Differential COVID-19 case positivity in New York City neighborhoods: Socioeconomic factors and mobility

Abstract

Background: New York City (NYC) has been one of the hotspots of the COVID-19 pandemic in the United States. By the end of April 2020, close to 165 000 cases and 13 000 deaths were reported in the city with considerable variability across the city's ZIP codes. Objectives: In this study, we examine: (a) the extent to which the variability in ZIP code-level case positivity can be explained by aggregate markers of socioeconomic status (SES) and daily change in mobility; and (b) the extent to which daily change in mobility independently predicts case positivity. Methods: COVID-19 case positivity by ZIP code was modeled using multivariable linear regression with generalized estimating equations to account for within-ZIP clustering. Daily case positivity was obtained from NYC Department of Health and Mental Hygiene and measures of SES were based on data from the American Community Survey. Changes in human mobility were estimated using anonymized aggregated mobile phone location systems. Results: Our analysis indicates that the socioeconomic markers considered together explained 56% of the variability in case positivity through April 1 and their explanatory power decreased to 18% by April 30. Changes in mobility during this time period are not likely to be acting as a mediator of the relationship between ZIP-level SES and case positivity. During the middle of April, increases in mobility were independently associated with decreased case positivity. Conclusions: Together, these findings present evidence that heterogeneity in COVID-19 case positivity during NYC’s spring outbreak was largely driven by residents’ SES.