November 5, 2020
Analyzing places and spaces can be useful for researchers seeking to identify areas where populations face public health challenges. Geographic and geospatial analysis can help us understand where outbreaks of disease might occur, where people are most susceptible to illness and if their environment contributes to health outcomes.
This analysis is especially useful for identifying those that are at higher risk of specific disparities due to social and geographic factors. Arrianna Planey, PhD, MA, an assistant professor of health policy and management at the UNC Gillings School of Global Public Health and a fellow at the Cecil G. Sheps Center for Health Services Research, is a co-author on two recent studies that used such analysis to identify potential health disparities in metropolitan areas locally and nationally.
Published in the Open Forum Infectious Diseases journal, the newest research explores the correlation between neighborhoods in the Raleigh-Durham region of North Carolina and test positivity rates for SARS-CoV-2, the virus that causes COVID-19. Planey worked in partnership with researchers in the Duke University School of Medicine to determine whether neighborhood statistics – such as the area deprivation index, population density and household size – and demographic factors like age, race and gender contributed to higher odds of testing positive for the virus.
Through the use of geospatial modeling, the study found that the odds of testing positive for SARS-CoV-2 were higher for both Black and Hispanic individuals, as well as for those in neighborhoods with a higher proportion of Black or Hispanic residents. This finding is consistent with our understanding that COVID-19 disproportionately affects racial and ethnic minorities, as they are more likely to be underinsured, have pre-existing conditions, less likely to work remotely and more likely to be “essential workers.”
“In this study, we did not find a strong association between geographic location/neighborhood, occupation and the positivity rate in Hispanic communities in the study area because Hispanic residents in the area are quite dispersed or spatially discontinuous. This is in contrast with the stronger patterns of racial segregation for Black and white communities in the Research Triangle,” Planey explained. “There’s also the added fact that occupational risk and exposure and larger, intergenerational households with one or more essential workers may have higher risk of SARS-CoV-2 transmission, but that is not clear in this study because we did not have individual occupational variables.”
The second study, published in the Journal of Transport Geography, compared the wages and commute times of workers with and without disabilities in regions in and around New York City. Planey worked with a team of researchers across the nation to apply statistical modeling to survey data of the working population in different parts of the New York metropolitan area to determine whether there were disparities in commute times or wages by residential location, race, ethnicity and gender among disabled workers.
The study found that, on the whole, disabled workers in the New York metro area earn significantly lower wages and have longer commute times, with the highest wage disparities happening in the city center and in the suburban regions. Oftentimes workers with disabilities had to commute longer in order to earn a higher wage. The study also found that white and Hispanic disabled women in the workforce had the shortest commute times compared with Black disabled women in the workforce. Notably, disabled women in the workforce often earned lower wages in comparison to disabled male workers.
“There’s a strong tradition among feminist geographers and health geographers of attending to gendered aspects of work and mobility,” Planey said. “The finding that white and Hispanic disabled women in the workforce had shorter commutes is consistent with prior work on spatial mismatch between where people live and where they work.”
Both studies underscore the important role geography plays in understanding outcomes and designing interventions that can promote health equity in regions of risk.
This work is part of a broader research agenda that attends to mobility and health outcomes. Planey is currently a co-investigator on the NC COVID-19 Mobility and Health Impacts study, a collaboration between UNC’s Highway Safety Research Center, the Sheps Center, the Gillings School, the Odum Institute for Research in Social Science and the NC State University Department of Statistics.
Contact the UNC Gillings School of Global Public Health communications team at firstname.lastname@example.org.