The Health Consequences of Urban Scaling

项目总结 新冠肺炎疫情已在美国导致10多万人死亡，在美国，新冠肺炎存在着非常广泛的不平等现象- 已经报告了19个少数族裔的结果，其中包括西班牙裔。拉美裔美国人患有特殊的 导致感染风险增加的社会脆弱性，以及增加流行率的特定风险因素 导致患严重疾病的风险增加。然而，拉美裔确诊病例的数量可能会很严重 由于地区和人口群体的测试覆盖率不同，因此被低估了。此外，最初步的 对死亡率不平等的衡量忽视了种族/族裔群体不同年龄结构的作用。 因此，在新冠肺炎结果中对种族/族裔不平等做出一致的估计是探索 这些不平等的趋势和预测因素，作为改进未来干预措施的目标的第一步。 同时，已经部署了几种非药物干预措施(NPI)来控制大流行， 种族/少数民族坚持或受益于(NPI)的能力受到几个结构性因素的限制 障碍，包括社会安全网不完善，远程办公的可能性较低，工作的可能性较高 在必要的职业中。总体而言，这些结构限制使隔离更具挑战性，并增加了 即使在社交距离较远的地区也有接触感染的可能性。在特定情况下持续的病毒传播 人口亚群使控制大流行对整个人口来说更具挑战性， 未来出现浪潮的可能性更大。总而言之，拉美裔是受影响最大的种族/民族之一。 由于大流行，同时也是最不能从NPI中受益的群体之一。为了现在和未来 面对一波又一波的大流行，当务之急是降低整个人群的感染风险，以减少社区 传输；因此。因此，了解卫生不平等在哪里以及为什么更广泛，以及NPI是否 跨不同群体的工作是通过降低社区整体水平来防止未来浪潮的关键 变速箱。我们建议系统地研究健康不平等异质性的趋势和预测因素。 在西班牙裔和非西班牙裔白人(NHW)之间以及社区之间的新冠肺炎结果 他们主要生活在哪里，跨越美国城市和在美国城市内部，以及NPI在拉美裔美国人中的潜在不平等影响 VS NHW。我们将利用30个最大的国家和地区的种族/民族和社区的数据 美国城市，修正了不完美的测试质量和覆盖率；(2)社会不平等衡量标准；以及(3) 各式各样的州、县、市级政策汇编。通过使用不同城市的样本， 我们将揭示不平等和这些不平等的预测因素，以便能够更具体地针对 可能被证明是继续控制当前大流行浪潮和预防未来的关键干预措施 海浪。我们还将展示NPI在西班牙裔或主要是西班牙裔美国人中是否效果较差 邻里关系。由于NPI仍然是疫情控制的最有效工具，它们在特定人群中的失败 亚群对整个人口来说是一种危险。 Drexel内部数据

PROJECT SUMMARY The COVID-19 pandemic has killed more than 100,000 people in the US, where very wide inequities in COVID- 19 outcomes have been reported for racial/ethnic minorities, including Hispanics. Hispanics suffer from specific social vulnerabilities that lead to increased risk of infection, and increased prevalence specific risk factors that lead to increased risk of severe illness. However, the number of confirmed cases in Hispanics may be severely underestimated due to differential coverage of testing by area and population group. Moreover, most preliminary measures of inequities in mortality have ignored the role of the different age structure of racial/ethnic groups. Creating consistent estimates of racial/ethnic inequities in COVID-19 outcomes is therefore key to exploring trends and predictors of these inequities, as a first step to improve the targeting of future interventions. Concurrently, several non-pharmaceutical interventions (NPI) have been deployed to control the pandemic, The capacity of racial/ethnic minorities to adhere to or benefit from (NPI) has been limited by several structural barriers, including deficient social safety nets, a lower possibility of teleworking and a higher likelihood of working in essential occupations. Overall, these structural constraints make isolation more challenging and increase the likelihood of exposure to infection even in areas with social distancing. Continued viral transmission in specific population subgroups makes the control of the pandemic more challenging for the entire population, and the emergence of future waves more likely. In summary, Hispanics are one of the racial/ethnic groups most impacted by the pandemic and, concurrently, one of the groups least able to benefit from NPI. For the current and future waves of the pandemic, it is imperative to reduce the risk of infection across the population to reduce community transmission; therefore. Therefore, understanding where and why health inequities are wider and whether NPI work across different groups is key to preventing future waves by reducing overall levels community transmission. We propose to systematically examine trends and predictors of heterogeneities of health inequities in COVID-19 outcomes between Hispanics and non-Hispanic whites (NHW), and between the neighborhoods where they predominantly live, across and within US cities, and the potential unequal effect of NPI in Hispanics vs NHW. We will leverage data on COVID-19 outcomes by race/ethnicity and neighborhood from the 30 largest cities of the US, corrected for imperfect testing quality and coverage; (2) social inequality measures; and (3) a diverse set of compilations of state-, county- and city-level policies. By using a heterogeneous sample of cities, we will uncover inequities and predictors of these inequities that will allow for more specific targeting of interventions that may prove key in continuing to control current waves of the pandemic and to prevent future waves. We will also demonstrate whether NPI may be less effective in Hispanics or predominantly Hispanic neighborhoods. Since NPI remain the most effective tool for epidemic control, their failure on specific population subgroups represents a hazard for the entire population. Drexel Internal Data