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    Research Letter
    June 18, 2020

    Associations Between Built Environment, Neighborhood Socioeconomic Status, and SARS-CoV-2 Infection Among Pregnant Women in New York City

    Author Affiliations
    • 1Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York
    • 2Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
    JAMA. 2020;324(4):390-392. doi:10.1001/jama.2020.11370

    The built environment is associated with infectious disease dynamics, particularly in diseases transmitted by contact, aerosols, or droplets.1,2 A recent study of the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic in New York revealed significant differences in hospitalization and death rates among the city’s boroughs, with the highest rates in Queens and the Bronx.3 To our knowledge, no studies have investigated associations between the built environment, markers of neighborhood socioeconomic status, and SARS-CoV-2 transmission. We leveraged a universal testing program for SARS-CoV-2 in pregnant women to examine associations between these factors and SARS-CoV-2 prevalence.

    We conducted a cross-sectional study of New York City residents delivering at NewYork–Presbyterian/Columbia University Irving Medical Center or Allen Hospital after implementation of universal SARS-CoV-2 nasopharyngeal quantitative reverse transcriptase–polymerase chain reaction testing at the time of admission to the labor and delivery unit from March 22 through April 21, 2020. We linked patients to demographic and socioeconomic data from the US Census Bureau’s American Community Survey,4 a national survey with detailed demographic, socioeconomic, and housing data, and to real estate tax data from New York’s Department of City Planning.5 We abstracted building-level variables, including number of residential units per building and mean assessed value (per square foot), and neighborhood-level variables, including median household income, poverty rate, unemployment rate, population density, household membership (persons per household), and household crowding (percentage of households with >1 person per room). Neighborhood was defined using New York City neighborhood tabulation areas, which divide the city into 195 districts, with at least 15 000 residents each.4