Neighbourhood inequity: Exploring the factors underlying racial and ethnic disparities in COVID‐19 testing and infection rates using ZIP code data in Chicago and New York

This paper compares ZIP code-level data on observed COVID-19 testing and case rates for the City of Chicago and New York City to better understand both: (i) the extent to which racial and ethnic disparities in COVID-19 testing and case rates exist at the neighbourhood level; and (ii) the most important neighbourhood-level drivers of these observed disparities. Through exploratory spatial mapping and econometric approaches, the paper finds that, across both cities, Hispanic-majority neighbourhoods have significantly lower testing rates than other racial/ethnic neighbourhood types, even when controlling for observed infection rates—which are also significantly higher for Hispanic-majority neighbourhoods. At the same time, White-majority neighbourhoods have significantly higher testing rates and lower observed infection rates. Given this observed disparity, the paper also examines a range of underlying factors that are potentially driving observed neighbourhood-level COVID-19 case rates. The findings suggest that higher socio-economic status and the provision of healthy, active built environments are significantly negatively associated with COVID-19 infection rates, while several aspects of social vulnerability are significant positive predictors of COVID-19 infection rates. These findings suggest that the health benefits from higher density, walkable built environments may play a larger “protective” role from observed COVID-19 case rates at the neighbourhood-level than previously assumed, while at the same time indicating that the increased prevalence of COVID-19 in Hispanic- and Black-majority neighbourhoods may be in part due to their greater risk of occupational exposure and multi-generational household structure (particularly for Hispanic-majority neighbourhoods).