Socioeconomic Disparities in Severe Acute Respiratory Syndrome Coronavirus 2 Serological Testing and Positivity in New York City

Abstract

Abstract Background We characterized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody test prevalence and positive test prevalence across New York City (NYC) in order to investigate disparities in testing outcomes by race and socioeconomic status (SES). Methods Serologic data were downloaded from the NYC Coronavirus data repository (August 2020–December 2020). Area-level characteristics for NYC neighborhoods were downloaded from United States census data and a socioeconomic vulnerability index was created. Spatial generalized linear mixed models were performed to examine the association between SES and antibody testing and positivity. Results The proportion of Hispanic population (posterior median, 0.001 [95% credible interval, 0.0003–0.002]), healthcare workers (0.003 [0.0001–0.006]), essential workers (0.003 [0.001–0.005]), age ≥65 years (0.003 [0.00002–0.006]), and high SES (SES quartile 3 vs 1: 0.034 [0.003–0.062]) were positively associated with antibody tests per 100000 residents. The White proportion (–0.002 [–0.003 to –0.001]), SES index (quartile 3 vs 1, –0.068 [–0.115 to –0.017]; quartile 4 vs 1, –0.077 [–0.134 to –0.018]) and age ≥65 years (–0.005 [–0.009 to –0.002]) were inversely associated with positive test prevalence (%), whereas the Hispanic (0.004 [0.002–0.006]) and essential worker (0.008 [0.003–0.012]) proportions had positive coefficients. Conclusions Disparities in serologic testing and seropositivity exist on SES and race/ethnicity across NYC, indicative of excess coronavirus disease burden in vulnerable and marginalized populations.