Black/African American Communities are at highest risk of COVID-19: spatial modeling of New York City ZIP Code-level testing results
Black/African American Communities are at highest risk of COVID-19: spatial modeling of New York City ZIP Code-level testing results
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DOI：
10.1016/j.annepidem.2020.08.012
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发表时间：
2020-11-01
影响因子：
5.6
通讯作者：
Frangos, Spiros
中科院分区：
文献类型：
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作者：
DiMaggio, Charles;Klein, Michael;Frangos, Spiros
目的：COVID-19感染的人群和空间特征尚不清楚，但越来越多的证据表明，除了个体临床因素外，人口统计学、社会经济和种族特征也起着重要作用。方法：采用集成嵌套拉普拉斯近似，利用贝叶斯层次泊松空间模型分析纽约市邮政编码制表区COVID-19阳性检测结果计数。结果：空间聚类约占数据变异的32%。与黑人/非裔美国人的比例相关，COVID-19检测阳性的风险增加了近5倍（发病率密度比= 4.8,95%可信区间为2.4,9.7）。65岁以上居民比例的增加、住房密度的增加以及患有心脏病的居民比例的增加都与风险增加一倍有关。在包括年龄、慢性阻塞性肺病、心脏病、住房密度和黑人/非裔美国人种族估计值在内的多变量模型中，与COVID-19检测阳性相关且概率大于偶然性的唯一变量是黑人/非裔美国人居民的比例和老年人的比例。结论：黑人/非裔美国人居民比例大的地区的风险明显更高，这并不能完全由环境特征和人口中已有的条件来解释。(C) 2020爱思唯尔公司版权所有。
Purpose: The population and spatial characteristics of COVID-19 infections are poorly understood, but there is increasing evidence that in addition to individual clinical factors, demographic, socioeconomic, and racial characteristics play an important role.Methods: We analyzed positive COVID-19 testing results counts within New York City ZIP Code Tabulation Areas with Bayesian hierarchical Poisson spatial models using integrated nested Laplace approximations.Results: Spatial clustering accounted for approximately 32% of the variation in the data. There was a nearly five-fold increase in the risk of a positive COVID-19 test (incidence density ratio = 4.8, 95% credible interval 2.4, 9.7) associated with the proportion of black/African American residents. Increases in the proportion of residents older than 65 years, housing density, and the proportion of residents with heart disease were each associated with an approximate doubling of risk. In a multivariable model including estimates for age, chronic obstructive pulmonary disease, heart disease, housing density, and black/African American race, the only variables that remained associated with positive COVID-19 testing with a probability greater than chance were the proportion of black/African American residents and proportion of older persons.Conclusions: Areas with large proportions of black/African American residents are at markedly higher risk that is not fully explained by characteristics of the environment and pre-existing conditions in the population. (C) 2020 Elsevier Inc. All rights reserved.