COVID-19 testing, case, and death rates and spatial socio-demographics in New York City

Social and Spatial Epidemiology Unit members, Byoungjun Kim, Andrew Rundle, Christopher Morrison, Charles Branas, and Dustin Duncan recently published research regarding neighborhood-level social and built environments as potential determinants of COVID-19 testing, case, and death rates in New York City.

There is emerging evidence that marginalized and vulnerable populations are disproportionately affected by COVID-19. In addition to the individual-level characteristics (i.e. age, race/ethnicity, and occupation), environmental factors in urban contexts such as urban design, housing density, and transportation systems can impact the transmission of infectious diseases. Recent analytic studies investigated the associations between neighborhood characteristics and the geographic distribution of COVID-19, but may have been susceptible to unstable population estimates in New York City. With the advent of COVID-19, the socio-demographic landscapes in New York City changed due to residents moving out of the city in response to the pandemic. However, the exodus from New York City was not uniform across neighborhoods, with greater migration occurring in higher income areas.  The COVID-19 rates provided by New York City Department of Health and Mental Hygiene are based on estimated populations from census data before the pandemic, thus the SARS-CoV-2 testing and COVID-19 case/death rates are may be biased estimates. Kim et al examined the geographic variation in socio-demographic characteristics and built environmental factors in New York City in relation to COVID-19 testing, case and death rates and used cell phone data to estimate the variation in how many residents had left New York City across neighborhoods.

Kim et al. used COVID-19 statistics for testing, positive cases, and death counts of New York City residents by residential ZCTA (ZIP Code Tabulation Area) obtained from the New York City Department of Health and Mental Hygiene on June 10, 2020. In order to account for the residents moving out of the city during the COVID-19 pandemic, a dataset of cellular phone usage was utilized as a proxy measure of population changes. The data from cellular phone towers captures the mobility and migration patterns of a wide range of residents, as the towers interact with all types of cellular devices even when those devices are in stand-by and calls are not in progress. More than 1 million cellular devices that interacted with cellular towers in New York City were analyzed, and the percentage change in registered cellular phone signals between March 1, 2020 and May 1, 2020 were aggregated into census tracts by Teralytics Inc. Lastly, pre-pandemic socio-demographic characteristics were calculated by ZCTA from the 2018 American Community Survey 5-year estimates, including age,  sex,  race/ethnicity, median income, household size, occupation, and commuting characteristics.

The spatial regression model results showed that different sets of neighborhood characteristics were independently associated with COVID-19 testing, case, and death rates. For example, consistent with previous findings, the proportions of Black and Hispanic residents in a ZCTA were positively associated with COVID-19 case rates.

Contrary to the conventional hypothesis, neighborhoods with low-density housing experienced higher COVID-19 case rates. While this is not consistent with the conventional hypothesis (i.e. higher density as a risk factor of the infection), there are inconsistent findings regarding the association between population density and COVID-19 rates. Recent studies on neighborhood-level factors in Chinese and European cities reported that population density was negatively or not associated with COVID-19. One explanation could be the differential application of mitigation strategies. Early in the pandemic, the Center for Disease Control and Prevention announced guidelines for maintaining safe operations of multifamily housing, including closing public areas in the building, disinfecting common areas, providing hand sanitizer in common areas, and mandatory mask-wearing.

In addition, higher pre-pandemic transit ridership in a neighborhood was not associated with higher COVID-19 case or death rates. Subway use has decreased dramatically after the declaration of a local state of emergency, and this null association may reflect the reduced overall ridership during the pandemic.

Lastly, in regard to the demographic changes out-migration during the pandemic may bias the estimates of COVID-19 rates. News-media reported that out-migration varied strongly by neighborhood socio-demographic characteristics, and Kim and colleagues’ analysis found that neighborhood level out-migration was also associated with COVID-19 case rates.

Figure 1. COVID-19 Testing, Case, Death Rates (/100,000) and Socio-demographics in New York City by ZCTA

Posted in COVID-19, Mapping, Neighborhood Environments, Social Environments, Socioeconomic Status, Spatial Analysis, Urban Design, Urban Health | Leave a comment

Gun Violence in a Time of COVID

COVID-19 and efforts to contain its spread have affected almost all aspects of our daily lives over the last year. Risks for crime and violence are no different. Early during the pandemic reports emerged of increased incidence of gun violence in some US cities, even while incidence of home invasions and other property crime decreased. At the same time, the nation has faced a collective reckoning with the systemic racism following the killing of unarmed black man, George Floyd, by an officer of the Minneapolis Police Department. Protests against police brutality and structural violence may have also contributed to the increase in gun violence.

Dr. Christopher Morrison, Assistant Professor of Epidemiology, and colleagues attempted to disentangle the effects of COVID-19 containment policies and the protests following George Floyd’s killing on gun violence in Philadelphia. In a research letter published in JAMA, the Journal of the American Medical Association, they used comprehensive data on shootings collected by the Philadelphia Police Department in a time series design. The authors identified that the best fitting statistical model included a gradual increase in gun violence that coincided with the beginning of COVID-19 containment policies. The protests following George Floyd’s killing were not independently related to increases in gun violence.

A devastating reality of the COVID-19 pandemic is that the disease itself and the steps we have taken to reduce its spread most greatly affect the least advantaged among us. And it has long been the case that gun violence concentrates in disadvantaged areas and among disadvantaged populations, including, particularly, young black men. It is perhaps no surprise that these enormous structural problems combined to further exacerbate enduring health inequities.

Time series of shootings in Philadelphia

Posted in COVID-19, Gun Violence, Injury | Leave a comment

Innovative Responses to Pandemic Related Disruptions in School Meal Programs

School meals are a vital source of federal food assistance; the National School Lunch and School Breakfast programs serve approximately 30 million lunches and 15 million breakfasts daily at low or no cost to students. At the start of the COVID-19 pandemic in March, schools closed across the country, leaving millions of children without access to the school meals they rely on to meet their nutritional needs. A team of researchers, including Dr. Eliza Kinsey with Columbia University’s Social & Spatial Epidemiology Unit, recently published a study in the American Journal of Public Health documenting the disruption to school meals as a result of COVID-related school closures. The authors estimate that more than 1.15 billion breakfasts and lunches for students in the U.S. who receive free and reduced-price meals were not served in school as a result of school closures during the nine-week period between March 9 and May 1.

Preparing school meals during the pandemic – Somerset County

In Maryland, which the researchers studied in depth, every day schools were closed, nearly 500,000 free or reduced-price meals were not served in school (the equivalent of almost 2.5 million meals per week). While Maryland estimates that by the week of April 20, they were distributing 1 million replacement meals to students weekly, this still represents a roughly 1.5 million meal weekly shortfall. Similarly, major cities like New York City, Philadelphia, and San Francisco provided far fewer meals than they would have if schools were open.

These shortfalls come despite major efforts at the federal, state and local level. The authors highlight the strategies that states and school districts are using to replace these missed meals, enabled in large part by 18 nationwide waivers from the U.S. Department of Agriculture intended to increase meal program flexibility and allow for innovation in meal service during the pandemic. In many districts, this has included serving meals in a grab-and-go format at centralized, outdoor locations and offering a week’s worth of meals at one time. Some districts, particularly in rural locations, have provided home delivery or distributed meals along school bus routes.

Lastly, the authors explore lessons learned from the pandemic with the goal of informing and strengthening future school nutrition policies. The challenges school nutrition operators face in keeping children fed during the pandemic highlight preexisting hurdles associated with running school nutrition programs when schools are not in session, and the pandemic can provide many useful lessons for future out-of-school meal provision.

All of the authors of this publication are members of the ad hoc COVID-19 School Nutrition Implications Working Group, jointly supported by Healthy Eating Research (HER), a national program of the Robert Wood Johnson Foundation (RWJF), and the CDC’s Nutrition and Obesity Policy Research and Evaluation Network (NOPREN). This project was supported by funding from NOPREN.


Posted in Childhood Adversity, COVID-19, Food Insecurity | Leave a comment

Postdoctoral Fellowship Program – Advanced Training in Environmental Health and Data Science: Molecules to Populations

Postdoctoral Fellowship

Advanced Training in Environmental Health and Data Science

Departments of Environmental Health Sciences and Epidemiology

Mailman School of Public Health at Columbia University

The Departments of Environmental Health Sciences and Epidemiology at Columbia’s Mailman School of Public Health are looking to appoint multiple postdoctoral fellows to a newly funded NIH-funded program for Advanced Training in Environmental Health and Data Science: Molecules to Populations.  These two-year appointments will start as early as July 1, 2020.  Applicants must propose a plan of research in the broader fields of environmental health sciences and mechanisms of disease, environmental epidemiology, or climate and health.  Interdisciplinary proposals incorporating features related to the exposome, health and wellness across the lifecourse and/or data science are particularly welcome.  This is a broad announcement. We expect to appoint multiple fellows pursuing topics that span different components of the program.

Fellows in the program will be expected to obtain core competencies in environmental health, epidemiology, and data science, to conduct independent research of high impact, and to undertake further interdisciplinary training. All fellows will be appointed in either the Department of Environmental Health Sciences or the Department of Epidemiology and will be affiliated with the Data Science Institute (DSI) of Columbia University. Fellows will participate in seminars and workshops offered through the program, the departments and DSI in order to enhance their domain knowledge and advance their training. Further, fellows will receive training in team science and grant writing and will help coordinate interdisciplinary teams comprised of pre-doctoral and post-doctoral fellows in the program that support the integration of data science methods in research.

The Departments of Environmental Health Sciences and Epidemiology at the Columbia University Mailman School of Public Health foster innovative scholarship in toxicology, epigenetics, environmental epidemiology, lifecourse epidemiology and the effects of climate change on human health.  Current faculty research spans topics including cancer, neurodegeneration and aging, the exposome, nutrition and food security, children’s health, air pollution, extreme weather events, molecular epidemiology and epigenetics, endocrine disruptors and metals and health research.  We welcome applicants with interests in these areas or in other topics within environmental health science, environmental epidemiology and climate and health.

These positions are supported by a National Institute for Environ­mental Health Sciences training grant and are limited to appli­cants who are US citizens or permanent residents. Information about the Departments of Environmental Health Sciences and Epidemiology is available at Applicants are encouraged to contact potential fac­ulty advisors of interest (see website for potential advisors) and to include a list of their names in the application. Applications should include a cover letter, a 5-page research proposal, curriculum vitae, and the names of 3 references. Questions should be directed to Jeffrey Shaman, Postdoctoral Program Director, 722 West 168th Street, Room 1104E, New York, NY 10032 or by email at [email protected]

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“I’m Not a Freshi”: Culture Shock, Puberty and Growing Up as British-Bangladeshi Girls

Most people wish to banish the awkwardness and confusion of puberty from their memories, but for Lauren Houghton, puberty has been the focus of her research for more than a decade. Fascinated by the opportunity it presented for biosocial inquiry, Lauren was struck by how few studies have taken a comparative biocultural approach. In a recent publication, Houghton et al. (2020) used mixed-methods in a study called the ABBY Project (Adolescence among Bangladeshi and British Youth) to compare experiences of puberty across cultures in a study of nearly 500 girls aged 5-16 who were either Bangladeshi, first-generation migrant to the UK, second-generation migrant, or white British.

This mixed-method research speaks to the power of speaking with participants rather than just collecting data from participants. The authors had originally predicted the age at puberty to follow a steady decline with increasing time lived in the UK (age at puberty decreasing in this order: Bangladeshi, 1st generation migrants, 2nd generation migrants, then white British).  But the finding that first generation had particularly early puberty was completely unexpected.

The design of Houghton’s fieldwork- two years embedded in the East London school system – allowed for the simultaneous collection of qualitative and quantitative data. This in turn allowed the authors to suggest explanations for why first generation girls seemed to mature so early. One clear finding was that the stigma of being “Freshis” (recent migrants to the UK) expressed by second generation Bangladeshi peers was a source of psychosocial stress.  This stress could be one explanation for the early puberty.

Members of the GAL Club, an after school club offered to schools and participants in exchange for their participation in the ABBY Project.

The social stickiness of this stigma was strengthened by an overall rejection of Bangladeshi culture among the British-Bangladeshi youth. For example, girls denied eating “Rice”, short hand for rice and curry, in front of their friends even though they reported eating it the night before in the 24-hour food recall conducted as part of the study. While they rejected Bangladeshi culture, they embraced being Muslim. Wearing hijab reflected their respectful practice of Islam. In fact, girls living in the UK were more likely to wear hijab than girls in Bangladesh. The girls explained a distinction between practicing the scarf (wearing it irregularly) and being dedicated to it (wearing it every day) (See Figure 1). This distinction became fertile ground to explore biocultural markers of puberty. Through an integrated mixed-methods approach it became clear that practicing the scarf aligned with the onset of adrenarche, a pre-cursor of puberty, and becoming dedicated to it aligned with the onset of menarche (a girl’s first period) for first generation girls (See Figure 2).  This is in sharp contrast to girls in Bangladesh among whom becoming dedicated to the scarf only occurred in early adulthood, if at all. The hijab emerged as a biocultural marker of first generation girls pubertal experience as they came of age in East London.

Ages at biological and cultural markers of puberty in Bangladeshi and British girls in the ABBY Project

Interpreting the results of epidemiological studies is standard practice, however, in this mixed-methods research we were able to turn to sociocultural explanations explicitly observed and inquired about with the actual population understudy to interpret our quantitative findings. The authors did not have to surmise blindly based on their own biased perspectives, but rather could make culturally-informed interpretations. Furthermore, they were able to integrate the qualitative findings with biomarkers, in this case measures of stress hormones. In the era of “big data,” when methodological advances are leading to studies of multiple “-omic” fields (such as genomics, epigenomics, proteomics, metabolomics, and microbiomics) this study is an example of how qualitative methods can add to these omics. “Emics”, the mapping of on-the-ground perspectives, derives from rich discussion with stakeholders directly affected by the problem under consideration. The ABBY Project illustrates how the incorporation of “emics” in addition to “omics” into epidemiologic studies will lead to a more engaged discipline of consequence.

Posted in Ethnicity, Gender, Immigration, Mixed Methods, Social Environments | Leave a comment

Trends in U.S. Women’s Binge Drinking in Middle Adulthood by Socioeconomic Status, 2006-2018

Cluster members Sarah McKetta and Katherine Keyes recently published research regarding national trends in binge drinking among women in the mid-life.

Multiple national surveys have found that women in the mid-life (~30-49) have dramatically increased binge drinking in recent years. While multiple hypotheses have been suggested to explain this increase, few have been empirically investigated. One hypothesized determinant of these trends is that shifts in women’s education and social position may be contributing to increases in binge drinking; if that’s true, the researchers anticipated that the increases in binge drinking prevalence would be concentrated among highly educated women and women with higher socio-economic status.

McKetta and Keyes used data from the National Health Interview Surveys (NHIS) from 2006 to 2018 to examine how trends in binge drinking among women ages 30-49 varied across two different measures of socio-economic status: education and family income.

They found that women had increases in binge drinking at all levels of education and income, but those with higher education and higher income had the most pronounced increases in binge drinking in recent years. For example, among women with less than high school education, the model-based predicted probability of binge drinking in 2006 was 10%, and 13% in 2018, adjusting for covariates (adjusted OR [AOR] 1.02, 95% CI 0.99, 1.04); among those with a college degree, binge drinking increased from a predicted 14% to 34% (AOR 1.10, 95% CI 1.08–1.11).  There appeared to be a threshold at college completion, as the increases among women in higher education categories were nearly identical.  Among women with family incomes less than 100% of the Federal Poverty Level (FPL), the model-based probability of binge drinking increased from 11% to 16% from 2006 to 2018 (AOR 1.03, 95% CI 1.01–1.05); whereas among those at the highest income level, 400% of the FPL or higher, binge drinking increased from 17% to 36% (AOR 1.09, 95% CI 1.07–1.10). In sensitivity analyses examining these trends among men, the socio-economic patterning of trends in binge drinking was much less pronounced.

The authors interpret these findings as evidence that increases in women’s binge drinking are concentrated among women at the highest levels of socio-economic status. This research corroborates previous research demonstrating the importance of college as a risk factor for binge drinking. This research also provides further evidence that alcohol researchers examining determinants of recent trends should be considering social factors, including the changing social landscape for women, such as increases in labor force engagement and role strain for women. The authors caution that the groups traditionally considered “high-risk” (i.e., young, college-aged men) are changing, and that providers should be screening all patients for alcohol consumption.

Posted in Alcohol, Alcohol Consumption, Socioeconomic Status | Leave a comment

Engaging with movement demands on their own terms: Professor Ruth Wilson Gilmore makes the case for abolition

There’s been much discussion about what organizers and protesters “really mean” by their demands to defund the police and abolish police and prisons, as those ideas enter the mainstream discourse.

One troubling pattern is emerging in these discussions among commentators and academics who identify with criminal legal system reform. Instead of openly debating the demands of demonstrators and organizers on their own terms, or admitting they disagree or think they’re infeasible, many are appropriating and coopting elements of the demands they find palatable, while redefining the elements they don’t. For the latter, they claim that people taking the streets aren’t saying what they actually mean, and proceed to offer what they think is a more reasonable interpretation.

Social epidemiologists have a responsibility not to decenter and erase the 30-plus years of brilliant, sophisticated scholarship and organizing that the mostly Black-women-led abolition movement has done to prepare us for this moment. When they, and the protesters and organizers on the ground in Minneapolis and across the country, say “defund the police,” they really mean defund, and when they say “abolish the police” (and prison!) they really mean abolish. And they have mountains of scholarly and popular literature enumerating what they mean in rich detail, which includes concrete, pragmatic, and proven alternative investments.

Sadly, at the very moment when white and/or well-off people least affected by state violence should be stepping back, listening, doing the reading, and amplifying the work of Black scholars, organizers, activists, and movement leaders, they’re centering white liberal subjectivity and pragmatism as normative and “objective,” and engaging in the sort of whitewashing and gaslighting that helps to reproduce white supremacy.

With this in mind, here is some required listening for social epidemiologists: This new two-part podcast interview with Professor Ruth Wilson Gilmore, a founder of the abolition movement and prolific scholaris essential.  In the words of the interviewer, Rutgers journalism Professor Chenjerai Kumanyika, “In addition to concrete lessons for organizers, Ruth Wilson Gilmore makes PROFOUND interventions in at least five different academic disciplines (geography, social work, ecology, criminology, economics, women’s studies etc.).” I would absolutely add public health to that list.

– Seth J. Prins, PhD MPH, Assistant Professor of Epidemiology and Sociomedical Sciences


Podcast on the The Intercept

And here are spotify links:

Part 1

Part 2

Finally, here are some excellent compendia of readings, interviews, and other resources on abolition and transformative justice:




Posted in Mass Incarceration | Leave a comment

How neighborhoods and infrastructure can impact HIV transmission among Black sexual minority men

Individual risky behaviors (ex. condomless sex, multiple partners, drug use) have long been a focus of HIV research and intervention strategies for sexual minority men (SMM). However, focusing on the individual level obscures the effects of broader societal influences and disparities. Importantly, Black SMM experience higher rates of HIV infection than their white counterparts, despite engaging in similar or fewer HIV risk behaviors. Individual behaviors cannot explain this disparity, and behavior-focused interventions cannot close this gap.

It is important to consider the upstream, structural causes of health disparities, especially those that are modifiable, in order to inform justice-oriented interventions. One such upstream cause is neighborhood factors.

Neighborhood problems — such as excessive noise, speeding cars, trash and litter, and lack of access to adequate food, shopping, sidewalks, parks and playgrounds — can have an impact on residents’ health. There are three major ways that these neighborhood problems operate on health. First, these problems can be stressors that prompt residents to engage in unhealthy behaviors as coping mechanisms (ex. Illicit drug use). Second, neighborhoods that are less pleasant to spend time in and more difficult to navigate can lack the social cohesion and community that can be protective when it comes to health behaviors. And third, neighborhood problems are often indicative of general disinvestment. The accompanying lack of access to material resources and services that might help residents avoid unhealthy behaviors and promote health preservation.

Dr. Dustin Duncan and colleagues at Columbia’s Spatial Epidemiology Lab conducted a study of 377 Black SMM in Jackson, Mississippi and Atlanta, Georgia to look for connections between neighborhood problems and HIV. Their findings suggest that “structural interventions that improve community infrastructure to reduce neighborhood problems (e.g., trash and litter) could help to alleviate the incidence of HIV among Black MSM in the Deep South.”

The study’s main finding was that a higher number of neighborhood problems was associated with drug use before or during sex. As a result, neighborhood problems could be considered a risk factor for HIV transmission.

We know that neighborhood problems are the by-product of historical neglect, especially of racially and economically segregated areas. Improving the infrastructure of these underserved neighborhoods could be one step in alleviating the incidence of HIV among Black SMM in the Deep South.


Reference: Duncan DT, Sutton MY, Park SH, Callander D, Kim B, Jeffries WL 4th, Henny KD, Harry-Hernández S, Barber S, Hickson DA. Associations Between Neighborhood Problems and Sexual Behaviors Among Black Men Who Have Sex with Men in the Deep South: The MARI Study. Arch Sex Behav. 2020 Jan;49(1):185-193.


Posted in Health Disparities, Neighborhood Disadvantage, Neighborhood Environments, Physical Disorder, Race, Racial Segregation, Urban Health | Leave a comment

“Black men loving Black men is the revolutionary act”1: Racial sexual exclusivity as both an effect and a protection against discrimination for Black sexual minority men

Often in public health, sexual relationships between Black gay, bisexual, and other sexual minority men (SMM) are framed as sources of risk and disease, especially in terms of HIV transmission. However, Black queer activists have long known that cultivating loving relationships between Black gay men is a way to build community, and can be a source of strength and resilience in the face racial discrimination. In response, researchers from Columbia’s Spatial Epidemiology Lab conducted a study to measure how sexual relationships between Black SMM can function as positive and preventive responses to racial discrimination, and associated psychological effects like depression symptoms.

The study involved 312 cisgender Black SMMs from the U.S. Deep South, in Jackson, Mississippi and Atlanta, Georgia. They were surveyed the assess levels of Black sexual exclusivity, sexual racial discrimination (whether they had been rejected by a potential partner because of their race), general daily discrimination experiences, and depressive symptoms.

Results of the study showed that men who experienced more racial discrimination were more likely to have exclusively Black sex partners. This could be a self-preservation mechanism, avoiding the daily discrimination that comes with navigating White social spaces.

Additionally (and perhaps intuitively), Black sexual exclusivity was associated with experiencing less sexual racial discrimination — perhaps by avoiding white sexual partners.

This work suggests that Black sexual exclusivity could help prevent depressive symptoms, by protecting Black SMM from sexual racial discrimination in addition to fostering love, closeness, and pleasure.

1Joseph Beam, “Caring for Each Other,” Black/Out, Summer 1986

Reference: English D, Hickson DA, Callander D, Goodman MS, Duncan DT. Racial Discrimination, Sexual Partner Race/Ethnicity, and Depressive Symptoms Among Black Sexual Minority Men. Arch Sex Behav. 2020 Mar 28. doi: 10.1007/s10508-020-01647-5.

Posted in Depression, Ethnicity, Health Disparities, Mental Health, Race, Racism, Social Networks | Leave a comment

@DearPandemic: a COVID-19-related scientific communication effort for the public

Epidemiologists and other scientists have become an important source of information for the public amid so much misinformation around COVID-19. “Dear Pandemic” is a public service effort by Dr. Sandra Albrecht, Assistant Professor of Epidemiology, in conjunction with an all-female team of 10 PhD-trained public health scientists/faculty from various institutions in the US and the UK, with expertise ranging across epidemiology, demography, nursing, health policy, and mental health clinical practice, among others. Together, they interpret the latest scientific findings, respond to queries from the public, and dispel myths around the virus via their “Dear Pandemic” social media profiles on Facebook, Instagram, and Twitter (@DearPandemic).  The team comes from different walks of life, so their collective networks exhibit broad geographic, political, cultural, and racial/ethnic diversity. Originally intended as a side project to deliver science-informed content to family, friends, and neighbors, this effort has grown into a large scientific communication effort with international reach that aims to educate and amplify facts and science for the public (see this JAMA Network article which calls for such efforts:

Follow @DearPandemic and share with family and friends:




Posted in COVID-19, Pandemic, Teaching Tools | Leave a comment