Mount Sinai unveils inequity index that links socioeconomic needs to Covid mortality

Mount Sinai researchers have created a neighborhood-level Covid-19 equity index to explore the relationship between socioeconomic disadvantages and infection and mortality rates during the pandemic, the health system announced Thursday.

The index was part of a study published this month in Nature Communications. It measured factors including employment, commuting patterns, population density, food access, socioeconomic status and access to health care. Mount Sinai used census data, subway ridership information and health data from the city and state between March and May to build the index.

Available data from the early days of the pandemic focused on the pre-existing conditions of Black and brown communities and how they contributed to the disproportionate impact of the coronavirus on those groups, said Daniel Carrión, postdoctoral research fellow at the Icahn School of Medicine at Mount Sinai. His team wanted to explore factors that preceded the conditions, such as socioeconomic issues, and back up those links with data, he said.

The study showed that ZIP codes with higher amounts of people per household and higher numbers of essential workers who could not work remotely, and those in which residents largely lacked stable insurance, experienced higher Covid-19 infection rates and more severe disease. Those neighborhoods also were associated with a lower median income, fewer grocers per 1,000 people and higher population density.

Although the study built its inequity index to exclude race as a variable, when the findings were retroactively broken down to reveal race and ethnicity makeup, the highest inequities were faced by Black and brown communities.

“Just race alone isn’t a factor for inequity,” Carrión said. “But it’s the structural barriers and social conditions communities of color are exposed to that account for the unequal impact of Covid.”

Although the index still needs to be validated with future studies, he said, it could end up being a tool to help policymakers come up with tailored approaches to handling health crises.

“In this pandemic, the solution had been to stay home and work remotely, but clearly many New Yorkers couldn’t do that,” Carrión said. The index can reveal which factors matter more by neighborhood, allowing for a stratified approach, he added.

The index also plays into vaccine access.

“Just as different communities had different reasons for their barriers to accessing health care, they too have different reasons for being unable to access vaccines,” Carrión said.

This story first appeared in our sister publication, Crain’s New York Business.