Abstract
Background
COVID-19 pandemic has resulted in considerable morbidity and mortality. New York State (NY) is the hotspot with most coronavirus cases, while there are spatial/temporal variations. Yet, few examined county-level factors of mortality in COVID-19 patients in NY. Based on the sociological framework in health, this study links large and representative public data to understand COVID-19 mortality in NY over different stages of pandemic.
Methods
Mortality cases were from Mar 17 (state of emergency; 0.1 per 100,000), Apr 18 (coronavirus peak; 87.4), Apr 25 (expand testing; 108.7), and May 11 (daily reduced to original; 137.6). Three domains (compositional, contextual, and collective) and 28 county-level predictors of mortality were extracted from American Community Survey, Area Health Resources, US Crime Data, and Religious Data systems for each county. Compositional domain covered socio-demographic characteristics in local areas (e.g., age, sex, race/ethnicity, housing). Contextual domain covered include social and physical opportunities (e.g., health insurance coverage, transportation, mental health providers). Collective domain covered neighborhood safety and religious adherents. Mixed effect regression with the least absolute shrinkage selection operator (LASSO) was used to select the predictors and estimate the parameters after adjusting the time effect and cumulative prevalence of COVID-19.
有道词典
; 0.1 per 100,000 people
详细X
;每100000人0.1
Results
NYC and the nearby boroughs (i.e., Bronx, Kings, Manhattan, Queens) had the highest cumulative mortality (231.69 per 100,000 people). Counties far from New York Cities (e.g., Allegany, Cortland, Delaware) had the lowest cumulative mortality. Spatial variation showed counties with larger population density (β=.01, p=.022) and/or higher proportion of people with at least high school education (β=227.24, p=.03) were at risk of higher cumulative mortality in COVID-19.
Conclusion
Unique spatial clustering mortality risk of COVID-19s was detected, highlighting important but understudied roles of contextual and collective factors. Tailored policy efforts shall be designed to support counties with large population density and high levels of education to prevent the mortality related to COVID-19 infection in NY.
Disclosures
All Authors: No reported disclosures
Structural Racism and Severe Maternal Morbidity in New York State