A Neighborhood Analysis of Time Trends in COVID-19 Infection in NYC.

ABSTRACT

To understand how observed COVID-19 diagnostic testing disparities across New York City (NYC) have impacted infection rates and COVID-19 spread, we examined neighborhood-level factors associated with, and the spatial distribution of, antibody test and infection rates, and compared changes over time by NYC ZIP code tabulation area (ZCTA). Data were obtained from 2019 American Community Survey 5-year estimates to create an SES index by ZCTA. Other predictors obtained from 2018 census data were the proportions of white residents, Hispanic residents and residents ≥ 65 years old. Multivariable Poisson regressions were performed to assess the rate of change for antibody testing and positivity, and to assess the independent associations with SES, race and age. Results: There was a significant association between the rate of antibody tests and SES quartiles (Q1 ßadj = 0.04, Q2 ßadj = 0.03 and Q3 ßadj = - 0.03, compared to Q4), and the proportion of residents who are white (ßadj = 0.004, p < .0001), Hispanic   (ßadj = 0.001, p < .0001), and ≥ 65 years (ßadj = 0.01, p < .0001). Total number of positive antibody tests was significantly inversely associated with SES quartile (Q1 ßadj = 0.50, Q2 ßadj = 0.48 and Q3 ßadj = 0.29, compared to Q4), and proportion of white residents (ß = - 0.001, p < .0001) and ≥ 65 years (ß = - 0.02, p < .0001), and significantly positively associated with proportion of Hispanic residents (ß = 0.003, p < .0001). There are disparities in antibody testing and positivity, reflecting disproportionate impacts and undercounts of COVID-19 infection across NYC ZCTAs. Future public health response should increase testing in these vulnerable areas to diminish infection spread.