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

Educational Objective
To understand how built environment affects the care pregnant women with COVID-19 receive in New York City
1 Credit CME

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.

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Article Information

Corresponding Author: Alexander Melamed, MD, MPH, Division of Gynecologic Oncology, Vagelos College of Physicians and Surgeons, Columbia University, 161 Ft Washington Ave, New York, NY 10032 (am5195@cumc.columbia.edu).

Published Online: June 18, 2020. doi:10.1001/jama.2020.11370

Author Contributions: Dr Melamed had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Drs Emeruwa and Ona contributed equally.

Concept and design: Shaman, Turitz, Gyamfi-Bannerman, Melamed.

Acquisition, analysis, or interpretation of data: Emeruwa, Ona, Gyamfi-Bannerman, Wright, Melamed.

Drafting of the manuscript: Emeruwa, Ona, Melamed.

Critical revision of the manuscript for important intellectual content: Emeruwa, Ona, Shaman, Turitz, Gyamfi-Bannerman, Wright.

Statistical analysis: Melamed.

Administrative, technical, or material support: Shaman, Turitz, Gyamfi-Bannerman.

Supervision: Turitz, Melamed.

Conflict of Interest Disclosures: Dr Shaman and Columbia University reported partial ownership of SK Analytics. Dr Shaman reported receiving personal fees from Business Networking International and Merck. Dr Gyamfi-Bannerman reported receiving grants from Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Heart, Lung, and Blood Institute, and AMAG/Society for Maternal-Fetal Medicine and receiving personal fees from Sera. Dr Wright reported receiving grants from Merck and receiving personal fees from Clovis Oncology. No other disclosures were reported.

Funding/Support: This study was supported by the National Center for Advancing Translational Sciences (KL2TR001874 [Dr Melamed]), the National Institute of General Medical Sciences (1U01GM110748 [Dr Shaman]), the National Science Foundation (DMS-2027369 [Dr Shaman]), National Heart, Lung, and Blood Institute (2R01HL098554 [Dr Gyamfi-Bannerman]), Eunice Kennedy Shriver National Institute of Child Health and Human Development (5UG1HD040485 [Dr Gyamfi-Bannerman]), the Society for Maternal-Fetal Medicine (Dr Gyamfi-Bannerman), and the Morris-Singer Foundation (Dr Shaman).

Role of the Funders/Sponsors: The funders/sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
Pinter-Wollman  N , Jelić  A , Wells  NM .  The impact of the built environment on health behaviours and disease transmission in social systems.   Philos Trans R Soc Lond B Biol Sci. 2018;373(1753):20170245. doi:10.1098/rstb.2017.0245PubMedGoogle Scholar
2.
Virtanen  M , Terho  K , Oksanen  T ,  et al.  Patients with infectious diseases, overcrowding, and health in hospital staff.   Arch Intern Med. 2011;171(14):1296-1298. doi:10.1001/archinternmed.2011.313PubMedGoogle ScholarCrossref
3.
Wadhera  RK , Wadhera  P , Gaba  P , Figueroa  JF , Joynt Maddox  KE , Yeh  RW , Shen  C .  Variation in COVID-19 hospitalizations and deaths across New York City boroughs.   JAMA. 2020;323(21):2192-2195. doi:10.1001/jama.2020.7197PubMedGoogle ScholarCrossref
4.
American community survey by neighborhood tabulation area. New York City Department of City Planning. Accessed May 6, 2020. https://www1.nyc.gov/site/planning/data-maps/open-data/dwn-acs-nta.page
5.
PLUTO database. New York City Department of City Planning. Accessed May 6, 2020. https://www1.nyc.gov/site/planning/data-maps/open-data.page
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