Coronavirus disease 2019 (COVID-19) mortality and neighborhood characteristics in Chicago

Abstract

Purpose: To describe coronavirus disease 2019 (COVID-19) mortality in Chicago during the spring of 2020 and identify at the census-tract level neighborhood characteristics that were associated with higher COVID-19 mortality rates.

Methods: Using Poisson regression and regularized linear regression (elastic net), we evaluated the association between neighborhood characteristics and COVID-19 mortality rates in Chicago through July 22 (2514 deaths across 795 populated census tracts).

Results: Black residents (31% of the population) accounted for 42% of COVID-19 deaths. Deaths among Hispanic/Latino residents occurred at a younger age (63 years, compared with 71 for white residents). Regarding residential setting, 52% of deaths among white residents occurred inside nursing homes, compared with 35% of deaths among black residents and 17% among Hispanic/Latino residents. Higher COVID-19 mortality was seen in neighborhoods with heightened barriers to social distancing and low health insurance coverage. Neighborhoods with a higher percentage of white and Asian residents had lower COVID-19 mortality. The associations differed by race, suggesting that neighborhood context may be most tightly linked to COVID-19 mortality among white residents.

Conclusions: We describe communities that may benefit from supportive services and identify traits of communities that may benefit from targeted campaigns for prevention and testing to prevent future deaths from COVID-19.

Keywords: Built environment; COVID-19; Health disparities; Prevention; Social determinants of health.

Fig. 1

COVID-19 death rates among noninstitutionalized population per thousand residents. For noninstitutionalized population, the rate of COVID-19 deaths per 1000 population (A), and subset of deaths in the black population (B), white population (C), and Hispanic/Latino population (D). Census-tracts with missing rates are census-tracts with no population (for A) or census-tracts with no population of the given race (for B–D).

Figure s1

Daily deaths from novel coronavirus in Chicago through July 22, 2020.

Figure s2

Correlation between tract-level characteristics in Chicago.

Figure s3

Trends in racial and ethnic composition of COVID-19 deaths in Chicago.

Figure s4

Trends in age of death from COVID-19 deaths in Chicago.

Figure s5

Racial and ethnic composition of Chicago.

Figure s6

Variability in neighborhood characteristics by race. Variability by race of the of two neighborhood characteristics robustly associated with COVID-19 mortality among white residents: (A, B) percent of adults without a high school diploma, (C, D) Percent of population that is Hispanic/Latino, (E, F) Percent of population that is Asian, and (G, H) percent of the population that is white. To further investigate whether neighborhoods with high death rates had an outsized influence on the results, the plots were separated based on whether they occurred in neighborhoods with low to moderate COVID-19 death rates (i.e., less than 1.5 deaths per thousand) (right side) or in neighborhoods with high COVID-19 death rates (i.e., more than 1.5 deaths per thousand, left side).