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Association between overcrowded households, multigenerational households, and COVID-19: a cohort study

OBJECTIVES: The role of overcrowded and multigenerational households as a risk factor for COVID-19 remains unmeasured. The objective of this study is to examine and quantify the association between overcrowded and multigenerational households and COVID-19 in New York City (NYC). STUDY DESIGN: Cohort...

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Autores principales: Ghosh, A.K., Venkatraman, S., Soroka, O., Reshetnyak, E., Rajan, M., An, A., Chae, J.K., Gonzalez, C., Prince, J., DiMaggio, C., Ibrahim, S., Safford, M.M., Hupert, N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Royal Society for Public Health. Published by Elsevier Ltd. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328572/
https://www.ncbi.nlm.nih.gov/pubmed/34492508
http://dx.doi.org/10.1016/j.puhe.2021.07.039
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author Ghosh, A.K.
Venkatraman, S.
Soroka, O.
Reshetnyak, E.
Rajan, M.
An, A.
Chae, J.K.
Gonzalez, C.
Prince, J.
DiMaggio, C.
Ibrahim, S.
Safford, M.M.
Hupert, N.
author_facet Ghosh, A.K.
Venkatraman, S.
Soroka, O.
Reshetnyak, E.
Rajan, M.
An, A.
Chae, J.K.
Gonzalez, C.
Prince, J.
DiMaggio, C.
Ibrahim, S.
Safford, M.M.
Hupert, N.
author_sort Ghosh, A.K.
collection PubMed
description OBJECTIVES: The role of overcrowded and multigenerational households as a risk factor for COVID-19 remains unmeasured. The objective of this study is to examine and quantify the association between overcrowded and multigenerational households and COVID-19 in New York City (NYC). STUDY DESIGN: Cohort study. METHODS: We conducted a Bayesian ecological time series analysis at the ZIP Code Tabulation Area (ZCTA) level in NYC to assess whether ZCTAs with higher proportions of overcrowded (defined as the proportion of the estimated number of housing units with more than one occupant per room) and multigenerational households (defined as the estimated percentage of residences occupied by a grandparent and a grandchild less than 18 years of age) were independently associated with higher suspected COVID-19 case rates (from NYC Department of Health Syndromic Surveillance data for March 1 to 30, 2020). Our main measure was an adjusted incidence rate ratio (IRR) of suspected COVID-19 cases per 10,000 population. Our final model controlled for ZCTA-level sociodemographic factors (median income, poverty status, White race, essential workers), the prevalence of clinical conditions related to COVID-19 severity (obesity, hypertension, coronary heart disease, diabetes, asthma, smoking status, and chronic obstructive pulmonary disease), and spatial clustering. RESULTS: 39,923 suspected COVID-19 cases were presented to emergency departments across 173 ZCTAs in NYC. Adjusted COVID-19 case rates increased by 67% (IRR 1.67, 95% CI = 1.12, 2.52) in ZCTAs in quartile four (versus one) for percent overcrowdedness and increased by 77% (IRR 1.77, 95% CI = 1.11, 2.79) in quartile four (versus one) for percent living in multigenerational housing. Interaction between both exposures was not significant (β(interaction) = 0.99, 95% CI: 0.99–1.00). CONCLUSIONS: Overcrowdedness and multigenerational housing are independent risk factors for suspected COVID-19. In the early phase of the surge in COVID cases, social distancing measures that increase house-bound populations may inadvertently but temporarily increase SARS-CoV-2 transmission risk and COVID-19 disease in these populations.
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spelling pubmed-83285722021-08-03 Association between overcrowded households, multigenerational households, and COVID-19: a cohort study Ghosh, A.K. Venkatraman, S. Soroka, O. Reshetnyak, E. Rajan, M. An, A. Chae, J.K. Gonzalez, C. Prince, J. DiMaggio, C. Ibrahim, S. Safford, M.M. Hupert, N. Public Health Original Research OBJECTIVES: The role of overcrowded and multigenerational households as a risk factor for COVID-19 remains unmeasured. The objective of this study is to examine and quantify the association between overcrowded and multigenerational households and COVID-19 in New York City (NYC). STUDY DESIGN: Cohort study. METHODS: We conducted a Bayesian ecological time series analysis at the ZIP Code Tabulation Area (ZCTA) level in NYC to assess whether ZCTAs with higher proportions of overcrowded (defined as the proportion of the estimated number of housing units with more than one occupant per room) and multigenerational households (defined as the estimated percentage of residences occupied by a grandparent and a grandchild less than 18 years of age) were independently associated with higher suspected COVID-19 case rates (from NYC Department of Health Syndromic Surveillance data for March 1 to 30, 2020). Our main measure was an adjusted incidence rate ratio (IRR) of suspected COVID-19 cases per 10,000 population. Our final model controlled for ZCTA-level sociodemographic factors (median income, poverty status, White race, essential workers), the prevalence of clinical conditions related to COVID-19 severity (obesity, hypertension, coronary heart disease, diabetes, asthma, smoking status, and chronic obstructive pulmonary disease), and spatial clustering. RESULTS: 39,923 suspected COVID-19 cases were presented to emergency departments across 173 ZCTAs in NYC. Adjusted COVID-19 case rates increased by 67% (IRR 1.67, 95% CI = 1.12, 2.52) in ZCTAs in quartile four (versus one) for percent overcrowdedness and increased by 77% (IRR 1.77, 95% CI = 1.11, 2.79) in quartile four (versus one) for percent living in multigenerational housing. Interaction between both exposures was not significant (β(interaction) = 0.99, 95% CI: 0.99–1.00). CONCLUSIONS: Overcrowdedness and multigenerational housing are independent risk factors for suspected COVID-19. In the early phase of the surge in COVID cases, social distancing measures that increase house-bound populations may inadvertently but temporarily increase SARS-CoV-2 transmission risk and COVID-19 disease in these populations. The Royal Society for Public Health. Published by Elsevier Ltd. 2021-09 2021-08-03 /pmc/articles/PMC8328572/ /pubmed/34492508 http://dx.doi.org/10.1016/j.puhe.2021.07.039 Text en © 2021 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Research
Ghosh, A.K.
Venkatraman, S.
Soroka, O.
Reshetnyak, E.
Rajan, M.
An, A.
Chae, J.K.
Gonzalez, C.
Prince, J.
DiMaggio, C.
Ibrahim, S.
Safford, M.M.
Hupert, N.
Association between overcrowded households, multigenerational households, and COVID-19: a cohort study
title Association between overcrowded households, multigenerational households, and COVID-19: a cohort study
title_full Association between overcrowded households, multigenerational households, and COVID-19: a cohort study
title_fullStr Association between overcrowded households, multigenerational households, and COVID-19: a cohort study
title_full_unstemmed Association between overcrowded households, multigenerational households, and COVID-19: a cohort study
title_short Association between overcrowded households, multigenerational households, and COVID-19: a cohort study
title_sort association between overcrowded households, multigenerational households, and covid-19: a cohort study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328572/
https://www.ncbi.nlm.nih.gov/pubmed/34492508
http://dx.doi.org/10.1016/j.puhe.2021.07.039
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