Doctoral Student’s COVID-19 Testing Disparities Research Makes Headlines

Research by Wil Lieberman-Cribbin, a doctoral student in environmental health sciences, is revealing neighborhood disparities in coronavirus testing in New York City. As any public health student knows, testing is the cornerstone of disease surveillance, and never more so than during a pandemic. Absent a clear picture of where COVID-19 is spreading, public health officials are less able to orchestrate an effective response. 

Lieberman-Cribbin’s research was the focus of an October 30 New York Times article, which summarized his findings:

“Overwhelmingly, the wealthiest neighborhoods—in fact, most of Manhattan below 110th Street—showed the highest rates of testing, while the poorest neighborhoods, in Central Brooklyn and the South Bronx, for example, largely correlated with the lowest. In some instances, the differences between the most affluent communities and the least advantaged were four times as great.”

The article goes on to note that testing disparities have been known for months, thanks again to Lieberman-Cribbin, who published a paper in the American Journal of Preventive Medicine which documented a similar imbalance in March and April. In that paper, Lieberman-Cribbin and his co-authors called for steps to correct the problem. But in subsequent research, they show that the gap has persisted.

Testing is more widely available in higher-income areas, through urgent-care centers and through resident’s employers and private schools who mandate testing. By contrast, in low-income communities of color, testing is largely done to diagnose those already experiencing symptoms or otherwise at high risk. As a result, positivity rates have been higher in these neighborhoods, suggesting that cases are much higher than official numbers. On November 2, Mayor Bill DeBlasio announced that the average number of new coronavirus cases over the last seven days was 593, marking the third day in a row that the level rose above the city’s warning threshold.

Disparities in COVID-19 cases and deaths are well known, and like disparities in testing, show no signs of going away. Another analysis by the doctoral student looks at neighborhood race and ethnicity as a determinant of COVID-19 mortality. He found that lower death rates are linked to neighborhoods with higher portions of white residents. Areas with greater proportions of Hispanic residents and older people had higher death rates. This research is currently under review for publication.

Lieberman-Cribbin has broad interest in studying health disparities related to disasters, particularly disasters driven by climate change, and linking environmental exposures to health outcomes using techniques in molecular epidemiology. He started his COVID-19 analyses in March while working at the Icahn School of Medicine at Mount Sinai using publicly available data from the New York City Department of Health and Mental Hygiene. “We knew from past work that there are racial, socioeconomic and other social factors that influence access to healthcare in general. Additionally, testing in New York City was not widespread or rolled out effectively across the city,” he says.

Going forward, the doctoral student says he will continue to monitor disparities in testing, as well as the distribution of antibody prevalence in New York City. “We’re also examining  how to account for the mobility of New Yorkers during the pandemic, and how the movement of people—likely from higher-income areas out of the city—could further influence testing disparities throughout the city.”