Książki

This book is the first social epidemiological study of COVID-19 spread in New York City (NYC), the primary epicenter of the United States. New York City spread COVID-19 throughout the United States. The context of epicenter formation determined the rapid, extreme rise of NYC case and mortality rates. Decades of public policies destructive of poor neighborhoods of color heavily determined the spread within the City. Premature mortality rates revealed the "weathering" of policy-targeted communities: accelerated aging due to chronic stress. COVID attacks the elderly more severely than those under the age of 60. Communities with high proportions of prematurely aged residents proved fertile ground for COVID illness and mortality. The very public policies that created swaths of white wealth across much of Manhattan and parts of Brooklyn destroyed the human diversity needed to ride out crises.

 Topics covered within the chapters include:

•  Premature Death Rate Geography in New York City: Implications for COVID-19
•  NYC COVID Markers at the ZIP Code Level
•  Prospero's New Castles: COVID Infection and Premature Mortality in the NY Metro Region
•  Pandemic Firefighting vs. Pandemic Fire Prevention
•  Conclusion: Scales of Time in Disasters

An exemplary study in health disparities, COVID-19 in New York City: An Ecology of Race and Class Oppression is essential reading for social epidemiologists, public health researchers of health disparities, those in public service tasked with addressing these problems, and infectious disease scientists who focus on spread in human populations of new zoonotic diseases. The brief also should appeal to students in these fields, civil rights scholars, science writers, medical anthropologists and sociologists, medical and public health historians, public health economists, and public policy scientists.

COVID-19 in New York City: An Ecology of Race and Class Oppression

Chapter 1: Premature Death Rate Geography in New York City: Implications for COVID-19
New York City has had the highest number and incidence of CoViD-19 cases and deaths in U.S. cities. The foundation of this public health catastrophe lies in the overall public health and socioeconomic (SE) structure of the city.
Premature (below age 65) mortality rate indicates background public health. In year 2000, community districts (CDs) with low population percent of over age 65 had high incidence of HIV mortality and its three associated mortalities (homicide, drugs, liver disease) as well as high poverty rate, high unemployment, low median income, and low percent of adults with college or higher degrees. NYC Health Departments' use of age 65 as the benchmark for premature death departs from that of the CDC's National Center for Health Statistics which uses age 75. This departure contributes to an underestimation of premature mortality rates and of public health deficiencies.
This study examines 2017 premature mortality rate of CDs, health outcomes associated with it, and contextual SE factors. Four health outcomes associated with premature mortality rate in multivariate regression: HIV, diabetes, and drug mortality rates and percent of births to teenagers. SE factors associated with premature mortality rate and its health guild were serious housing violations per 1000 units, unemployment rate, poverty rate, percent of adults with college or higher degrees (the only negative association), and indicators of segregation. Much of the context of year 2000 patterns of mortality disparities remained in 2017. 
The coronavirus pandemic plays out in NYC in this SE/public health system. Old age and age-related chronic conditions emerged as raised risks for serious CoViD injury and death. Premature mortality indicates a population's rapidity of physiological aging from structural stress: 'weathering'.
1.1 Summary 1.2 Introduction 1.3 Methods 1.4 Results 1.5 Discussion and Conclusion 1.6 References 

Chapter 2: NYC CoViD Markers at the ZIP Code Level
This chapter examines the geography of CoViD markers and premature mortality in the four central boroughs of New York City: Manhattan, Bronx, Brooklyn, and Queens. Manhattan and the Bronx, being similar in population, are compared, and Brooklyn is compared to Queens. The poverty belt of Brooklyn hosted high rates of CoViD deaths and premature mortality rates, whereas only the Rockaway Peninsula in Queens showed high rates of both. In Queens, few Zip Code areas suffered from moderate or high rates of premature mortality, but a cluster of areas around LaGuardia Airport had high rates of CoViD deaths. The populations of these five areas included high proportions of the foreign-born (54%-66%).
Manhattan below 96th Street enjoyed wide swaths of areas with low CoViD mortality rates and low premature mortality rates. The areas above 96th Street, however, showed moderate to high rates of CoViD death rates. Harlem, in particular, suffered from both high CoViD death rates and high premature mortality rates. Out of 24 areas in the Bronx, only two enjoyed low CoViD death rates. High CoViD death rates formed a belt across the northern Bronx, but the patchiness of CoViD death rates in the southern Bronx may be an artifact of inadequate testing. The south central Bronx featured a transect of areas with high premature mortality rates, in contrast with rates of CoViD rates. Only one area in the Bronx had a low rate of premature mortality.
From the maps of CoViD and premature mortality rates, the entire Bronx gives clear signals of borough-wide health crisis. The Bronx is the only borough where CoViD death rates have no significant association with any of the socioeconomic (SE) factors in the database. It is the only borough where premature death rateshave no association with cancer, flu/pneumonia, or diabetes mortality rates and the association with heart disease mortality is negative. Yet, the Bronx SE factors have significant associations with each other. It is the public health system that has shattered. Manhattan, in contrast, has CoViD markers and premature mortality rates with strong associations with SE factors, with each other and with other mortality rates.
Most of the entire Bronx was targeted with destructive public policies for many decades, as were selected areas of Manhattan, Brooklyn, and Queens. The maps of CoViD and premature mortality reflect the geography of governmental oppression and corruption against segregated populations. Even the map of Queens CoViD mortality rates shows negligence on the part of the health authorities in penetrating and winning the trust of the many immigrant communities by establishing a long-term relationship. The maps show results of a range of governmental actions/inactions from active oppression to oblivious neglect to negligent failure. The tight connections in Manhattan resemble the structure of an ecosystem without diversity and with great brittleness. Future impacts could lead to a regime change that brings Manhattan into closer configuration to the Bronx.
2.1 Summary 2.2 Introduction 2.3 Methods 2.4 Results 2.4.1 Brooklyn and Queens 2.4.2 Manhattan and the Bronx 2.4.3 Public Health of the Four Boroughs2.5 Discussion 2.6 References 

Chapter 3: Prospero's new castles: COVID infection and premature mortality in the New York metro region
Methods developed to analyze spread of the 1980-1990 AIDS syndemic within the New York Metropolitan Region (NYMR) are updated and applied to the rate of COVID-19 deaths in the early months of the pandemic, and to premature mortality, across that conurbation. For COVID deaths, 21 of the 24 NYMR counties are strongly linked through diffusion mechanisms well-indexed by standard journey-to-work statistics, as modulated by local poverty rates. While the Bronx leads the COVID death rate, three highly affluent counties - Hunterdon, NJ; Putnam, NY; and Manhattan -- are less well-integrated into the overall spread process at this early stage. These areas, however, must ultimately be drawn into the system of the other 21 counties over the next few years. There is, after all, no effective mechanism to impede the ultimate spread of the infection: concentration is not containment but the central mechanism for the emergence of pathogens across both local and national urban structures. Comparison of the COVID death pattern with that of general premature mortality shows a striking inverse commuting pattern, but similar dependence on poverty. For both afflictions, the Bronx, focus of 'planned shrinkage' polices of the 1970s, is singularly marked by death.
3.1 Summary 
3.2 Introduction3.3 The AIDS syndemic3.4 The COVID-19 pandemic 3.5 Diffusion in a commuting field 3.6 Toward a national model3.7 Discussion 3.8 References3.9 Appendix: The data set

Chapter 4: Pandemic Firefighting vs. Pandemic Fire Prevention
While firefighting is necessary, it is not sufficient: preventing fires is preferable to controlling and containing them. Pandemic prevention cannot be disentangled from matters of neoliberal land use and agricultural policies and practices. Spatially, temporally, and genetically 'smoothed' economies-of-scale factory farming and rapacious conversion of virgin and traditional landscapes into rangeland are a sure prescription for repeated pandemics. Eventually, some such mass outbreak will harvest the lives of 30%-50% of those infected. Further study finds pandemic penetrance under current population levels and travel patterns likely to be very high, particularly in the context of a broad distribution of 'refugia' made up of marginalized or self-isolated sociogeographic entities.
4.1 Summary 4.2 Introduction 4.3 Pandemics in waiting: neoliberal land use policies 4.4 Pandemic penetrance 4.5 Refugia: failure of the 'R0' model 4.6 Discussion 4.7 References 

Chapter 5: Conclusion: Scales of Time in Disasters
The authors examine the implications of the CoVid-19 pandemic's explosion in the New York Metropolitan Region from the perspective of both historical trajectory and Holling's (1973) ideas of 'ecosystem resilience' transitions, akin to the eutrophication of a pristine lake by sewage runoff. Without significant alteration in 'upstream' policies and power relations driving pandemic emergence, the U.S. Empire appears to be entering a period of 'Justinian Plagues' similar to those that decimated the Roman Empire.
5.1 Summary 5.2 Futures 5.3 References