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Neighborhood Disadvantage Measures and COVID-19 Cases in Boston, 2020.
Samuels-Kalow, Margaret E; Dorner, Stephen; Cash, Rebecca E; Dutta, Sayon; White, Benjamin; Ciccolo, Gia E; Brown, David F M; Camargo, Carlos A.
  • Samuels-Kalow ME; 2348 Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Dorner S; 2348 Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Cash RE; 2348 Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Dutta S; 2348 Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • White B; 2348 Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Ciccolo GE; 2348 Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Brown DFM; 2348 Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Camargo CA; 2348 Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Public Health Rep ; 136(3): 368-374, 2021 05.
Article in English | MEDLINE | ID: covidwho-1138485
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Poverty / Ethnicity / Residence Characteristics / Medically Uninsured / Vulnerable Populations / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Public Health Rep Year: 2021 Document Type: Article Affiliation country: 00333549211002837

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Poverty / Ethnicity / Residence Characteristics / Medically Uninsured / Vulnerable Populations / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Public Health Rep Year: 2021 Document Type: Article Affiliation country: 00333549211002837