoric of One World Freedom Tower On September 11th, 2001, the world was shocked by an attack carried out on the lower-west side of the New York City borough of Manhattan, at the symbolic site of the well known Two-World Trade Center. The event only lasted a short while, before resolving, and became recognized not long after by the country as a national tragedy; the world mourned shortly after as the smoke cleared. Five years following the at-tacks on 9-11, the city began efforts to construct a new tower that would be seen by all as a historic landmark, and a symbol of the country's strength and resilience in the face of those who would seek to destroy the American way of life. The monument is called the One World Trade Center, or Freedom Tower as it is now more widely recognized by those from New York and aboard. The Tower can mean many things to many people including, hope, pride, freedom, strength, resilience: symbols are often known for their ambiguous natures, and historic landmarks are no exception to the eyes of those who wish to pull meaning from an extended metaphor. This article will draw upon the earlier thoughts of Richard Weaver's theory of tyrannizing images, to reflect upon how freedom is used in the rhetoric of New York City's One World Trade Center as a metaphor embodying the American ide-ology of wealth being equivalent to salvation in the pursuit of happiness.

Traditional and Nontraditional Collaborations to Improve Population Health Using Geospatial Information System Maps: Analysis of the Opioid Crisis

IntroductionThe study aims were to analyze interprofessional practice collaborations among traditional and nontraditional health care providers and to educate nurse practitioner preceptors and students on population health, specifically, implementation of geospatial information system (GIS) maps and the correlation with the opioid crisis. MethodsA descriptive analysis was used to examine New York State data on the opioid crisis in comparison to outcome data from GIS maps of opioid use in two boroughs in New York City. Web-based modules were designed for analysis of GIS maps of opioid use near practice settings. ResultsNew York State data provided context for local opioid use, while GIS maps identified specific areas of the New York City boroughs that were most affected by the opioid epidemic. DiscussionThe importance of local GIS maps is that the information is available in real-time, and thus interventions can be designed, evaluated, and changed quickly to meet the immediate needs of the community.

Business improvement districts and the influence of historical community development: The Forest Avenue and South Shore BIDs of New York City

Business improvement districts (BIDs) have become increasingly prevalent entities in urban neighbourhoods and communities. BIDs are non-profit organisations established to deliver public services and improve economic conditions by imposing additional assessments on property owners. BIDs are invariably intertwined with the communities they are established to serve, and as a result understanding the complex relationship between BIDs and communities is imperative. This paper seeks to evaluate the role historical community development and community actors play in the development and implementation of BIDs by utilising a case study analysis of two BIDs in the New York City borough of Staten Island. Findings from this study reveal that historical patterns of community development are the principal determinant of the organisational objectives and budget allocation of BIDs. Further research concerning the interconnection between communities and BIDs is also suggested.

The association between pollutant levels and asthma-related emergency department visits in the Bronx after the World Trade Center attacks

Objective: To examine the potential impact of the World Trade Center (WTC) attacks on asthma-related emergency department visits (AREDV) in the New York City borough of the Bronx. Methods: We obtained daily nitrogen dioxide (NO2), sulfur dioxide (SO2) and ozone (O3) values from the National Climatic Data Center’s collection station in the Bronx from 1999 and 2002, a year before and after the WTC attacks. We compared daily AREDV and pollutant levels between 1999 and 2002 using the Wilcoxon signed rank sum test. We considered each season separately due to seasonal variations of AREDV and pollutants. We then used multiple linear regression models to assess the relationships between the changes in AREDV and the changes in pollutants from 1999 to 2002 in each season. Results: There were statistically significant increases from 1999 to 2002 in the daily NO2 in the summer. Significant increases for daily SO2 and O3 values from 1999 to 2002 occurred in all seasons. Significant increases occurred in daily AREDV values in the spring and fall. Multiple linear regression analyses showed that increases in the daily O3 values were significantly associated with increases in AREDV from 1999 to 2002 in the summer season. Conclusion: We observed a possible association between the WTC attacks and significant increases in O3 and SO2 for all seasons, and NO2 for the summer. AREDV significantly increased following the WTC attacks. Increases in daily O3 values were significantly associated with increases in AREDV in the summer season.

School Lunch Environmental Factors Impacting Fruit and Vegetable Consumption

ObjectiveAssess impact of school lunch environmental factors on fruit and vegetable (F&V) consumption in second and third grade students. DesignCross-sectional observations in 1 school year. ParticipantsStudents from 14 elementary schools in 4 New York City boroughs (n = 877 student-tray observations). Main Outcome Measure(s)Dependent variables were F&V consumption collected by visual observation. Independent variables included school lunch environmental factors, and individual-level and school-level demographics. AnalysisHierarchical linear modeling was used with F&V consumption as the outcome variable, and relevant independent variables included in each model. ResultsSlicing or precutting of fruits and having lunch after recess were positively associated (P < .05) with .163- and .080-cup higher fruit consumption across all students, respectively. Preplating of vegetables on lunch trays, having 2 or more vegetable options, and having lunch after recess were positively associated (P < .05) with .024-, .009-, and .007-cup higher vegetable consumption across all students, respectively. Conclusions and ImplicationsAlthough there was a small increase in intake, results of the study support that some school lunch environmental factors affect children's F&V consumption, with some factors leading to more impactful increases than others. Slicing of fruits seems most promising in leading to greater fruit consumption and should be further tested.

The association of environmental, meteorological, and pollen count variables with asthma-related emergency department visits and hospitalizations in the Bronx

Objective: To better understand how meteorological variables, air quality variables, and pollen counts collectively contribute to asthma-related emergency department visits (AREDV) and asthma-related hospitalizations (ARH) among pediatric and adult patients in the New York City borough of the Bronx. Methods: The numbers of daily adult and pediatric AREDV and ARH from 2001 to 2008 were obtained from three Bronx hospitals. After removing outliers, interpolating missing data, and standardizing variable values by scaling the data using z-scores, data were analyzed using Spearman rank tests and linear regression models for the full year and each season. Results: There were a total of 42,065 AREDV and 1,664 ARH at both Bronx hospitals. With the exception of a spring peak in AREDVs, AREDVs and ARHs follow a cyclical pattern, climbing in the fall, plateauing in the winter, dropping in the spring, and reaching a low in the summer. Among the 11 air quality, meteorological, and pollen count variables, temperature and tree pollen made the greatest contribution to AREDV with scaled coefficients of –0.337 and 0.311 respectively; equating to an additional AREDV for every 5.0-unit decrease in temperature and an additional AREDV for every 186.0-unit increase in tree pollen. These two variables were confirmed to have independent associations with AREDV prior to the data interpolation. Grass pollen was also found to have a relatively large contribution to AREDV during the summer with a scaled coefficient of 0.314, equating to an additional AREDV for every 2.3-unit increase in grass pollen. Conclusion: There are distinct peaks of increased AREDVs that are closely associated with increased tree pollen counts in the spring and decreasing temperatures in the fall. Early anticipation of these air quality, meteorological, and pollen factor changes based on ongoing surveillance could potentially guide clinical practice and minimize AREDVs in the Bronx.

Bloom SOFC system powers SUNY medical centre in Brooklyn

The SUNY Downstate Medical Center in the New York City borough of Brooklyn has unveiled a new initiative with Bloom Energy and utility Con Edison, to provide the hospital with clean, reliable energy that will also reduce the strain on Brooklyn's power grid and help reduce local air pollution.

Evaluating a Multidisciplinary Approach for the Management of Severe Asthma in the New York City Borough of the Bronx: The Montefiore Asthma Center Experience

Evaluating a Multidisciplinary Approach for the Management of Severe Asthma in the New York City Borough of the Bronx: The Montefiore Asthma Center Experience

Forbidden Colors

Forbidden Colors

New York City Department of Parks and Recreation

In January 2013, John C. Liu, New York City's comptroller, wrote to the residents of the city about his audit of the New York City Department of Parks and Recreation (DPR). Liu summarized his office's findings: “The audit found that DPR was not carrying out and overseeing capital construction projects in a timely and cost effective manner.” To investigate the existence of the in organizations, information from nearly 1,800 capital projects undertaken between 1998 and 2008 was obtained from the office of the chief engineer of the New York City DPR. In light of the data, how severe was the planning fallacy during this time and could it be used for overcoming the planning fallacy? Excerpt UVA-QA-0815 Rev. Aug. 11, 2015 New York City Department of Parks and Recreation On January 11, 2013, John C. Liu, New York City's comptroller, wrote to the residents of the city about his audit of the New York City Department of Parks and Recreation (DPR). Among his responsibilities, the comptroller made recommendations for city programs and operations and audited city agencies. Liu summarized his office's findings: “The audit found that DPR was not carrying out and overseeing capital construction projects in a timely and cost effective manner.” New York City Department of Parks and Recreation The New York City DPR was responsible for maintaining more than 1,700 city parks and recreational facilities, preserving natural areas, and furnishing recreational properties. The agency was in charge of 29,098 acres of parks, beaches, playgrounds, stadiums, marinas, gardens, and squares. The DPR not only cared for street and park flora and fauna, historic houses, statues, monuments, and open spaces in the five New York City boroughs, but also oversaw activities supporting physical fitness, environmental education, and performing arts. . . .

Change in Brooklyn and Queens: How New York?s Reforming the Energy Vision Program and Con Edison Are Reshaping Electric Distribution Planning

The New York City boroughs of Brooklyn and Queens are undergoing a period of gentrification, infrastructure rebuilding, new construction, and load growth not experienced in decades. Significant numbers of residents are moving in, and structures that had been abandoned or were in disrepair are being refurbished and modernized to accommodate the burgeoning population. Homes, businesses, and industries are reviving areas long in decline, and Brooklyn's growth has made it the nation?s fourth most populous city, according to the U.S. Census Bureau.

A City's Desert: No Apples in the Big Apple? (B)

The New York City Department of Health and Mental Hygiene's Physical Activity and Nutrition Program needed to come up with an innovative solution to the many health problems, such as obesity, diabetes, and heart disease that plagued residents of poorer areas in the city, while increasing economic opportunity for neighborhood residents. The result was the launching of Green Carts, a new mobile food vending initiative to support the introduction of healthier food options to residents of “food deserts” in New York City boroughs. The challenge was navigating the diverse landscape of players and engaging all of the relevant stakeholders to come up with a solution that was both feasible and sustainable. This case exemplifies the how partnership and strategic alliances can be used to have significant social impact. The beauty of this example is that it simultaneously addresses two large social issues: 1) access to healthy food options in urban food deserts and 2) creating self-employment opportunities for members of disadvantaged communities. This case also illustrates how the public sector can act as social innovators.Evaluate a complex real-world example of the types of partnership that must be formed in order to achieve scalable social impact. Use the ecosystem analysis framework provided in class to analyze the potential stakeholder groups and make recommendations about the types of partnership that should be put in place in order to maximize the effectiveness of the program.

A City's Desert: No Apples in the Big Apple? (A)

The New York City Department of Health and Mental Hygiene's Physical Activity and Nutrition Program needed to come up with an innovative solution to the many health problems, such as obesity, diabetes, and heart disease that plagued residents of poorer areas in the city, while increasing economic opportunity for neighborhood residents. The result was the launching of Green Carts, a new mobile food vending initiative to support the introduction of healthier food options to residents of “food deserts” in New York City boroughs. The challenge was navigating the diverse landscape of players and engaging all of the relevant stakeholders to come up with a solution that was both feasible and sustainable. This case exemplifies the how partnership and strategic alliances can be used to have significant social impact. The beauty of this example is that it simultaneously addresses two large social issues: 1) access to healthy food options in urban food deserts and 2) creating self-employment opportunities for members of disadvantaged communities. This case also illustrates how the public sector can act as social innovators.Evaluate a complex real-world example of the types of partnership that must be formed in order to achieve scalable social impact. Use the ecosystem analysis framework provided in class to analyze the potential stakeholder groups and make recommendations about the types of partnership that should be put in place in order to maximize the effectiveness of the program.