The Environmental and Social Determinants of Health Matter in a Pandemic: Predictors of COVID-19 Case and Death Rates in New York City

Our research objective was to determine which environmental and social factors were predictive of coronavirus disease 2019 (COVID-19) case and death rates in New York City (NYC), the original epicenter of the pandemic in the US, and any differential impacts among the boroughs. Data from various sources on the demographic, health, and environmental characteristics for NYC zip codes, neighborhoods, and boroughs were analyzed along with NYC government’s reported case and death rates by zip code. At the time of analysis, the Bronx had the highest COVID-19 case and death rates, while Manhattan had the lowest rates. Significant predictors of a higher COVID-19 case rate were determined to be proportion of residents aged 65 years plus; proportion of residents under 65 years with a disability; proportion of White residents; proportion of residents without health insurance; number of grocery stores; and a higher ozone level. For COVID-19 death rates, predictors include proportion of residents aged 65 years plus; proportion of residents who are not US citizens; proportion on food stamps; proportion of White residents; proportion of residents under 65 years without health insurance; and a higher level of ozone. Results across boroughs were mixed, which highlights the unique demographic, socioeconomic, and community characteristics of each borough. To reduce COVID-19 inequities, it is vital that the NYC government center the environmental and social determinants of health in policies and community-engaged interventions adapted to each borough.

The Right to Food and the Planetary Boundaries framework

The 'Right to Food' is a legal entitlement owed to all human beings established in international law more than half a century ago. Fulfilment of the right has been entrusted to states parties to the 1966 International Covenant on Economic, Social and Cultural Rights (ICESCR). However, in practice, the right is often breached because of hostility or indifference from individuals or institutions refusing access to provisions, or because of vicissitudes of nature. Adverse impacts due to human interference in natural processes are increasingly noticeable in the area of food production. These processes have been classified into nine distinct categories, all of which need be kept within certain margins, so-called 'Planetary Boundaries', which delineate a safe operating space for humanity. This paper discusses the impact each of these human-induced developments has on the provision of food as well as the other way round and what the consequences would be if the boundaries were exceeded. Yet there are means of keeping the worst consequences of most of these processes at bay. The paper explores some of these.