Covid19 In New York City An Ecology Of Race And Class Oppression Springerbriefs In Public Health

New York City has had the highest number and incidence of CoViD-19 cases and deaths in U.S. cities. The foundation of this public health catastrophe lies in the overall public health and socioeconomic (SE) structure of the city.

Premature (below age 65) mortality rate indicates background public health. In year 2000, community districts (CDs) with low population percent of over age 65 had high incidence of HIV mortality and its three associated mortalities (homicide, drugs, liver disease) as well as high poverty rate, high unemployment, low median income, and low percent of adults with college or higher degrees. NYC Health Departments' use of age 65 as the benchmark for premature death departs from that of the CDC's National Center for Health Statistics which uses age 75. This departure contributes to an underestimation of premature mortality rates and of public health deficiencies.

This study examines 2017 premature mortality rate of CDs, health outcomes associated with it, and contextual SE factors. Four health outcomes associated with premature mortality rate in multivariate regression: HIV, diabetes, and drug mortality rates and percent of births to teenagers. SE factors associated with premature mortality rate and its health guild were serious housing violations per 1000 units, unemployment rate, poverty rate, percent of adults with college or higher degrees (the only negative association), and indicators of segregation. Much of the context of year 2000 patterns of mortality disparities remained in 2017. 

The coronavirus pandemic plays out in NYC in this SE/public health system. Old age and age-related chronic conditions emerged as raised risks for serious CoViD injury and death. Premature mortality indicates a population's rapidity of physiological aging from structural stress: weathering'.

This chapter examines the geography of CoViD markers and premature mortality in the four central boroughs of New York City: Manhattan, Bronx, Brooklyn, and Queens. Manhattan and the Bronx, being similar in population, are compared, and Brooklyn is compared to Queens. The poverty belt of Brooklyn hosted high rates of CoViD deaths and premature mortality rates, whereas only the Rockaway Peninsula in Queens showed high rates of both. In Queens, few Zip Code areas suffered from moderate or high rates of premature mortality, but a cluster of areas around LaGuardia Airport had high rates of CoViD deaths. The populations of these five areas included high proportions of the foreign-born (54%-66%).

Manhattan below 96th Street enjoyed wide swaths of areas with low CoViD mortality rates and low premature mortality rates. The areas above 96th Street, however, showed moderate to high rates of CoViD death rates. Harlem, in particular, suffered from both high CoViD death rates and high premature mortality rates. Out of 24 areas in the Bronx, only two enjoyed low CoViD death rates. High CoViD death rates formed a belt across the northern Bronx, but the patchiness of CoViD death rates in the southern Bronx may be an artifact of inadequate testing. The south central Bronx featured a transect of areas with high premature mortality rates, in contrast with rates of CoViD rates. Only one area in the Bronx had a low rate of premature mortality.

From the maps of CoViD and premature mortality rates, the entire Bronx gives clear sign