Neighborhood Disadvantage Measures and COVID-19 Cases in Boston, 2020. (May 2021)

• Record Type: Journal Article
• Authors: Samuels-Kalow, Margaret E.; Dorner, Stephen; Cash, Rebecca E.; Dutta, Sayon; White, Benjamin; Ciccolo, Gia E.; Brown, David F.M.; Camargo, Carlos A.
• Is Part Of: Public health reports. Volume 136:Number 3(2021)
• Page Start: 368
• Page End: 374
• Publication Date: 2021-05
• Subjects: COVID-19 -- social determinants of health -- geospatial analysis; Public health -- United States -- Periodicals; 614.0973
• DOI: 10.1177/00333549211002837
• Languages: English
• ISSNs: 0033-3549

Abstract

Objective: Understanding the pattern of population risk for coronavirus disease 2019 (COVID-19) is critically important for health systems and policy makers. The objective of this study was to describe the association between neighborhood factors and number of COVID-19 cases. We hypothesized an association between disadvantaged neighborhoods and clusters of COVID-19 cases. Methods: We analyzed data on patients presenting to a large health care system in Boston during February 5–May 4, 2020. We used a bivariate local join-count procedure to determine colocation between census tracts with high rates of neighborhood demographic characteristics (eg, Hispanic race/ethnicity) and measures of disadvantage (eg, health insurance status) and COVID-19 cases. We used negative binomial models to assess independent associations between neighborhood factors and the incidence of COVID-19. Results: A total of 9898 COVID-19 patients were in the cohort. The overall crude incidence in the study area was 32 cases per 10 000 population, and the adjusted incidence per census tract ranged from 2 to 405 per 10 000 population. We found significant colocation of several neighborhood factors and the top quintile of cases: percentage of population that was Hispanic, non-Hispanic Black, without health insurance, receiving Supplemental Nutrition Assistance Program benefits, and living in poverty. Factors associated with increased incidence of COVID-19 included percentage of population that is Hispanic (incidence rate ratio [IRR] = 1.25; 95% CI, 1.23-1.28) and percentage of households living in poverty (IRR = 1.25; 95% CI, 1.19-1.32). Conclusions: We found a significant association between neighborhoods with high rates of disadvantage and COVID-19. Policy makers need to consider these health inequities when responding to the pandemic and planning for subsequent health needs.