Pandemic Injustice: Spatial and Social Distributions of COVID-19 in the US Epicenter

Abstract

We examine the uneven social and spatial distributions of COVID-19 and their relationships with indicators of social vulnerability in the U.S. epicenter, New York City (NYC). As of July 17th, 2020, NYC, despite having only 2.5% of the U.S. population, has [Formula: see text]6% of all confirmed cases, and [Formula: see text]16% of all deaths, making it a key learning ground for the social dynamics of the disease. Our analysis focuses on the multiple potential social, economic, and demographic drivers of disproportionate impacts in COVID-19 cases and deaths, as well as population rates of testing. Findings show that immediate impacts of COVID-19 largely fall along lines of race and class. Indicators of poverty, race, disability, language isolation, rent burden, unemployment, lack of health insurance, and housing crowding all significantly drive spatial patterns in prevalence of COVID-19 testing, confirmed cases, death rates, and severity. Income in particular has a consistent negative relationship with rates of death and disease severity. The largest differences in social vulnerability indicators are also driven by populations of people of color, poverty, housing crowding, and rates of disability. Results highlight the need for targeted responses to address injustice of COVID-19 cases and deaths, importance of recovery strategies that account for differential vulnerability, and provide an analytical approach for advancing research to examine potential similar injustice of COVID-19 in other U.S. cities. Significance Statement Communities around the world have variable success in mitigating the social impacts of COVID-19, with many urban areas being hit particularly hard. Analysis of social vulnerability to COVID-19 in the NYC, the U.S. national epicenter, shows strongly disproportionate impacts of the pandemic on low income populations and communities of color. Results highlight the class and racial inequities of the coronavirus pandemic in NYC, and the need to unpack the drivers of social vulnerability. To that aim, we provide a replicable framework for examining patterns of uneven social vulnerability to COVID-19- using publicly available data which can be readily applied in other study regions, especially within the U.S.A. This study is important to inform public and policy debate over strategies for short- and long-term responses that address the injustice of disproportionate impacts of COVID-19. Although similar studies examining social vulnerability and equity dimensions of the COVID-19 outbreak in cities across the U.S. have been conducted (Cordes and Castro 2020, Kim and Bostwick 2002, Gaynor and Wilson 2020; Wang et al. 2020; Choi and Unwin 2020), this study provides a more comprehensive analysis in NYC that extends previous contributions to use the highest resolution spatial units for data aggregation (ZCTAs). We also include mortality and severity rates as key indicators and provide a replicable framework that draws from the Centers for Disease Control and Prevention’s Social Vulnerability indicators for communities in NYC.

Telehealth in Trans and Gender Diverse Communities: the Impact of COVID-19

“…SARS-COV2 has had a disproportionate impact on marginalized communities worldwide [ 2 – 6 ]. TGD communities are no exception to this [ 7 , 8 ••]; multiple explanations exist for these inequities—some include that TGD workers are economically marginalized and thus more likely to participate in front line work (and the economic insecurity created from such work), along with having fewer economic resources to cover for loss of work [ 9 ].…”

Spatial Disparities of COVID-19 Cases and Fatalities in United States Counties

“…Only recently has there been a focus on place, or what Perry et al [9] term the precarity of place, in addition to urban-rural influences on COVID-19 experiences [10]. Research has mostly examined the geography of COVID-19 risk based on individual-level factors (e.g., social determinants of health) or community-based elements (e.g., resilience, social vulnerability, or public health mitigation measures) over a short study period or wave of the pandemic [11,12], or in specific sub-national areas [9,13,14]. Thus far, there has not been a longer-term (year-long) study for the US examining the spatial and temporal county-level variability in COVID-19 cases and fatalities that considers several influential elements of social context or measurements of pre-emergent economic recovery.…”

A climate resilience research renewal agenda: learning lessons from the COVID-19 pandemic for urban climate resilience

“…Observed interactions include a compounding of risk and loss including embedded inequalities by gender, race and income or livelihood (e.g. McPhearson et al, 2020). For example, when vulnerable elderly populations are simultaneously exposed to COVID-19 and heatwave risk.…”