As the coronavirus pandemic shows evidence of being an urban pandemic, understanding how the structural inequities in cities that we already know are driving climate injustice, may also be driving COVID-19 injustice, is critical to shine a bright light on. We distill questions of who is most affected by COVID-19 in NYC down to 5 key metrics.
Once again frontline, low income and communities of color are most impacted. At the time of this writing, there have been 147,297 confirmed cases and 15,869 deaths in New York City, with the City on mandatory “P.A.U.S.E” until May 15, 2020. In early March, the Urban Systems Lab team asked the question, are those who are most vulnerable to climate impacts in NYC, also likely to be most impacted by COVID-19? Now that data on positive COVID-19 cases in NYC is available we are able to answer the question with clarity.
What we find is all too unsurprising, and yet important to amplify as we continue emergency response, advocate for economic relief, and plan next steps as the crisis evolves over the coming months. Though these are results for NYC, we suggest we may see similar patterns in other US cities.
1. The urban poor may be the largest casualty
Our findings clearly show that those with the least economic resources, at least in terms of income, have the highest rates of positive COVID-19 cases. Overall the poverty rate in NYC is 17.3% (2018 data), with unemployment at 4.2% as of March 2020 (however, not reflective of recent unemployment filings). Although trends show extreme poverty levels have decreased over the past several years, a larger share of New Yorkers — 43.1 percent — were “near poverty” in 2017. Currently, the Bronx has the highest share of communities living below the poverty line (2018 NYC Community Health Atlas). The neighborhoods that have the highest percent of poverty based on income and necessary expenses are Fordham and University Heights (34%), Highbridge and Concourse (32%), Morrisania and Crotona (31%), Belmont and East Tremont (31%). The CUNY Graduate School of Public Health & Health Policy (CUNY SPH) is also analyzing job loss rates in NYC. In their initial tracking survey conducted March 20–22 findings show 29% of New York City residents are reporting that either they or someone in their household has lost their job as a result of coronavirus. Job loss is also disproportionately impacting Hispanic and lower income city residents with two in five respondents (41%) saying either they or a household member lost their job in the last two weeks.
2. Communities of color are most affected
Our analysis confirms some of the recent reports from researchers and news outlets (See The Guardian, The Atlantic, The NY Times, The Gothamist) around the country that highlight the racial inequities of the pandemic. A comparative analysis of those testing positive for COVID-19 per zip code in New York City with race and ethnicity show how the pandemic is impacting communities of color disproportionately. The data released by the NYC Department of Health, broken down by zip code, shows 34% of COVID-19 deaths were Hispanic, 28% African American and Black, 27% White, and 7% Asian.
3. Having insurance matters
According to the NYC Department of Health and Mental Hygiene, there were approximately 615,000 uninsured New Yorkers in 2017, roughly 7% of the City’s population (U.S. Census Bureau). Among city residents who were not U.S. citizens about 300,000, or nearly 22%, were uninsured — and the rate was likely even higher among noncitizens who were undocumented. Queens Community District 7 (Flushing, Murray Hill, and Whitestone), had an uninsured rate of 15.5% in 2017, the highest in the city. Yet there are no public hospital facilities in the district. Likewise, Brooklyn Community District 7 (Sunset Park and Windsor Terrace) had an uninsured rate of 12.4% and no public hospital facilities in proximity. Neighborhoods, such as Queens Community Districts 3 (Jackson Heights and North Corona) and 4 (Elmhurst and South Corona), with comparatively high shares of uninsured residents as well as nearby public hospital facilities. More than 14 percent of residents in Queens Community Districts 3 and 4 were without insurance.
4. More people in the home matters
Population density plays a key role in the inequitable impacts of COVID-19. This is especially the case in New York, the largest city in the United States with about 8.3 million people in 2018 (with the metropolitan area home to approximately 20.3 million people). According to the NYC Department of Planning, “New York has the highest population density of any major city in the United States, with over 27,000 people per square mile,” and accounts for over 40% of the entire population of New York State. However, while New York has been characterized as the “epicenter” of the COVID-19 outbreak, new research from The Marron Institute of Urban Management (NYU) describes cities like New York as the “vanguard” on the pandemic front, explaining observed COVID-19 rates are likely higher in cities because they tend to be the locations for the onset of infection earlier on in the spread, and because more testing is occurring per capita.
5. Elderly are at risk, no matter what
In New York City there are approximately 1.4 million elderly, age 60 and older, which constitute 17% of the population, and the proportion is projected to increase to 50% of the population in the next two decades. According to the 2018 NYC Community Health Atlas, the neighborhoods that have the highest percent of adults ages 65 and older include: Coney Island (22%), Upper East Side (20%), Rego Park and Forest Hills (19%), Riverdale and Fieldston (18%), Throgs Neck and Co-op City (18%).
In past CDC reports, and recent data from the New York City Department Department of Health, older groups are observed to have higher hospitalization and fatality rates (with those aged 85 or more, ranging from 10% to 27%; and persons aged 65–84 years, ranging from 3% to 11%). In NYC, elderly communities make up most of the city’s hospitalizations and deaths with 42% of coronavirus patients hospitalized in New York City so far, 65 or older. About 9% of the patients in the 18–44 age group had to be hospitalized, compared to 22% of patients 45–64, 36% of patients 65–74, and half of those 75 and over. That’s similar to the nationwide portion with approximately 45% of US hospitalizations for the 65 or older age group.
A Cautionary Tale for Cities Around the World
Although New York presents a specific example of racial disparity in COVID-19 cases, the underlying data should be of concern to cities around the country and world. Over the past few weeks, cities such as New Orleans, Detroit, Chicago and Milwaukee are observing similar trends in COVID-19 cases among Hispanic, Black and African American communities. These trends are making visible decades of disinvestment in urban centers, disparities in access to education, affordable food, housing, and healthcare, and disproportionate economic impacts among other factors. These socio-economic and health issues are intimately linked to community resilience and reflect a long history of racism and equity issues that have laid the groundwork for a lack of preparedness across city, state and Federal scales.
The National Urban League and the N.A.A.C.P. are now sounding the alarm and calling the inadequate Federal response a civil rights issue. Organizers point out that the Centers for Disease Control did not initially release racial demographic information until pressure was placed on the agency to look critically at correlations in cases, race and ethnicity. As cities come to terms with the full extent of the coronavirus crisis, we must undertake a deep examination of how structural injustices have and may continue to impact key decision making, emergency planning and response, especially for those most in need and affected.
Finally, as the summer approaches and temperatures increase, the USL is beginning to examine the threats changing weather may bring to an already stressed capacity for emergency response. Extreme weather — heat waves, floods, storm events — can have overlapping and cascading risks that may further exacerbate impacts on minority and low income populations. Our ongoing research will focus on how COVID-19 social distancing policies in NYC, which have already induced a radical shift in the locations of where people need services, may shift exposure to potential weather-related extremes. For instance what interrelated and cascading impacts will COVID-19 have during potential heat waves? What happens during a black out? Or if critical infrastructure is disrupted? These issues will disproportionately impact vulnerable communities yet again, and will require a different kind of emergency response and decision making to ensure all communities can thrive and adapt to our current moment.
About the Research
As communities worldwide respond to the COVID-19 crisis, the Urban Systems Lab (USL) team stands in solidarity with frontline responders, those most affected, and communities working to help those most in need. With our resilience tested, the USL will be providing resources and new analysis on potential impacts of COVID-19 on vulnerable communities in NYC, and the interdependent risks of COVID-19 and climate. We are updating our website regularly including key research, datasets, and relevant articles that may be important to stay informed of during this ongoing crisis. We hope this will provide a useful resource to visualize how to understand multiple dimensions of how COVID-19 may impact communities and so that we can share strategies, actions, and nurture hope in a time of uncertainty.
Data used in the maps and plots above are from the NYC Department of Health’s Github and the American Community Survey (2017). Shaded areas represent the 95% confidence intervals.
The Urban Systems Lab’s research efforts include work and analysis from Zbigniew Grabowski, Pablo Herreros, Rositsa T. Ilieva, Chris Kennedy, Ahmed Mustafa, Timon McPhearson, Luis Ortiz, Claudia Tomateo, Daniel Sauter, Joseph Steele, Avigail Vantu and others on the USL Team.
To learn more visit: http://urbansystemslab.com/covid19