Department of Health Sciences, Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866, USA.
Sociology and Environmental Science & Policy Programs, Schmid & Wilkinson Colleges, Chapman University, Orange, CA 92866, USA.
Int J Environ Res Public Health. 2022 Apr 21;19(9):5066. doi: 10.3390/ijerph19095066.
U.S. non-citizen residents are burdened by inequitable access to socioeconomic resources, potentially placing them at heightened risk of COVID-19-related disparities. However, COVID-19 impacts on non-citizens are not well understood. Accordingly, the current study investigated COVID-19 mortality disparities within New York (NYC) and Los Angeles (LAC) to test our hypothesis that areas with large proportions of non-citizens will have disproportionately high COVID-19 mortality rates. We examined ecological associations between March 2020-January 2021 COVID-19 mortality rates (per 100,000 residents) and percent non-citizens (using ZIP Code Tabulation Areas (ZCTA) for NYC and City/Community units of analysis for LAC) while controlling for sociodemographic factors. Multiple linear regression analyses revealed significant positive associations between the percentage of non-citizen residents and COVID-19 mortality rates in NYC (95% CI 0.309, 5.181) and LAC (95% CI 0.498, 8.720). Despite NYC and LAC policies intended to provide sanctuary and improve healthcare access for non-citizen residents, communities with larger proportions of non-citizens appear to endure higher COVID-19 mortality rates. The challenges that non-citizens endure-e.g., inequitable access to public benefits-may discourage help-seeking behaviors. Thus, improved health surveillance, public health messaging, and sanctuary policies will be essential for reducing COVID-19 mortality disparities in communities with large shares of non-citizens.
美国的非公民居民在获得社会经济资源方面存在不平等，这可能使他们面临更高的 COVID-19 相关差异风险。然而，人们对非公民的 COVID-19 影响了解不足。因此，本研究调查了纽约市（NYC）和洛杉矶市（LAC）的 COVID-19 死亡率差异，以检验我们的假设，即拥有大量非公民的地区将出现不成比例的高 COVID-19 死亡率。我们使用邮政编码区（ZCTA）进行纽约市的分析，使用城市/社区分析单位进行洛杉矶市的分析，检验了 2020 年 3 月至 2021 年 1 月 COVID-19 死亡率（每 10 万人）与非公民比例（%）之间的生态关联，同时控制了社会人口因素。多元线性回归分析显示，非公民居民比例与纽约市 COVID-19 死亡率之间存在显著正相关（95%CI 0.309，5.181），与洛杉矶市 COVID-19 死亡率之间存在显著正相关（95%CI 0.498，8.720）。尽管纽约市和洛杉矶市制定了旨在为非公民居民提供庇护和改善医疗保健机会的政策，但拥有更大比例非公民的社区似乎仍面临更高的 COVID-19 死亡率。非公民所面临的挑战，例如公共福利获取的不平等，可能会阻碍寻求帮助的行为。因此，改进健康监测、公共卫生信息传递和庇护政策对于减少非公民比例较高社区的 COVID-19 死亡率差异至关重要。
