1. Citizenship Matters: Non-Citizen COVID-19 Mortality Disparities in New York and Los Angeles
- Author
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Douglas, Jason A, Bostean, Georgiana, Nash, Angel Miles, John, Emmanuel B, Brown, Lawrence M, and Subica, Andrew M
- Subjects
Public Health ,Health Sciences ,Human Society ,Prevention ,Good Health and Well Being ,COVID-19 ,Citizenship ,Humans ,Los Angeles ,New York ,New York City ,SARS-CoV-2 ,non-citizens ,Black and Latinx ,health disparities ,systemic racism ,social determinants of health ,Toxicology - Abstract
U.S. non-citizen residents are burdened by inequitable access to socioeconomic resources, potentially placing them at heightened risk of COVID-19-related disparities. However, COVID-19 impacts on non-citizens are not well understood. Accordingly, the current study investigated COVID-19 mortality disparities within New York (NYC) and Los Angeles (LAC) to test our hypothesis that areas with large proportions of non-citizens will have disproportionately high COVID-19 mortality rates. We examined ecological associations between March 2020-January 2021 COVID-19 mortality rates (per 100,000 residents) and percent non-citizens (using ZIP Code Tabulation Areas (ZCTA) for NYC and City/Community units of analysis for LAC) while controlling for sociodemographic factors. Multiple linear regression analyses revealed significant positive associations between the percentage of non-citizen residents and COVID-19 mortality rates in NYC (95% CI 0.309, 5.181) and LAC (95% CI 0.498, 8.720). Despite NYC and LAC policies intended to provide sanctuary and improve healthcare access for non-citizen residents, communities with larger proportions of non-citizens appear to endure higher COVID-19 mortality rates. The challenges that non-citizens endure-e.g., inequitable access to public benefits-may discourage help-seeking behaviors. Thus, improved health surveillance, public health messaging, and sanctuary policies will be essential for reducing COVID-19 mortality disparities in communities with large shares of non-citizens.
- Published
- 2022