Open Access Open Access  Restricted Access Subscription or Fee Access

Walking distance for vulnerable populations to public health emergency response points of dispensing in New York City

Kate Whittemore, MPH, Mustafa Ali, MPH, Andrew Schroeder, MPA, MA, Neil M. Vora, MD, David Starr, MIA, Demetre Daskalakis, MD, MPH, David E. Lucero, PhD

Abstract


During certain public health emergencies, points of dispensing (PODs) may be used to rapidly distribute medical countermeasures such as antibiotics to the general public to prevent disease. Jurisdictions across the country have identified sites for PODs in preparation for such an emergency; in New York City (NYC), the sites are identified based largely on population density. Vulnerable populations, defined for this analysis as persons with income below the federal poverty level, persons with less than a high school diploma, foreign-born persons, persons of color, persons aged ≥65 years, physically disabled persons, and unemployed persons, often experience a wide range of health inequities. In NYC, these populations are often concentrated in certain geographic areas and rely heavily on public transportation. Because public transportation will almost certainly be affected during large-scale public health emergencies that would require the rapid mass dispensing of medical countermeasures, we evaluated walking distances to PODs. We used an ordinary least squares (OLS) model and a geographically weighted regression (GWR) model to determine if certain characteristics that increase health inequities in the population are associated with longer distances to the nearest POD relative to the general NYC population. Our OLS model identified shorter walking distances to PODs in neighborhoods with a higher percentage of persons with income below the federal poverty level, higher percentage of foreign-born persons, or higher percentage of persons of color, and identified longer walking distances to PODs in neighborhoods with a higher percentage of persons with less than a high school diploma. Our GWR model confirmed the findings from the OLS model and further illustrated these patterns by certain neighborhoods. Our analysis shows that currently identified locations for PODs in NYC are generally serving vulnerable populations equitably—particularly those defined by race or income status—at least in terms of walking distance.

Keywords


points of dispensing, health equity, GIS

Full Text:

PDF

References


Office of the Assistant Secretary for Preparedness and Response: Strategic National Stockpile. Available at https://www.phe.gov/about/sns/Pages/default.aspx. Accessed May 7, 2018.

Office of the Assistant Secretary for Preparedness and Response: Stockpile responses. Available at https://www.phe.gov/about/sns/Pages/responses.aspx. Accessed May 7, 2018.

Khan S, Richter A: Dispensing mass prophylaxis—The search for the perfect solution. Homeland Security Aff. 2012; 8(3): 1-20.

Greene SK, Levin-Rector A, Hadler JL, et al.: Disparities in reportable communicable disease incidence by census tract-level poverty, New York City, 2006-2013. Am J Public Health. 2015; 105(9): e27-e34.

Fang J, Madhavan S, Bosworth W, et al.: Residential segregation and mortality in New York city. Soc Sci Med. 1998; 47(4): 469-476.

Asada Y, Whipp A, Kindig D, et al.: Inequalities in multiple health outcomes by education, sex, and race in 93 US counties: Why we should measure them all. Int J Equity Health. 2014; 13: 47.

Singh GK, Rodriguez-Lainz A, Kogan MD: Immigrant health inequalities in the United States: Use of eight major national data systems. Sci World J. 2013; 2013: 1-21.

Bhalla MC, Burgess A, Frey J, et al.: Geriatric disaster preparedness. Prehosp Disaster Med. 2015; 30(5): 443-446.

Stough LM, Sharp AN, Decker C, et al.: Disaster case management and individuals with disabilities. Rehabil Psychol. 2010; 55(3): 211-220.

McDermott S, Martin K, Gardner JD: Disaster response for people with disability. Disabil Health J. 2016; 9(2): 183-185.

Kim TJ, von Dem Knesebeck O: Is an insecure job better for health than having no job at all? A systematic review of studies investigating the health-related risks of both job insecurity and unemployment. BMC Public Health. 2015; 15: 985.

United States Census Bureau: American Community Survey 5-Year Estimates, 2011-2015. Available at https://factfinder.census.gov/. Accessed May 7, 2018.

New York City Department of City Planning: Population. Available at http://www1.nyc.gov/site/planning/data-maps/nyc-population.page. Accessed May 7, 2018.

New York City OpenData: Neighborhood tabulation areas. Available at https://data.cityofnewyork.us/City-Government/Neighborhood-Tabulation-Areas/cpf4-rkhq. Accessed May 7, 2018.

New York City Department of City Planning: Glossary of planning terms. Available at http://www1.nyc.gov/site/planning/zoning/glossary.page. Accessed May 7, 2018.

Esri: ArcGIS Pro. Available at https://www.esri.com/en-us/arcgis/products/arcgis-pro/overview. Accessed May 7, 2018.

Spatial Reference: Available at http://spatialreference.org/ref/esri/nad-1983-stateplane-new-york-long-island-fips-3104-feet/. Accessed May 7, 2018.

Python Software Foundation: Python language reference, version 2.7. Available at https://www.python.org/. Accessed May 7, 2018.

StatsModels: Statistics in Python. Available at https://www.statsmodels.org/stable/index.html. Accessed May 7, 2018.

Belsley DA, Kuh E, Welsch RE: Regression Diagnostics: Identifying Influential Data and Sources of Collinearity. Hoboken, NJ: Wiley, 2005.

Brunsdon C, Fotheringham AS, Charlton ME: Geographically weighted regression: A method for exploring spatial nonstationarity. Geograph Anal. 2010; 28(4): 281-298.

New York City Economic Development Corporation: New Yorkers and their cars. Available at https://www.nycedc.com/blogentry/new-yorkers-and-cars. Accessed May 7, 2018.

Columbia University Mailman School of Public Health: Geographically weighted regression. Available at https://www.mailman.columbia.edu/research/population-health-methods/geographically-weighted-regression#courses. Accessed May 7, 2018.




DOI: https://doi.org/10.5055/jem.0574

Refbacks

  • There are currently no refbacks.


Copyright (c) 2021 Journal of Emergency Management