Socioeconomic Disparities in Severe Acute Respiratory Syndrome Coronavirus 2 Serological Testing and Positivity in New York City.

ABSTRACT

BACKGROUND: We characterized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody test prevalence and positive test prevalence across New York City (NYC) in order to investigate disparities in testing outcomes by race and socioeconomic status (SES). METHODS: Serologic data were downloaded from the NYC Coronavirus data repository (August 2020-December 2020). Area-level characteristics for NYC neighborhoods were downloaded from United States census data and a socioeconomic vulnerability index was created. Spatial generalized linear mixed models were performed to examine the association between SES and antibody testing and positivity. RESULTS: The proportion of Hispanic population (posterior median, 0.001 [95% credible interval, 0.0003-0.002]), healthcare workers (0.003 [0.0001-0.006]), essential workers (0.003 [0.001-0.005]), age ≥65 years (0.003 [0.00002-0.006]), and high SES (SES quartile 3 vs 1 0.034 [0.003-0.062]) were positively associated with antibody tests per 100000 residents. The White proportion (-0.002 [-0.003 to -0.001]), SES index (quartile 3 vs 1, -0.068 [-0.115 to -0.017]; quartile 4 vs 1, -0.077 [-0.134 to -0.018]) and age ≥65 years (-0.005 [-0.009 to -0.002]) were inversely associated with positive test prevalence (%), whereas the Hispanic (0.004 [0.002-0.006]) and essential worker (0.008 [0.003-0.012]) proportions had positive coefficients. CONCLUSIONS: Disparities in serologic testing and seropositivity exist on SES and race/ethnicity across NYC, indicative of excess coronavirus disease burden in vulnerable and marginalized populations.