Socioeconomic Disparities in Subway Use and COVID-19 Outcomes in New York City
Karla Therese L Sy, Micaela E Martinez, Benjamin Rader, Laura F White, Karla Therese L Sy, Micaela E Martinez, Benjamin Rader, Laura F White
Abstract
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.
Keywords: COVID-19; New York City; SARS-CoV-2; health disparities; infectious disease; social determinants of health; social epidemiology.
© The Author(s) 2021. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.
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References
- Stojkoski V, Utkovski Z, Jolakoski P, et al. The socio-economic determinants of the coronavirus disease (COVID-19) pandemic [preprint]. medRxiv. 2020. (doi: 10.1101/2020.04.15.20066068).
- Wu T, Perrings C, Kinzig A, et al. Economic growth, urbanization, globalization, and the risks of emerging infectious diseases in China: a review. Ambio. 2017;46(1):18–29.
- Rader B, Scarpino SV, Nande A, et al. Crowding and the shape of COVID-19 epidemics. Nat Med. 2020;26(12):1829–1834.
- US Census Bureau . 2012–2016 American Community Survey (ACS) 5-year Estimates. 2020. . Accessed February 26, 2020.
- New York City Department of Transportation . 2019 Citywide Mobility Survey Results. New York, New York. 2020. . Accessed May 21, 2020.
- Metropolitan Transit Authority . Annual subway ridership. 2020. . Accessed May 11, 2020.
- Blue VJ. Coronavirus deaths in New York increase slightly, Cuomo says. New York Times. May 20, 2020. . Accessed May 22, 2020.
- Dunn CG, Kenney E, Fleischhacker SE, et al. Feeding low-income children during the COVID-19 pandemic. N Engl J Med. 2020;382(18):e40.
- Tsai J, Wilson M. COVID-19: a potential public health problem for homeless populations. Lancet Public Health. 2020;5(4):e186–e187.
- Mazza M, Marano G, Lai C, et al. Danger in danger: interpersonal violence during COVID-19 quarantine. Psychiatry Res. 2020;289:113046.
- US Bureau of Labor Statistics . Workers who could work at home, did work at home, and were paid for work at home, by selected characteristics, averages for the period 2017–2018. 2019. . Accessed May 7, 2020.
- Quealy K. The richest neighborhoods emptied out most as coronavirus hit New York City. New York Times. May 15, 2020. . Accessed May 19, 2020.
- Cooley P, Brown S, Cajka J, et al. The role of subway travel in an influenza epidemic: a New York City simulation. J Urban Health. 2011;88(5):982–995.
- United States Census Bureau . ZIP Code Tabuation Areas (ZCTAs). . Accessed February 26, 2020.
- New York State Office of Information Technology Services . Fare card history for Metropolitan Transportation Authority (MTA): beginning 2010. 2020. . Accessed February 26, 2020.
- New York City Department of Health and Mental Hygiene NYC coronavirus (COVID-19) data. 2020. . Accessed May 1, 2020.
- Randhawa AK, Fisher LH, Greninger AL, et al. Changes in SARS-CoV-2 positivity rate in outpatients in Seattle and Washington State, March 1–April 16, 2020. JAMA. 2020;323(22):2334–2336.
- Bernal JL, Cummins S, Gasparrini A. Interrupted time series regression for the evaluation of public health interventions: a tutorial. Int J Epidemiol. 2017;46(1):348–355.
- R Core Team . R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2017.
- Kully SA. Following orders: a timeline of state and city action on COVID. 2020; . Accessed April 21, 2020.
- City of New York. Mayor de Blasio issues new guidance to New Yorkers. March 20, 2020. .
- Nayak A, Islam SJ, Mehta A, et al. Impact of social vulnerability on COVID-19 incidence and outcomes in the United States [preprint]. medRxiv. 2020. (doi: 10.1101/2020.04.10.20060962). Accessed May 29, 2020.
- Abedi V, Olulana O, Avula V, et al. Racial, economic and health inequality and COVID-19 infection in the United States [published online ahead of print September 1, 2020]. J Racial Ethn Health Disparities. doi: 10.1101/2020.04.10.20060962.
- Beckles GL, Chou CF. Disparities in the prevalence of diagnosed diabetes - United States, 1999-2002 and 2011-2014. MMWR Morb Mortal Wkly Rep. 2016;65(45):1265–1269.
- Shaw KM, Theis KA, Self-Brown S, et al. Chronic disease disparities by county economic status and metropolitan classification, behavioral risk factor surveillance system, 2013. Prev Chronic Dis. 2016;13:E119.
- Shahu A, Herrin J, Dhruva SS, et al. Disparities in socioeconomic context and association with blood pressure control and cardiovascular outcomes in ALLHAT. J Am Heart Assoc. 2019;8(15):e012277.
- Van Lancker W, Parolin Z. COVID-19, school closures, and child poverty: a social crisis in the making. Lancet Public Health. 2020;5(5):e243–e244.
- Wood LJ, Davies AP, Khan Z. COVID-19 precautions: easier said than done when patients are homeless. Med J Aust. 2020;212(8):384–384.e1.
- Marques ES, Moraes CL, Hasselmann MH, et al. Violence against women, children, and adolescents during the COVID-19 pandemic: overview, contributing factors, and mitigating measures. Cad Saude Publica. 2020;36(4):e00074420.
- Rader B, Astley CM, Sy KTL, et al. Geographic access to United States SARS-CoV-2 testing sites highlights healthcare disparities and may bias transmission estimates. J Travel Med. 2020;27(7):taaa076.
- Souch JM, Cossman JS. A commentary on rural-urban disparities in COVID-19 testing rates per 100,000 and risk factors. J Rural Health. 2021;37(1):188–190.
- Wadhera RK, Wadhera P, Gaba P, et al. Variation in COVID-19 hospitalizations and deaths across New York City boroughs. JAMA. 2020;323(21):2192–2195.
- New York State, Governor's Press Office . Amid ongoing COVID-19 pandemic, Governor Cuomo announces results of state's antibody testing survey at churches in lower-income NYC communities of color show 27 percent of individuals tested positive for COVID-19 antibodies. 2020. .
- Kissler SM, Kishore N, Prabhu M, et al. Reductions in commuting mobility correlate with geographic differences in SARS-CoV-2 prevalence in New York City. Nat Commun. 2020;11(1):4674–4674.
Source: PubMed