New York City Department of Health and Mental Hygiene, New York, New York. ORCID: https://orcid.org/0000-0002-5321-6521.
New York City Department of Health and Mental Hygiene, New York, New York.
J Emerg Manag. 2021 Nov-Dec;19(6):519-529. doi: 10.5055/jem.0574.
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.
在某些公共卫生紧急情况下，配给点（POD）可用于向公众快速分发抗生素等医疗对策，以预防疾病。全国各地区都已确定了 POD 地点，以应对此类紧急情况；在纽约市（NYC），这些地点主要是根据人口密度确定的。弱势群体在本分析中定义为收入低于联邦贫困线的人、未完成高中学业的人、外国出生的人、有色人种、年龄≥65 岁的人、身体残疾人和失业者，他们经常经历广泛的健康不平等。在纽约市，这些人群通常集中在某些地理区域，并且严重依赖公共交通工具。由于在需要大规模分发医疗对策的大规模公共卫生紧急情况下，公共交通几乎肯定会受到影响，因此我们评估了到 POD 的步行距离。我们使用普通最小二乘法（OLS）模型和地理加权回归（GWR）模型来确定是否某些增加人口健康不平等的特征与相对于纽约市一般人群到最近 POD 的距离较长有关。我们的 OLS 模型确定，在收入低于联邦贫困线的人比例较高、外国出生的人比例较高或有色人种比例较高的社区，到 POD 的步行距离较短，而在完成高中学业的人比例较高的社区，到 POD 的步行距离较长。我们的 GWR 模型证实了 OLS 模型的发现，并通过某些社区进一步说明了这些模式。我们的分析表明，纽约市目前确定的 POD 地点通常在服务弱势群体方面是公平的，尤其是在种族或收入状况方面，至少在步行距离方面是公平的。
