Disparities in COVID-19 Testing and Positivity in New York City

Existing socioeconomic and racial disparities in healthcare access in New York City have likely impacted the public health response to COVID-19. An ecological study was performed to determine the spatial distribution of COVID-19 testing by ZIP code Tabulation Area and investigate if testing was asso...

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Bibliographic Details
Published in:American journal of preventive medicine 2020-09, Vol.59 (3), p.326-332
Main Authors: Lieberman-Cribbin, Wil, Tuminello, Stephanie, Flores, Raja M., Taioli, Emanuela
Format: Article
Language:English
Subjects:
Cities
Clinical Laboratory Techniques
Coronavirus Infections - diagnosis
Coronavirus Infections - epidemiology
Coronavirus Infections - ethnology
Coronaviruses
COVID-19
COVID-19 diagnostic tests
COVID-19 Testing
Ethnic Groups - statistics & numerical data
European Continental Ancestry Group - statistics & numerical data
Health care access
Health disparities
Health Services Accessibility
Healthcare Disparities
Hispanic Americans - statistics & numerical data
Humans
Inequality
New York City - epidemiology
Pandemics
Pneumonia, Viral - diagnosis
Pneumonia, Viral - epidemiology
Pneumonia, Viral - ethnology
Poverty
Principal components analysis
Public health
Race
Racial differences
Racial inequality
Socioeconomic Factors
Socioeconomic status
Spatial analysis
Unemployment
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Summary:Existing socioeconomic and racial disparities in healthcare access in New York City have likely impacted the public health response to COVID-19. An ecological study was performed to determine the spatial distribution of COVID-19 testing by ZIP code Tabulation Area and investigate if testing was associated with race or SES. Data were obtained from the New York City coronavirus data repository and 2018 American Community Survey 5-year estimates. A combined index of SES was created using principal component analysis and incorporated household income, gross rent, poverty, education, working class status, unemployment, and occupants per room. Multivariable Poisson regressions were performed to predict the number of total tests and the ratio of positive tests to total tests performed, using the SES index, racial composition, and Hispanic composition as predictors. The number of total tests significantly increased with the increasing proportion of white residents (β=0.004, SE=0.001, p=0.0032) but not with increasing Hispanic composition or SES index score. The ratio of positive tests to total tests significantly decreased with the increasing proportion of white residents in the ZIP code Tabulation Area (β= −0.003, SE=0.000 6, p
ISSN:0749-3797
1873-2607
DOI:10.1016/j.amepre.2020.06.005