The Impact of COVID-19 on New York's Poorest: An Analysis of Excess Mortality During the Pandemic Using Burial Records from Hart Island

COVID-19 对纽约最贫困人口的影响：利用哈特岛的埋葬记录对大流行期间的过度死亡率进行分析

• 批准号: 10533809
• 负责人: FRANK HEILAND
• 金额: $ 8.26万
• 依托单位: BERNARD M. BARUCH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-12-02 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10533809
• 关键词: Accidents; Acute; Address; Affect; African American; Age; Attention; Burial; COVID-19; COVID-19 disparity; COVID-19 impact; COVID-19 mortality; COVID-19 outbreak; COVID-19 pandemic; COVID-19 pandemic effects; Cause of Death; Censuses; Cessation of life; Characteristics; Chronic; Cities; Communities; Country; Data; Death Rate; Death Records; Demography; Disease; Disease Outbreaks; Drug abuse; Economically Deprived Population; Economics; Epidemiologic Methods; Epidemiology; Ethnic Origin; Excess Mortality; Faculty; Family; Frequencies; Geography; Health; Healthcare Systems; Height; Hispanic; Hospitalization; Immigration; Indigent; Individual; Inequality; Infection; Island; Link; Literature; Location; Low Income Population; Low income; Neighborhoods; New York; New York City; Phase; Population; Poverty; Privatization; Probability; Public Health; Race; Records; Reporting; Research; Research Infrastructure; Resources; Risk; Role; Seasons; Services; Site; Social Distance; Sociology; Source; Suicide; Testing; Time; United States; Vulnerable Populations; Writing; ethnic disparity; experience; health care availability; health record; innovation; mortality; new outbreak; novel coronavirus; pandemic disease; pandemic impact; population health; public health priorities; racial disparity; respiratory virus; sex; social; socioeconomic disadvantage; statistics; stay-at-home order

We propose to investigate the impact of COVID-19 on mortality among poor New Yorkers using burial records from Hart Island, the city’s potter’s field. We will look at all-cause excess mortality during the first and second wave of the outbreak by sex, race/ethnicity, and location. Excess mortality is defined as the difference (or ratio) between the actual number of deaths observed and the number of deaths expected in the absence of the pandemic. It is a key metric to understand the full impact of the pandemic on mortality and population health. Studying excess mortality is important as the official COVID-19-related death count may understate the true number of deaths due to lack of testing, false negatives, and misclassification of cause-of-death. COVID-19 may also indirectly affect mortality from other causes. Individuals with acute or chronic health conditions, which are more prevalent among the poor, may be more likely to die because of these issues and the greater strain on the healthcare system. Social distancing and stay-at-home orders may decrease mortality from accidents but could raise mortality from other causes such as suicide and drug abuse. Understanding how COVID-19 affects socio-economically disadvantaged populations is an important public health priority, but no official statistics speak to its impact on the poor. Estimates of excess mortality among New Yorkers using Hart Island individual-level death records will help shed light on this important issue. These data provide a never-before-explored source to study the impact of the pandemic. Decedents on Hart Island constitute a particularly vulnerable population as they are among the poorest-of-poor New Yorkers. They are expected to be more likely to suffer from lack of timely access to healthcare, and may face greater risk of misclassification upon death, owing to a lack of social and material resources. Analysis of preliminary data shows as many as seven times the number of deaths during the height of the initial COVID-19 outbreak in April 2020 compared to the same period in 2019, confirming the feasibility and potential of the proposed research. This research will link place-of- death addresses with censuses blocks and nested geographies, facilitating estimation of individual and community characteristics to more fully describe inequality in COVID deaths. Further, while indigent burial is an ongoing tragedy found throughout the world during the COVID-19 pandemic, it remains almost completely unstudied in the scientific literature. The proposed research will provide much-needed analysis of a public health and social crisis by drawing on the expertise of faculty in demography, geography, and epidemiology.

我们建议调查Covid-19对贫穷纽约人使用的影响 该市波特田地哈特岛（Hart Island）的埋葬记录。我们将查看全原因超过 性别，种族/种族和地点的第一波和第二波爆发中的死亡率。 过剩的死亡率定义为实际死亡人数之间的差异（或比率） 观察到的以及在没有大流行的情况下预期的死亡人数。这是一个关键指标 了解大流行对死亡率和人口健康的全部影响。 研究过剩死亡率很重要，因为与19号的官方相关死亡人数可能 低估由于缺乏测试，假否定性和错误分类而导致的真实死亡人数 死亡原因。 COVID-19也可能间接影响其他原因的死亡率。个人 在穷人中更普遍的急性或慢性健康状况可能更多 可能是由于这些问题而死的，并且对医疗保健系统的压力更大。社会的 疏远和在家订单可能会降低事故的死亡率，但可能会增加 来自其他原因，例如自杀和滥用药物的死亡率。 了解Covid-19如何影响社会经济扰动的人群是一个 重要的公共卫生优先事项，但没有官方统计数据表明其对穷人的影响。 使用哈特岛个体级死亡的纽约人死亡过多的估计 记录将有助于阐明这一重要问题。这些数据提供了从未有过的探索的 研究大流行的影响的来源。哈特岛的死者构成了一个特别 脆弱的人口是最贫穷的纽约人之一。他们有望 更有可能因缺乏及时获得医疗保健而受苦，并且可能面临更大的风险 由于缺乏社会和物质资源，死亡后的分类错误。 初步数据的分析显示了死亡人数的七倍 与2019年同一时期相比 确认拟议研究的可行性和潜力。这项研究将联系起来 死亡与人口普查区块和嵌套地理的地址，支持估计 个人和社区特征，以更充分地描述共同死亡中的不平等。 此外，虽然贫穷的葬礼是在世界范围内发现的一场持续的悲剧 COVID-19大流行，在科学文献中几乎完全没有研究。 拟议的研究将对公共卫生和社会危机的急需分析 利用人口，地理和流行病学教师的专业知识。