York City Research Articles

Neighborhood Gentrification and Food Insecurity Among Urban Older Adults: Evidence From New York City.

Gentrification is a prevalent neighborhood development process in urban areas across the United States. Prior studies have identified the influence of gentrification on late-life health and quality of life, yet little is known about its relationship with food insecurity, an important public health issue for older adult populations. Using New York City as a case study, this study investigated associations between living in a gentrifying neighborhood and food insecurity, as well as the mediating roles of neighborhood environment factors-social cohesion, public transportation, and food environment. This study adopted 2 waves of annual data from the Poverty Tracker Study (2015-2016; N = 703) merged with American Community Survey and spatial data sets to measure gentrification and neighborhood factors. Adjusted logistic regressions were used to examine the associations between gentrification and food insecurity. Further mediation analyses were conducted to test the mechanisms of such associations. Older adults in gentrifying neighborhoods were more likely to have food insecurity than those in moderate- to high-income neighborhoods. Compared to low-income neighborhoods, older adults in gentrifying neighborhoods had a lower likelihood of reporting food insecurity. Two significant mediators were found when comparing gentrification with moderate- to high-income neighborhoods: social cohesion and healthy food outlets. This study highlights the importance of gentrification in determining late-life food insecurity and identifies possible mechanisms with policy and social service implications to reduce the risk of food insecurity in urban areas.

Home Blood Pressure Telemonitoring and Nurse Case Management in Black and Hispanic Patients With Stroke

Black and Hispanic patients have high rates of recurrent stroke and uncontrolled hypertension in the US. The effectiveness of home blood pressure telemonitoring (HBPTM) and telephonic nurse case management (NCM) among low-income Black and Hispanic patients with stroke is unknown. To determine whether NCM plus HBPTM results in greater systolic blood pressure (SBP) reduction at 12 months and lower rate of stroke recurrence at 24 months than HBPTM alone among Black and Hispanic stroke survivors with uncontrolled hypertension. Practice-based, multicenter, randomized clinical trial in 8 stroke centers and ambulatory practices in New York City. Black and Hispanic study participants were enrolled between April 18, 2014, and December 19, 2017, with a final follow-up visit on December 31, 2019. Participants were randomly assigned to receive either HBPTM alone (12 home BP measurements/week for 12 months, with results transmitted to a clinician; n = 226) or NCM plus HBPTM (20 counseling calls over 12 months; n = 224). Primary outcomes were change in SBP at 12 months and rate of recurrent stroke at 24 months. Final statistical analyses were completed March 14, 2024. Among 450 participants who were enrolled and randomized (mean [SD] age, 61.7 [11.0] years; 51% were Black [n = 231]; 44% were women [n = 200]; 31% had ≥3 comorbid conditions [n = 137]; 72% had household income <$25 000/y [n = 234/324]), 358 (80%) completed the trial. Those in the NCM plus HBPTM group had a significantly greater SBP reduction than those in the HBPTM alone group at 12 months (-15.1 mm Hg [95% CI, -17.2 to -13.0] vs -5.8 mm Hg [95% CI, -7.9 to -3.7], respectively; P < .001). The between-group difference in SBP reduction at 12 months, adjusted for primary care physician clustering, was -8.1 mm Hg (95% CI, -11.2 to -5.0; P < .001) at 12 months. The rate of recurrent stroke was similar between both groups at 24 months (4.0% in the NCM plus HBPTM group vs 4.0% in the HBPTM alone group, P > .99). Among predominantly low-income Black and Hispanic stroke survivors with uncontrolled hypertension, addition of NCM to HBPTM led to greater SBP reduction than HBPTM alone. Additional studies are needed to understand the long-term clinical outcomes, cost-effectiveness, and generalizability of NCM-enhanced telehealth programs among low-income Black and Hispanic stroke survivors with significant comorbidity. Clinical Trials.gov Identifier: NCT02011685.

Progress Toward Tuberculosis Elimination and Tuberculosis Program Performance - National Tuberculosis Indicators Project, 2016-2022.

Elimination of tuberculosis (TB) is defined as reducing TB disease incidence in the United States to less than 1 case per million persons per year. In 2022, TB incidence in the United States was 2.5 TB cases per 100,000 persons. CDC's TB program developed a set of national TB indicators to evaluate progress toward TB elimination through monitoring performance of state and city TB program activities. Examining TB indicator data enables state- and city-level TB programs to identify areas for program evaluation and improvement activities. These data also help CDC identify states and cities that might benefit from technical assistance. The 5-year period for which the most recent data were available for each of five indicators: 1) overall TB incidence (2018-2022), 2) TB incidence among non-U.S.-born persons (2018-2022), 3) percentage of persons with drug susceptibility results reported (2018-2022), 4) percentage of contacts to sputum acid-fast bacillus (AFB) smear-positive TB patients with newly diagnosed latent TB infection (LTBI) who completed treatment (2017-2021), and 5) percentage of patients with completion of TB therapy within 12 months (2016-2020). The National TB Indicators Project (NTIP) is a web-based performance monitoring tool that uses national TB surveillance data reported through the National TB Surveillance System and the Aggregate Reports for TB Program Evaluation. NTIP was developed to facilitate the use of existing data to help TB program staff members prioritize activities, monitor progress, and focus program improvement efforts. The following five indicators were selected for this report because of their importance in Federal TB funding allocation and in accelerating the decline in TB cases: 1) overall TB incidence in the United States, 2) TB incidence among non-U.S.-born persons, 3) percentage of persons with drug susceptibility results reported, 4) percentage of contacts to sputum AFB smear-positive TB cases who completed treatment for LTBI, and 5) percentage of patients with completion of TB therapy within 12 months. For this report, 52 TB programs (50 states, the District of Columbia, and New York City) were categorized into terciles based on the 5-year average number of TB cases reported to National TB Surveillance System. This grouping allows comparison of TB programs that have similar numbers of TB cases and allocates a similar number of TB programs to each category. The following formula was used to calculate the relative change by TB program for each indicator: [(% from year 5 - % from year 1 ÷ % from year 1) × 100]. During the 5-year period for which the most recent data were available, most TB programs had improvements in reducing overall TB incidence (71.2%) and increasing the percentage of contacts receiving a diagnosis of LTBI who completed LTBI treatment (55.8%); the majority of programs (51.0%) also had improvements in reducing incidence among non-U.S.-born persons. The average percentage of persons with drug susceptibility results reported in most jurisdictions (28 of 52, [53.9%]) met or exceeded the 5-year national average of 97% (2018-2022). The percentage of contacts to sputum acid-fast bacillus (AFB) smear-positive TB patients with newly diagnosed latent TB infection (LTBI) who completed treatment increased in 29 of 52 (55.8%) jurisdictions from 2017 to 2021, signifying that, for most jurisdictions, steps have been taken to enhance performance in this area. The average percentage of patients with completion of TB therapy within 12 months was at or above the national average of 89.7% in approximately two-thirds (32 of 52 [61.5%]) of jurisdictions. This report is the first to describe a 5-year relative change for TB program performance. These results suggest that TB programs are making improvements in activities that help identify persons with TB and LTBI and ensure patients complete treatment in a timely manner. Use of NTIP data from individual TB programs enables a more detailed examination of trends in program performance and identification of areas for program improvement. Assessing indicator trends by TB program provides an opportunity to gain a better understanding of program performance in comparison to other programs. It can also facilitate communication between programs regarding successes and challenges in program improvement. This information is valuable for TB programs to allocate resources effectively and provide additional context on TB control for public health policymakers.

New York city taxi demand forecast based on ARIMA model

The competition in the taxi market is becoming increasingly fierce, but there is a gap between the demand and the number of taxis in some time periods, which not only intensifies ineffective competition among taxis but also brings inconvenience to passengers. This study aims to establish a predictive model to predict the demand for taxis in different time periods in the city. The data was collected from New York City yellow taxi data which was from June 1st, 2022 to June 6th, 2022. After processing the raw data, the optimal parameter selection of the model is determined through ADF testing to improve accuracy. Through ACF and PACF calculation, the data and images are analyzed to find the most suitable p and q values. Use ARIMA model to fit the data and obtain a model with robust fitting parameters. The distribution of predicted values is very consistent with actual data. The model was used for 50 periods of prediction, and through analysis of the research results, the fitting effect of the prediction was good. It was found that the accuracy of the model was high, proving its ability to predict short-term taxi demand.

Viral Load Suppression in People Living with HIV Before and During the COVID-19 Pandemic in Brooklyn, New York.

Consistent care is crucial for the health maintenance of people living with human immunodeficiency virus (HIV) (PWH). The coronavirus 2019 (COVID-19) epidemic disrupted patient care in New York City (NYC), yet few studies investigated the association between COVID-19 and viral load suppression in PWH in NYC. This study aims to assess how the COVID-19 pandemic impacted HIV viral load and CD4 + T-cell counts in PWH. Medical records of 1130 adult HIV patients who visited the Special Treatment and Research Health Center in Brooklyn, NY, between January 2019 and May 2023 were compared across three timeframes (pre-pandemic, January 1, 2019 to December 31, 2019; first pandemic phase, March 19, 2020 to December 31, 2020; and second pandemic phase, January 1, 2021 to May 11, 2023). Demographic and clinical variables (e.g. viral load and CD4 + T cell count) were assessed. About 40% of patients did not have routine laboratory monitoring during the first pandemic phase compared with pre-pandemic. The mean HIV viral load was higher during the second pandemic phase compared with pre-pandemic (p = 0.009). The percentages of patients with undetectable HIV viral load and numbers (mm3) of CD4 + T-cells were similar for all time periods. These findings indicate that the COVID-19 pandemic may have exacerbated challenges for individuals who already had barriers to medication adherence or access. However, most individuals remained consistently on their antiretrovirals throughout the pandemic. Further studies are warranted to determine how to mitigate the impact of future pandemics for the health of PWH.

The Biased Enforcement of Rarely Followed Rules.

We examined whether the enforcement of phantom rules-frequently broken and rarely enforced codified rules-varies by the race of the rule breaker. First, we analyzed whether race affects when 311 calls, a nonemergency service, end in arrest in New York City. Across 10 years, we found that calls from census blocks of neighborhoods consisting of mostly White individuals were 65% less likely to escalate to arrest than those where White people were the numerical minority. Next, we experimentally manipulated transgressor race and found that participants (N = 393) who were high in social dominance orientation were more likely to route 311 calls to 911 when the transgressor was Black (vs. White). We also explored the subjective experience of phantom rule enforcement; People of color report they are more likely to be punished for violating phantom rules compared to White people. Overall, we find evidence of racism in the enforcement of phantom rules.

Virtual Biostats Day: An interactive online Biostatistics outreach program directed at high school students in groups historically underrepresented in STEM careers

Persistent underrepresentation of Black and Hispanic Statistics degree holders relative to the U.S. population occurs at all levels in post-secondary education, contributing to the underrepresentation of Black and Hispanic Bio/Statisticians. Attempting to address this inequity before the undergraduate level, Memorial Sloan Kettering (MSK)’s Bridge to Biostats committee was established with the mission to increase awareness of and interest in the field of Biostatistics among high school students in groups underrepresented in STEM fields. We describe in this paper an outreach program targeted to underrepresented students in New York City with innate aptitude and interest in STEM subjects, but minimal exposure to Statistics. Virtual Biostats Day is a 1-1/4 hour online exposure program that incorporates interactive elements exploring statistical concepts alongside clear descriptions of the field of Biostatistics and the roles and responsibilities of a Biostatistician. Students are also introduced to professional Biostatisticians who describe their journeys from high school to where they are today. This combination of didactic and active learning has engaged students, even in the online environment. We relate our experience in implementing and presenting our program to students and provide a complete toolkit for other Bio/Statistics departments or organizations interested in engaging in similar outreach work.

Modeling food-related business closure in select New York City communities using multi-scale and spatial features

This paper introduces an extensible framework to predict small-business closures to inform urban planners, lenders, and business owners as to factors to improve business resilience. This paper couples machine learning with two point of interest (POI) datasets and infrastructure data and uses New York State’s COVID-19 PAUSE as a stressor for investigating small-business resiliency. The study included 2537 food-related, non-chain, retail businesses across select New York City zip codes, of which 17.7% closed permanently. Macro-, meso-, and micro-levels of features included the neighborhood profile, street dynamics, and venue-specific, location-related characteristics. A Gaussian Mixture Neural Network model achieved 74.1% precision, 92.5% recall, and an 82.3% F1-score without use of financial data. High-end restaurants located further than average from public transit were most at risk for closure, while non-restaurant, food businesses in commercially diverse areas having higher-than-average social media ratings were least at risk. This paper introduces a model for timely prediction of pandemic-induced, food-related, small-business closures without reliance on private or protected financial data, and provides insights into urban design to promote small, food business survivability.

Study: Cannabis use disorder is a developmental disease

A study released May 8 focused on the serious danger of psychosis related to frequent high‐dose cannabis use. Written by veteran cannabis researcher Jasmin Hurd, M.D. and colleagues, the study, “The developmental trajectory to cannabis use disorder” (to be published in the May issue of the American Journal of Psychiatry), senior author Hurd, working with lead author Jess Hinckley, M.D, an adolescent psychiatrist at Mt. Sinai Hospital in New York City, looked at the many harms of cannabis use to young people who are still developing.

NPCC4: New York City climate risk information 2022-observations and projections.

New York City (NYC) faces many challenges in the coming decades due to climate change and its interactions with social vulnerabilities and uneven urban development patterns and processes. This New York City Panel on Climate Change (NPCC) report contributes to the Panel's mandate to advise the city on climate change and provide timely climate risk information that can inform flexible and equitable adaptation pathways that enhance resilience to climate change. This report presents up-to-date scientific information as well as updated sea level rise projections of record. We also present a new methodology related to climate extremes and describe new methods for developing the next generation of climate projections for the New York metropolitan region. Future work by the Panel should compare the temperature and precipitation projections presented in this report with a subset of models to determine the potential impact and relevance of the "hot model" problem. NPCC4 expects to establish new projections-of-record for precipitation and temperature in 2024 based on this comparison and additional analysis. Nevertheless, the temperature and precipitation projections presented in this report may be useful for NYC stakeholders in the interim as they rely on the newest generation of global climate models.

Gender differences in spatio-temporal dynamics: Visualizing bike-sharing mobility patterns in New York City

Urban spaces distinctly modulate the mobility patterns of men and women, with new mobility modes manifesting gender differences. In this study, by visualizing bike-sharing mobility patterns in New York City, we reveal significant disparities in cycling usage between males and females. During weekdays, the findings highlight a pattern of male dominance in most areas, particularly in business districts. In some recreational and residential areas, routes with higher proportions of female cyclists are observed. Additionally, weekends experience a surge in the proportion of female cyclists, predominantly in leisure-oriented locations. These findings highlighted the need for urban planning to account for gender differences across space and time to meet diverse mobility needs.

Neighborhood Safety and Neighborhood Police Violence Are Associated with Psychological Distress among English- and Spanish-Speaking Transgender Women of Color in New York City: Finding from the TURNNT Cohort Study.

Transgender women of color (TWOC) experience high rates of police violence and victimization compared to other sexual and gender minority groups, as well as compared to other White transgender and cisgender women. While past studies have demonstrated how frequent police harassment is associated with higher psychological distress, the effect of neighborhood safety and neighborhood police violence on TWOC's mental health is rarely studied. In this study, we examine the association between neighborhood safety and neighborhood police violence with psychological distress among TWOC. Baseline self-reported data are from the TURNNT ("Trying to Understand Relationships, Networks and Neighborhoods among Transgender Woman of Color") Cohort Study (analytic n = 303). Recruitment for the study began September 2020 and ended November 2022. Eligibility criteria included being a TWOC, age 18-55, English- or Spanish-speaking, and planning to reside in the New York City metropolitan area for at least 1year. In multivariable analyses, neighborhood safety and neighborhood police violence were associated with psychological distress. For example, individuals who reported medium levels of neighborhood police violence had 1.15 [1.03, 1.28] times the odds of experiencing psychological distress compared to those who experienced low levels of neighborhood police violence. Our data suggest that neighborhood safety and neighborhood police violence were associated with increased psychological distress among TWOC. Policies and programs to address neighborhood police violence (such as body cameras and legal consequences for abusive officers) may improve mental health among TWOC.

Do digital technologies reduce racially biased reporting? Evidence from NYPD administrative data

Recent work has emphasized the disproportionate bias faced by minorities when interacting with law enforcement. However, research on the topic has been hampered by biased sampling in administrative data, namely that records of police interactions with citizens only reflect information on the civilians that police elect to investigate, and not civilians that police observe but do not investigate. In this work, we address a related bias in administrative police data which has received less empirical attention, namely reporting biases around investigations that have taken place. Further, we investigate whether digital monitoring tools help mitigate this reporting bias. To do so, we examine changes in reports of interactions between law enforcement and citizens in the wake of the New York City Police Department's replacement of analog memo books with mobile smartphones. Results from a staggered difference in differences estimation indicate a significant increase in reports of citizen stops once the new smartphones are deployed. Importantly, we observe that the rise is driven by increased reports of "unproductive" stops, stops involving non-White citizens, and stops occurring in areas characterized by a greater concentration of crime and non-White residents. These results reinforce the recent observation that prior work has likely underestimated the extent of racial bias in policing. Further, they highlight that the implementation of digital monitoring tools can mitigate the issue to some extent.

Zika Virus Infection Knowledge and Communication Preferences Among Women of Reproductive Age in Central Brooklyn, New York: A Thematic Analysis.

The 2016 outbreak of Zika virus (ZIKV) infected millions and resulted in thousands of infants born with malformations. Though the clusters of severe birth defects resulting from this outbreak have subsided, ZIKV continues to be a concern throughout much of Latin America and the Caribbean. Travel and sexual intercourse remain the dominant transmission risk factors for women of reproductive age and their partners. This is particularly true for communities in Brooklyn, New York, that comprise large immigrant and foreign-born populations. Practitioners of public health understand little about how women at risk for ZIKV are most likely to receive information about the virus or who they trust most to provide that information. In the context of five focus group discussions, this study explored the knowledge and communication preferences of 20 women of reproductive age in Central Brooklyn. Results derived from a thematic analysis suggest that while most women are familiar with mosquitos as ZIKV vectors, knowledge of sexual transmission is considerably lower. Many respondents believe that only women who are pregnant or trying to become pregnant are at risk, and public health agencies, such as the U.S. Centers for Disease Control and Prevention, remain the most trusted sources of information. These findings can support more effective communication about the risks of ZIKV infection and other vector-borne diseases to women in New York City and similar urban communities.

An Analysis of Agenda Setting and Framing of American Marathon Television Coverage

This study examined nationally televised marathon coverage of three major U.S. marathons (the Boston Marathon, the Bank of America Chicago Marathon, and the Tata Consultancy Services New York City Marathon) to understand how able-bodied men and women, and men and women using wheelchairs were represented. Just under 8 hr of coverage was analyzed for clock time and the descriptions of athletes divided by divisions of able-bodied men and women and wheelchair athlete men and women. Able-bodied women received the majority of clock time in Boston and Chicago, while able-bodied men received the majority of clock time in New York City. Athletes using wheelchairs, both men and women, received much smaller amounts of coverage, especially in New York City. Women received more announcer mentions in all three races, with a heavier focus on their background, coaching, and emotion, although the only statistically significant category was emotion. Experience and race strategy/training were heavily emphasized for all divisions. Through this analysis, race producers have more guidance on how to cover future marathons in a more equitable and appropriate manner.

The association between street construction projects and community violence in New York City.

Community violence is a major cause of injury and death in the United States. Empirical studies have identified that some place-based interventions of urban private places, such as remediations of vacant lots and buildings, are associated with reductions in community violence in surrounding areas. The aim of this study was to examine whether routine maintenance and repair of urban public places (e.g., street construction projects) are also associated with reductions in community violence, proxied by violent crime. This staggered adoption difference-in-difference analysis investigated the association between street construction projects and community violence in New York City from 2010-2019, divided into 40 calendar quarters. The units of analysis were street-quarters (n = 155,280). Intervention street-quarters were those with completed projects in 2010-2019; control streets were those where projects were scheduled but not completed before 2019. The outcome of community violence was proxied by counts of crime and violence incidents reported to the New York Police Department, within street-quarters. There were 79,592 street-quarters with any community violence incidents (51.2%). We found that street construction projects were associated with a decrease in reckless endangerment (ATT = -0.013; 95% CI = -0.021, -0.004), robbery (ATT = -0.035; 95% CI = -0.063, -0.007), and weapons offenses (ATT = -0.016; 95% CI = -0.031, -0.001) occurring on street-quarters. Street construction projects may be yet another type of place-based intervention to reduce community violence.

Participant adherence in a lung cancer screening (LCS) program in a non-smoking population.

10556 Background: LCS guidelines in smoking populations includes an annual low-dose CT Chest (LDCT) scan. Historically, real-world adherence to repeat imaging following the baseline LDCT has been low at 22% (Silvestri et al. Chest 2023). Various reasons for non-adherence have been cited and can be amplified in populations where English is not the primary language, low health literacy, or logistical reasons that interfere with scheduling. We are conducting the Female Asian Nonsmoker Screening Study (FANSS), which is a pilot study for Asian women with no smoking history to provide LDCTs to this population. We describe the strategies utilized to address potential barriers to adherence and report the participant (pt) adherence observed to date for this population. Methods: FANSS is an IRB-approved trial that provides LDCTs annually for 3 years and has an interim follow-up phone call every 6 months. All aspects of the study other than the LDCT could be conducted virtually pending pt preference. All pt interactions were conducted in the pt’s requested language. LDCTs were interpreted according to Lung-RADS. Review of the LDCT results were available in-person or virtually by a nurse practitioner or the principal investigator. The timeline for the 2nd and 3rd LDCT after the baseline scan was determined as follows: pts with negative findings were recommended for a repeat LDCT in 1 year; pts with suspicious findings were reviewed at the NYU Multidisciplinary Nodule Board and recommended for a repeated LDCT in a 3 or 6 month interval. A bilingual (English and Chinese speaking) research coordinator and medical secretaries reached out to pts at their preferred contact (email, phone, or text) for scheduling the follow-up LDCT. Up to three attempts to reach pts to schedule their follow-up LDCT were made. Results: From 3/5/21 to 1/27/24, 634 subjects completed their baseline LDCTs. Language interpretation services were utilized in 30% of pts. As of 1/27/24, 215 pts were due for their 2nd LDCT: 195 (91%) completed (186) or scheduled (9) the LDCT, 5 pts withdrew their consent, and 15 did not complete the scan. The main reasons for not completing the scans were: living outside New York City, other health concerns, and lost to follow-up. As of 1/27/24, 95 pts were due for their 3rd LDCT: 87 (92%) completed (82) and scheduled (5) the LDCT, and 8 did not complete the scan due to being lost to follow-up. Conclusions: The FANSS population is a unique pt cohort comprised of all Asian women who do not qualify for current LCS guidelines. Interventions to address potential adherence issues were implemented. In our research-based setting, virtual conduct of most of the study procedures allowed pt flexibility. Pt outreach to ensure follow-up by contacting through various methods also ensured adherence of &gt;90%. These interventions can be considered for use in other LCS programs to improve adherence to LCS follow-up.

Disparities in the initial presentation of melanoma across two socioeconomically diverse New York City neighborhoods.

1593 Background: Disparities in stage at diagnosis among melanoma patients are often seen between urban and rural communities, with patients in rural areas being diagnosed with more advanced tumors. Factors contributing to the disparities include decreased access to dermatologists in rural areas, and lower socioeconomic status (SES). We investigated urban disparities in melanoma T stage at diagnosis among patients residing in 2 New York City (NYC) neighborhoods of differing SES and receiving care within the NYU Langone Health System. The neighborhoods were: Upper East Side (UES) and Brighton Beach/Coney Island (BB/CI). Methods: We conducted a retrospective chart review (NYU IRB 23-01020) of melanoma patients (N=243) diagnosed from 2018-2022 using ICD-10-CM codes: C43 (malignant melanoma of skin); D03 (melanoma in situ); and Z85.820 (personal history of malignant melanoma of skin). For community-level data we used the American Academy of Dermatology’s “Find a Dermatologist” search function to locate member-dermatologists; New York State Cancer Registry data (2016-2020) to determine annual melanoma incidence; and the United States Census Bureau Public Use Microdata Areas to determine the proportion of Non-Hispanic Whites (NHW), income levels, and educational attainment. The distribution of T stages was compared using a chi-square test. A two-sample test was used to assess equality of proportions. Results: In UES, the annual melanoma incidence was 30.2/100,000 (95% CI: 27.4-33.2); NHW comprised 74.6% of the population; the median household income was $135,820; 78% attained education higher than high school; and there are 190 dermatologists within a 0.5-mile radius. In BB/CI the annual melanoma incidence was 14/100,000 (95% CI: 11.6-16.9); NHW comprised 55.1% of the population; the median household income was $43,118; 46% attained education higher than high school; and there is 1 dermatologist within a 0.5-mile radius. There are 15 dermatologists within a 3.0-mile radius. 155 and 88 patients met inclusion criteria in UES and BB/CI respectively. The distribution of T stages (i.e. Tis to T4) was significantly different between UES and BB/CI with higher proportions of advanced stage tumors in BB/CI (p=0.0002). Specifically, the proportion of (T2+T3+T4) tumors/total melanomas was 35/155 (23%) in UES; and 41/88(47%) in BB/CI (p&lt;0.0001). For reference, the proportion of T2+T3+T4 melanomas in the United States is 30%. Conclusions: We identified substantial disparities in the initial presentation of melanoma in 2 NYC neighborhoods, with proportionately more advanced stage tumors in the community of low educational attainment, less access to dermatologic services, and lesser household income. Neighborhood-based approaches to uncover melanoma disparities can identify areas for community outreach and engagement efforts to improve melanoma awareness and access to dermatologic care.

Missed Opportunities: Characteristics of People Who Received a Concurrent HIV/AIDS Diagnosis in New York State From 2016 to 2021.

Late HIV diagnosis is associated with a wide range of negative outcomes. The aim of this study was to identify the characteristics of individuals who received a concurrent diagnosis (CDX) in New York State (NYS) so that more effective interventions can be developed to encourage earlier testing among these populations. The NYS HIV registry was used to identify people who received a CDX from 2016 to 2021. A CDX was a diagnosis that met the criteria for a stage 3 HIV infection within 30 days of the initial HIV diagnosis. Sex at birth, race/ethnicity, transmission risk group, age at diagnosis, region of residence at diagnosis, urbanicity of zip code of diagnosis, and type of diagnosing facility were used as covariates. Bivariate and multivariate risk ratios were calculated to quantify associations between CDX and covariates. There were 14,866 people newly diagnosed with HIV in NYS from 2016 to 2021, of which 19.0% had a CDX. Those with female sex at birth, history of injection drug use, or history of male-to-male sexual contact/history of injection drug use risk were less likely to have a CDX. Increased age, Asian race/ethnicity, residence outside of New York City, and diagnosis at inpatient facilities or emergency rooms were associated with an increased likelihood of a CDX. Populations with the highest proportions of CDX were ones that made up a small percentage of all new HIV diagnoses and may not be benefiting as much from current HIV prevention efforts. There are complex interactions between many factors including geographic and social characteristics that may lead to delayed diagnostic testing.

Evaluating associations of bisphenol and phthalate exposure with time to pregnancy and subfecundity in a New York City pregnancy cohort

It is important to understand the impact of consumer chemical exposure and fecundity, a couple’s measure of probability of successful conception, given approximately 15% of couples experience infertility. Prior research has generally found null associations between bisphenol and phthalate exposure and fecundability, measured via time to pregnancy (TTP). However, this research has not been updated with current chemical exposures and have often lacked diversity in their study populations. We evaluated the associations between common bisphenol and phthalate chemical exposure groups and TTP as well as subfecundity (TTP>12 months) in the New York University Children’s Health Study, a diverse pregnancy cohort from 2016 onward. Using first-trimester spot-urine samples to measure chemical exposure and self-reported TTP from first-trimester questionnaires, we observed a significant adverse association between total bisphenol exposure and certain phthalate groups on TTP and odds of subfecundity. Furthermore, in a mixtures analysis to explore the joint effects of the chemical groups on the outcomes, we found evidence of a potential interaction between total bisphenol exposure and low-molecular weight phthalates on TTP. Future research should continue to update our knowledge regarding the complex and potentially interacting effects of these chemicals on reproductive health.