Pandemic Injustice: Spatial and Social Distributions of COVID-19 in the US Epicenter
Authors: McPhearson Timon , Grabowski Zbigniew , Herreros-Cantis Pablo , Mustafa Ahmed , Ortiz Luis , Kennedy Christopher , Tomateo Claudia , Lopez Bianca , Olivotto Veronica , Vantu Avigail 
Published: April 2021

We examine the uneven social and spatial distributions of COVID-19 and their relationships with indicators of social vulnerability in the U.S. epicenter, New York City (NYC). As of July 17th, 2020, NYC, despite having only 2.5% of the U.S. population, has [Formula: see text]6% of all confirmed cases, and [Formula: see text]16% of all deaths, making it a key learning ground for the social dynamics of the disease. Our analysis focuses on the multiple potential social, economic, and demographic drivers of disproportionate impacts in COVID-19 cases and deaths, as well as population rates of testing. Findings show that immediate impacts of COVID-19 largely fall along lines of race and class. Indicators of poverty, race, disability, language isolation, rent burden, unemployment, lack of health insurance, and housing crowding all significantly drive spatial patterns in prevalence of COVID-19 testing, confirmed cases, death rates, and severity. Income in particular has a consistent negative relationship with rates of death and disease severity. The largest differences in social vulnerability indicators are also driven by populations of people of color, poverty, housing crowding, and rates of disability. Results highlight the need for targeted responses to address injustice of COVID-19 cases and deaths, importance of recovery strategies that account for differential vulnerability, and provide an analytical approach for advancing research to examine potential similar injustice of COVID-19 in other U.S. cities. Significance Statement Communities around the world have variable success in mitigating the social impacts of COVID-19, with many urban areas being hit particularly hard. Analysis of social vulnerability to COVID-19 in the NYC, the U.S. national epicenter, shows strongly disproportionate impacts of the pandemic on low income populations and communities of color. Results highlight the class and racial inequities of the coronavirus pandemic in NYC, and the need to unpack the drivers of social vulnerability. To that aim, we provide a replicable framework for examining patterns of uneven social vulnerability to COVID-19- using publicly available data which can be readily applied in other study regions, especially within the U.S.A. This study is important to inform public and policy debate over strategies for short- and long-term responses that address the injustice of disproportionate impacts of COVID-19. Although similar studies examining social vulnerability and equity dimensions of the COVID-19 outbreak in cities across the U.S. have been conducted (Cordes and Castro 2020,Kim and Bostwick 2002,Gaynor and Wilson 2020; Wang et al. 2020; Choi and Unwin 2020), this study provides a more comprehensive analysis in NYC that extends previous contributions to use the highest resolution spatial units for data aggregation (ZCTAs). We also include mortality and severity rates as key indicators and provide a replicable framework that draws from the Centers for Disease Control and Prevention’s Social Vulnerability indicators for communities in NYC.