Mount Sinai Scientists Study Reveal that Pandemic Hits Blacks, Latinos Far Worse in NYC

Mount Sinai Scientists Study Reveal that Pandemic Hits Blacks, Latinos Far Worse in NYC

Not surprisingly, the poor side of town was far more devastated by this pandemic than the well-to-do. In New York, that means that those areas across the Boroughs with greater poverty experienced more infections and death from the virus, evidencing what many in the barrios and ghettos across America already know: that the purported health system in many cases isn’t really that available in the first place. Or put another way, it’s a system that allows those with privilege, that is money, education, and networks to benefit over all else. During the pandemic, illness and death were one way to showcase this unfortunate reality. But the economic damage to the working poor was catastrophic and the impact of this crisis event and the associated authoritarian leaning responses are just now starting to be understood. As far as proof that the poor and minority communities of New York were more severely impacted comes a National Institutes of Health (NIH)-funded study conducted by Mount Sinai scientists who created a neighborhood-level COVID-19 inequity index. Not surprisingly, they found that those New York City neighborhoods with higher socioeconomic disadvantage experienced greater infection and death from the coronavirus. The social determinants of health (SDoH) in America are a powerful, yet unfortunate, way to predict who will be hit harder by crisis such as a pandemic. Authoritarian responses directed by comfortable upper echelons of government and society can permanently dislocate the economically disadvantaged, leading to all sorts of new problems and more severe health equity dynamics.

Social Determinants of Health

The index measured factors that fueled inequities in the residents’ lives, such as employment and commuting patterns, population density of their neighborhood, food access, socioeconomic status, and access to health care. This allowed the scientists to compare between neighborhoods the contributions of these social factors in facilitating disease transmission during the first wave of the pandemic in a study published in Nature Communications in June.

“Much of the early rhetoric around COVID-19 disparities centered on comorbidities which, due to health disparities, may have explained why communities of color were suffering higher mortality. But we were seeing more people of color getting infected in the first place,” said Daniel Carrión, PhD, MPH, first author and postdoctoral researcher in the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai. “Our research team wanted to add to the literature outlining how structural racism is related to neighborhood disadvantage, and how that disadvantage is related to increased COVID-19 infections and mortality.”

Blacks Hit Worse

The COVID-19 inequity index showed that the disparities were considerably worse based on neighborhood racial and ethnic composition; Black neighborhoods had the highest average inequity index, followed by Latinx communities, while white neighborhoods had the lowest. The authors believe one of the reasons for these disparities is the diminished capacity to socially isolate based on where someone lives.

This study showed that areas with higher COVID-19 inequity indices had higher subway ridership after New York State introduced stay-at-home orders. This implies that the residents had less capacity to socially distance, the researchers said, possibly due to their jobs as essential workers or because they lived in denser housing.

‘Social Factors’ Useful for Public Intervention

The researchers believe their approach to identifying social factors that are associated with viral spread may be useful throughout the United States to pinpoint potential areas for targeted public health intervention.

“The social factors in the COVID-19 inequity index are upstream neighborhood characteristics–they were already in place before the pandemic,” said Allan Just, PhD, senior author on the study and Assistant Professor of Environmental Medicine and Public Health at Icahn Mount Sinai. “In the near term, this speaks to the importance of place-based interventions in Black, Indigenous, and people of color (BIPOC) communities to reduce disease incidence and mortality, such as improved and targeted vaccine availability for these communities. This also supports the need to look at social factors in pandemic preparedness.”

The team analyzed many forms of publicly available data, including census, New York City subway ridership, New York City Department of Health and Mental Hygiene infections and mortality data, and other datasets available through New York City’s and New York State’s open data portals.

Many neighborhood-level social variables are closely related; for example, median income can be strongly associated with education or even food access. This can be a challenge for traditional statistical approaches, so the team employed a new statistical framework designed to deal with these challenges, developed by co-author Elena Colicino, PhD, Assistant Professor of Environmental Medicine and Public Health at Icahn Mount Sinai.

The COVID-19 inequity index included neighborhood-level characteristics, but specifically excluded race and ethnicity as input variables. “Past literature shows that structural racism operates by historically sorting BIPOC people into neighborhoods that do not have the same resources and may facilitate infectious disease transmission,” said Dr. Carrión. “We wanted to see if our index reconstructed those racial disparities.”

About the Mount Sinai Health System

The Mount Sinai Health System is New York City’s largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai is a national and international source of unrivaled education, translational research and discovery, and collaborative clinical leadership ensuring that we deliver the highest quality care–from prevention to treatment of the most serious and complex human diseases. The Health System includes more than 7,200 physicians and features a robust and continually expanding network of multispecialty services, including more than 400 ambulatory practice locations throughout the five boroughs of New York City, Westchester, and Long Island. Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report’s “Honor Roll” of the Top 20 Best Hospitals in the country and the Icahn School of Medicine as one of the Top 20 Best Medical Schools in the country. Mount Sinai Health System hospitals are consistently ranked regionally by specialty and our physicians in the top 1% of all physicians nationally by U.S. News & World Report.

Lead Research/Investigator

Daniel Carrión, PhD, MPH, first author and postdoctoral researcher in the Department of Environmental Medicine and Public Health at the Icahn School of Medicine at Mount Sinai

Responses

  1. Agree with CJJohnson. Low D3. Now let’s add in all the poor health conditions that come from a terrible diet.
    Everyone in NYC is packed in like sardines, rich and poor alike. Population density is not the issue. Money is not really the issue, as a healthy diet does not require huge amounts of money to enact, and a very large percentage of the poor are on social support. Other lifestyle decisions (alcoholism, drug use) and outlooks (the short horizon no-hoper self-reinforcing depressive worldview) leads to those other lifestyle decisions. I think it’s high time to stop trying to blame everyone for the problems endemic to one or two minority groups. They need to improve their own lot. It can’t be done for them, and many of those efforts actually cause resentment and make excuses for not bothering to self-improve.

  2. The finger still points to the FDA. This time the food division rather than drugs. Both corrupt, subject to “regulatory capture”.

    What are the underlying causes of the underlying health conditions that have made non-white populations more vulnerable to effects of SARS-Cov-2?

    Processed food disease. Toxins allowed as ingredients of highly processed foods. Approved by the FDA as if safe, when the science shows otherwise. There is a problem when 6 yo children have non-alcoholic fatty liver disease.

    “This is the epidemic okay?
    Forget the rest.
    Forget coronavirus.
    This is the problem right here … fatty liver disease.”

    “Corporate Wealth or Public Health?” – Dr. Robert Lustig (Jan 2020)

    May 2020, Dr. Lustig’s new book released:

    “Dr. Robert Lustig, a pediatric endocrinologist and Professor Emeritus at the University of California, San Francisco, has written a number of excellent books about health. His latest, “Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine” goes deep into the details of how changes in our food supply have damaged our metabolic health. (The created term “metabolical” is actually a portmanteau of the words “metabolic” and “diabolical.”)

    https://youtu.be/9GZ49PvXgFM

    https://robertlustig.com/
    https://eatreal.org/