York City Research Articles

Recent Trends in Opioid-Involved Overdose Deaths in New York City, 1999 to 2020

Recent Trends in Opioid-Involved Overdose Deaths in New York City, 1999 to 2020

Who Really Represents Me? The Case of Afro-Latinx Bureaucratic Representation in New York City Public Schools

Who Really Represents Me? The Case of Afro-Latinx Bureaucratic Representation in New York City Public Schools

Clinical and Diagnostic Features of West Nile Virus Neuroinvasive Disease in New York City

West Nile virus (WNV) neuroinvasive disease (WNND) occurs in approximately 1 percent of WNV-infected patients and typically presents as encephalitis, meningitis, or acute flaccid paralysis (AFP). WNND remains a difficult inpatient diagnosis, creating significant challenges for prognostication and therapy selection. We characterized the clinical and diagnostic features of WNND cases at two major academic medical centers in New York City in routine clinical practice. We retrospectively reviewed the charts of thirty-six patients with WNND, including twenty-six encephalitis, four meningitis, and six AFP cases. The most common presenting symptoms were fever (86.1%) and gastrointestinal symptoms (38.9%) in addition to altered mental status (72.2%), lethargy (63.9%), gait disturbances (46.2%), and headache (44.4%). Fourteen (48.3%) patients displayed acute magnetic resonance imaging (MRI) findings, particularly T2 hyperintensities in the bilateral thalami, brainstem, and deep white matter. New York State Department of Health WNV CSF IgM testing was utilized for diagnosis in 58.3% of patients; however, just 38.1% had the result by discharge, compared to 85.6% of those who underwent serum IgM testing. The median length of stay was 13.5 days, 38.9% were intubated, and three patients (8.9%) died during acute hospitalization. Our findings underscore the morbidity, mortality, and diagnostic challenges of WNND, suggesting the potential utility of serum IgM testing in combination with confirmatory CSF testing to expedite diagnosis in the acute setting.

Formal and informal dimensions of housing allocation: housing actors and gatekeepers of low-income migrants’ access to housing in the Bronx, New York City

AbstractIt is recognised that migrants’ access to housing in destination cities is shaped by a number of factors. This paper takes as its focus the processes of housing allocation for low-income West African migrants in the Bronx, New York City. Drawing on 37 semi-structured interviews with housing providers and intermediary organisations that perform housing-related functions, the paper builds upon literature on migration industries and informal housing solutions among migrant communities, and reveals the formal and informal systems which migrants must navigate in order to secure housing. The specific roles which housing providers and intermediary organisations – including housing advocacies NGOs, public institutions, and religious groups – play are highlighted. The paper shows that informal processes operating in the low-income housing market in the Bronx mirror the operations of formal institutional structures, but instead of financial and legal grounds for housing allocation, informal migration industries are centred on social ties within the established migrant community. Such arrangements provide much-needed access to affordable housing for low-income tenants and facilitate further migration.

Coming Up…

The annual meeting of the American Psychiatric Association will be held May 4‐8 in New York City. For more information, go to https://www.psychiatry.org/psychiatrists/meetings/annual‐meeting

Abstract PO1-10-04: Racial and Ethnic Disparities in Anthracycline and HER2-targeted Cardiotoxicity in Patients With Breast Cancer Using Global Longitudinal Strain Imaging Techniques

Abstract Purpose: Studies of global longitudinal strain (GLS) as a predictor of cancer treatment-related cardiac dysfunction (CTRCD) have been limited in racial/ethnic minority populations who are more likely to have risk factors associated with CTRCD. Our aim was to assess the utilization of GLS and development of CTRCD in a racially and ethnically diverse population of patients at an academic center in New York City. Methods: Patients were included if they had a breast cancer diagnosis and began treatment with anthracycline or HER2-directed therapies at Columbia University Irving Medical Center (CUIMC) from February 1, 2020-July 31, 2022. All patients and variables were identified via the electronic health record. Cardiovascular comorbidities including obesity, hypertension, diabetes, hyperlipidemia, coronary artery disease, congestive heart failure, and other cardiac disease, were recorded. Receipt of transthoracic echocardiogram(s) (TTE) with/without GLS were recorded, along with GLS and left ventricular ejection fraction (LVEF) values. CTRCD was defined as LVEF decrease of ≥10% to a LVEF value < 53% or GLS decrease of ≥ 15% from baseline or GLS < -18%. Analyses included descriptive statistics and univariable and multivariable logistic regression models to evaluate predictors of CTRCD by either LVEF or GLS definition. Results: We identified 270 eligible patients. Mean age was 51.8 years (standard deviation 13.0), 85 (31.5%) identified as White, 47 (17.4%) as Black/African, and 16 (5.9%) as Asian; 135 (50.0%) identified as Non-Hispanic/Latino, and 79 (29.2%) as Hispanic/Latino. Approximately half of the patient cohort, n=137 (50.7%) had a TTE with GLS during the study period. Of the TTEs done at CUIMC (n=658), 270 (41%) were ordered with GLS assessment, of which 184 (68%) reported a GLS value and 86 (32%) were not assessable due to image quality. Forty-three (16%) patients developed CTRCD: 20 (7%) by GLS criteria, 13 (5%) by LVEF criteria, and 10 (4%) by both GLS and LVEF criteria. In univariable analyses, race (OR 5.78, 95%CI 1.62-20.4 Asian compared to White), treatment with HER2 therapy without anthracycline versus anthracycline (OR 2.78, 95%CI 1.34-6.23), and prescription for cardiac medication prior to systemic therapy (OR 2.27, 95%CI 1.08-4.63) were predictors of CTRCD by any definition. In multivariable analysis, race (OR 7.86, 95%CI 1.71-38.50 Asian compared to White), and receipt of HER2 therapy without anthracycline compared to anthracycline (OR 5.13, 95%CI 1.42-25.00) were predictors of CTRCD. In multivariable analysis of CTRCD by GLS criteria only, race (OR 78.47, 95%CI 1.47-53.96 Asian compared to White), and treatment (OR 11.23, 95%CI 1.85-219 HER2 therapy compared to anthracycline; OR 58.7, 95%CI 1.05-60.59 HER2 therapy and anthracycline compared to anthracycline). Conclusions: In this retrospective analysis of a racially and ethnically diverse patient population, more than a third of Asian patients developed CTRCD, although the study is limited by small sample sizes. Asian race and receipt of anti-HER2 therapy were independent risk factors for CTRCD. Asian race was especially a predictor of CTRCD by GLS definition. Detection bias may explain the differences in CTRCD by drug class, as patients complete serial TTEs while receiving HER2-directed therapy, while patients who receive an anthracycline without HER2-directed therapy typically only receive a baseline TTE. Future research to better characterize racial differences in CTRCD incidence and develop interventions to reduce this disparity is an area warranting further investigation. Demographic and Tumor Related Factors Associated with CTRCD (n=270) Univariable and multivariable analysis of CTRCD by LVEF or GLS definition. Multivariable analysis was adjusted for all variables listed. Citation Format: Amanda Wang, Jayant Raikhelkar, Rohit Raghunathan, Julia McGuinness, Neil Vasan, Meghna Trivedi, Kevin Kalinsky, Katherine Crew, Melissa Beauchemin, Jason Wright, Dawn Hershman, Melissa Accordino. Racial and Ethnic Disparities in Anthracycline and HER2-targeted Cardiotoxicity in Patients With Breast Cancer Using Global Longitudinal Strain Imaging Techniques [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-10-04.

Patterns and Factors Associated With Alcohol Misuse Among Young Black Men Who Have Sex With Men in New York City.

Alcohol misuse is a significant health concern among gay, bisexual, same-gender-loving, and other men who have sex with men (MSM). Yet, little is known about the severity and predictors of alcohol misuse among self-reported young Black MSM. This study aimed to identify patterns of and factors associated with alcohol misuse in a sample of young Black MSM living in New York City. Baseline data from a randomized controlled trial aimed at improving the uptake of HIV testing among 250 MSM aged 18 to 29 were analyzed. Log-binominal regression analyses were conducted to assess the association of demographic and psychosocial factors with alcohol misuse in the past year and past 3 months among young Black MSM. Overall, 33.2% and 28.0% of young Black MSM in the study experienced alcohol misuse in the past year and past 3 months, respectively. In the adjusted model, factors positively associated with past-year alcohol misuse included marijuana use, a history of drug use, and having one-two or more than two male sex partners. Likewise, participants who used marijuana and those with one-two or more than two male partners were more likely to report past 3-month alcohol misuse. No significant association was found between positive screening for depressive symptoms, chemsex, internalized homophobia, and the likelihood of having alcohol misuse. The high prevalence of alcohol misuse underscores the importance of raising awareness of alcohol misuse and designing alcohol risk reduction programs that jointly address HIV risk among young Black MSM.

Investigation on the joint travel behavior in bike sharing systems during the COVID-19 pandemic: Insights from New York City

As the COVID-19 pandemic worsened, many people saw bikes as one of the safest means of transportation in the hard-hit cities. All the bike sharing utilization patterns during the pandemic are worthy of careful attention. However, there is still a lack of comprehensive understanding of niche but notable cycling behaviors, such as multi-person round trip (MPRT), defined as two or more cyclists intentionally riding together then returning bikes to the original docking station. This study extends the relevant literature by firstly proposing a MPRT identification framework based on individual bike sharing trip records, with consideration of interpersonal relationships between co-travelers, as well as the specificity of round trips against one-way trips. Taking New York City as a case study, this study examines the changes over space and time of MPRT frequencies from 2019 (i.e. pre-pandemic period) to 2020 (i.e. pandemic period), and the reasons for it. Notably, special consideration of the aforementioned analysis is paid to the influence of the real-time situation of COVID-19 in terms of cases, deaths, hospitalizations, and tests. Results reveal that (1) the MPRT frequencies obey a long tail distribution, both prior to and during the COVID-19 outbreak; (2) the group size, temporal patterns and co-traveler community are profoundly affected by the COVID-19 outbreak; (3) four indicators related to COVID-19 show different influences on co-travelers over time; (4) bike sharing availability and personal economic situation are closely related with MPRT frequencies. These findings can help develop more targeted strategies for improving the operation of a bike sharing system to meet the possible diversified demands of cyclists during the future pandemics.

Attitudes Toward the Uptake of Combination HIV Prevention Methods Among Young Black and Latino Heterosexual Couples Living in New York City: A Qualitative Study

Attitudes Toward the Uptake of Combination HIV Prevention Methods Among Young Black and Latino Heterosexual Couples Living in New York City: A Qualitative Study

An examination of sexual coercion experiences among Latinx female college students

ABSTRACT The current study examined sexual coercion among Latinx female college students in New York City. It identified frequently reported sexual coercion tactics and disclosure behaviours, delineating these experiences by race and cultural values. Latinx women (N = 158) from several public colleges were surveyed, and 49.4% (n = 78) experienced sexual coercion – with most reporting helplessness tactics (39.2%; n = 62). No differences were found among race, although this sample of Black Latinx students endorsed coercion more often than non-Black students. Most participants sought informal support, and specifically disclosed to a female friend (82.9%, n = 34). Lastly, attitudes toward familism and religiosity did not affect disclosure in this sample. These findings highlight the nuances of young Latinx women’s sexual experiences and have implications for sexual violence education for Latinx youth. It also has implications for college mental health professionals working with Latinx students with histories of sexual coercion. PRACTICE IMPACT STATEMENT Due to the nature of negative sexual experiences experienced among youth, sexual education curriculum and prevention training in educational institutions must emphasise the importance of sexual consent and identifying appropriate and inappropriate sexual advances. Curriculum must be tailored towards the demographics and respective potential cultural contexts of school district populations. College mental health professionals should be properly trained on how sexual coercion manifests in college-age relationships in addition to current training on identifying sexual harassment, sexual assault, and alcohol/drug induced rape.

Heavy Metal Contamination of Consumer Products: an Analysis of New York City Health Department Data.

Heavy Metal Contamination of Consumer Products: an Analysis of New York City Health Department Data.

Emergency Medical Services Use in New York City Amidst Record-Breaking Fine Particulate Matter Levels from the Canadian Wildfires, June 2023

Emergency Medical Services Use in New York City Amidst Record-Breaking Fine Particulate Matter Levels from the Canadian Wildfires, June 2023

Assessing the Validity of the Social Impact Scale Among a Longitudinal Cohort of Adolescents and Young Adults Living With Perinatally Acquired HIV.

With few psychometrically evaluated HIV-related stigma measures for adolescents and young adults living with HIV, we examined the developmental applicability (ie, validity) of 2 subscales of the commonly used stigma measure, the Social Impact Scale, among a cohort of adolescents and young adults with perinatally acquired HIV. Data were obtained from a New York City longitudinal study (N = 340). This study primarily comprised Black and Latinx adolescents and young adults with either perinatally acquired HIV or those with perinatal exposure but who are uninfected. Data for this analysis were obtained from the population with perinatally acquired HIV and spanned approximately a 15-year survey period (2003-2018). A confirmatory factor analysis was used at 7 time points to assess whether the Social Rejection and Internalized Shame subscales were consistent in this cohort over time. Overall and individual Cronbach alphas were reported to show the strength of the internal consistency. The mean age from baseline to follow-up 6 ranged from 12 to 23 years over the study period. The Social Rejection subscale was acceptably valid across follow-up periods with strong factor loadings and Cronbach alphas higher than 0.70. However, the Internalized Shame subscale was less valid among younger adolescents. Starting at follow-up 2, we observed better validity with the Internalized Shame subscale performance. Future research must consider mechanisms for developing and adapting measures from a developmental perspective to best measure the experiences of HIV-related stigma among younger populations.

Shady solar: understanding barriers and facilitators to residential solar adoption for low- and moderate-income homeowners in New York City

Low- and moderate-income (LMI) households face substantial barriers in accessing solar energy despite incentives at the local, state, and federal levels. Notwithstanding the rapid deployment of resources, there is still much to understand and address from a program design and implementation perspective to effectively realize an equitable energy transition. This qualitative study, which draws on interviews with policymakers, implementers, and LMI homeowners, provides novel insights into barriers and facilitators surrounding the inclusive adoption of solar energy. Our findings underscore the substantial differences and frequent misalignments in perspectives among these stakeholders. We find that both implementers and LMI homeowners encounter economic and administrative burdens, though the specific ways these factors hinder solar adoption differ between the groups. We leverage the viewpoints and experiences of policymakers, implementers, and LMI homeowners to guide evidence-based recommendations to overcome the many hurdles that actively impede equitable and inclusive solar adoption.

A Price Too High: Injury and Assault among Delivery Gig Workers in New York City.

The occupational health burden and mechanisms that link gig work to health are understudied. We described injury and assault prevalence among food delivery gig workers in New York City (NYC) and assessed the effect of job dependence on injury and assault through work-related mechanisms and across transportation modes (electric bike and moped versus car). Data were collected through a 2022 survey commissioned by the NYC Department of Consumer and Worker Protection among delivery gig workers between October and December 2021 in NYC. We used modified Poisson regression models to estimate the adjusted prevalence rate ratio associations between job dependence and injury and assault. Of 1650 respondents, 66.9% reported that food delivery gig work was their main or only job (i.e., fully dependent). About 21.9% and 20.8% of respondents reported being injured and assaulted, respectively. Injury and assault were more than twice as prevalent among two-wheeled drivers, in comparison to car users. Fully dependent respondents had a 1.61 (95% confidence interval (CI) 1.20, 2.16) and a 1.36 (95% CI 1.03, 1.80) times greater prevalence of injury and assault, respectively, than partially dependent respondents after adjusting for age, sex, race and ethnicity, language, employment length, transportation mode, and weekly work hours. These findings suggest that fully dependent food delivery gig workers, especially two-wheeled riders, are highly vulnerable to the negative consequences of working conditions under algorithmic management by the platforms. Improvements to food delivery gig worker health and safety are urgently needed, and company narratives surrounding worker autonomy and flexibility need to be revisited.

Urban social movements as extended class actors: struggles over reproduction in Buenos Aires, New York City and Hamburg

Along with a resurgence in urban social movements (USMs) since the Global Financial Crisis in 2007–08 has come renewed interest in what form(s) of social struggle these movements represent. This is because USMs cannot be straightforwardly explained by the contradiction between capital and labour, as they happened outside the workplace. With the aim of conceptualising USMs, a comparative and empirical case study was conducted on urban development and protest in New York City, Buenos Aires and Hamburg. Approaches ranging from spatial theory to urban sociology and political economy informed the theoretical framework. The study was empirically based on 47 interviews with activists, as well as the observation of participants at protest events and document analysis (both of publications by urban protest initiatives and urban development statistics). Emerging similarities regarding the relational and cognitive structures of investigated protests suggest that contemporary USMs are collective actors counteracting urban dispossession and are thus linked to the capitalist mode of accumulation. Therefore, the article argues for an understanding of USMs as extended class struggles over social reproduction in the city. This terminology is intended not only to highlight that USMs are expressions of the crisis of social reproduction in cities, but also to categorise the characteristic features of USMs – which represent struggles for the use value of a city. USMs can, moreover, contribute to social change, especially if they are able to provide alternative means of social reproduction through the appropriation of urban space.

How shareable is your trip? A path-based analysis of ridesplitting trip shareability

As an emerging sustainable mobility solution, ridesplitting services match passengers in a similar direction with a single vehicle to reduce fleet size, vehicle kilometers traveled and traffic emissions. However, these benefits can only be achieved with successful matching (sharing) between passengers, which emphasizes the importance of a comprehensive understanding of the matching success rate, i.e., shareability. Despite extensive research into the determinants of shareability, existing literature either relies on simulations and theoretical models with limited empirical validation, or focuses on system-level shareability for the whole market, overlooking the significant spatiotemporal variability of shareability across trips. This study aims to fill these gaps by proposing a path-based model that leverages real-world ridesplitting data to quantify the determinants of shareability at a finer spatiotemporal granularity. Utilizing data from New York City, our results show that: (1) shareability is spatiotemporally heterogeneous; (2) high demand intensity, especially the intensity of medium−/short-distance trips, contributes to greater shareability; (3) the positive contribution of demand intensity diminishes as it increases; (4) a higher road speed improves shareability; (5) excessive one-way street and over-dense street network are related to low shareability. These findings validate and enrich prior findings, which can be used to inform the future development of ridesplitting services.

The Influence of the COVID 19 Pandemic on Food Insecurity Among Cancer Survivors Across New York State.

People surviving cancer represent a particularly vulnerable population who are at a higher risk for food insecurity (FI) due to the adverse short- and long-term effects of cancer treatment. This analysis examines the influence of the COVID-19 pandemic on the prevalence of FI among cancer survivors across New York State (NYS). Data from the 2019 and 2021 NYS Behavioral Risk Factor Surveillance System (BRFSS) were used to estimate the prevalence of FI. Multivariable logistic regression was used to explore socioeconomic determinants of FI. Among cancer survivors, FI varied geographically with a higher prevalence in New York City compared to the rest of the state (ROS) prior to (25.3% vs. 13.8%; p = .0025) and during the pandemic (27.35% vs. 18.52%; p = 0.0206). In the adjusted logistic regression model, pre-pandemic FI was associated with non-White race (OR 2.30 [CI 1.16-4.56]), household income <$15,000 (OR 22.67 [CI 6.39-80.43]) or $15,000 to less than <$25,000 (OR 22.99 [CI 6.85-77.12]), and more co-morbidities (OR 1.39 [CI 1.09-1.77]). During the pandemic, the association of FI with non-White race (OR 1.76 [CI 0.98-3.16]) was attenuated but remained significant for low household income and more co-morbidities. FI was newly associated with being out of work for less than one year (OR 6.36 [CI 1.80-22.54] and having one (OR 4.42 [CI 1.77-11.07]) or two or more children in the household (OR 4.54 [CI 1.78-11.63]). Our findings highlight geographic inequities and key determinants of FI among cancer survivors that are amendable to correction by public health and social policies, for which several were momentarily implemented during the pandemic.

Coming Up…

The annual meeting of the American Psychiatric Association will be held May 4‐8 in New York City. For more information, go to https://www.psychiatry.org/psychiatrists/meetings/annual‐meeting

APA conference theme: Addiction

The theme of this year's annual meeting of the American Psychiatric Association (APA) is “Confronting Addiction from Prevention to Recovery.” This is appropriate considering the crisis facing America and the fact that outgoing president Petros Levounis, M.D., is an addiction psychiatrist. ADAW will of course be at the meeting, which is in New York City and starts May 4. Among the sessions are (links will take you to the APA meeting website with presenters and descriptions of presentations).