A new city-oriented COVID Local Risk Index has now been launched to help municipal leaders identify cities and neighbourhoods with populations at higher risk of COVID-19 infection and more severe illness, by incorporating key risk factors of race and ethnicity, age, household crowding, poverty and underlying health conditions such as diabetes and obesity.

The neighbourhood-level COVID Local Risk Index is available on the City Health Dashboard, an online resource with community-level health, social and economic data for 750 cities across the United States, developed by researchers at NYU Grossman School of Medicine with support from the Robert Wood Johnson Foundation.

This measure calculates COVID-19 risk down to the hyperlocal, neighbourhood level by relying on key health, economic and social data at the census tract-level. Other measurements and indexes rely on county or state data to estimate census tract risk or do not include social and economic factors to determine COVID-19 risk. Additionally, the index allows for comparison of COVID-19 risk across other cities and between neighbourhoods.

“While COVID affects every community, we know its harm is disproportionately greater in certain groups, including people of colour, those with underlying health conditions, older people, and frontline workers with low incomes,” says Marc N Gourevitch MD, MPH, the Muriel G and George W Singer Professor of Population Health and chair of the Department of Population Health at NYU Langone, as well as the principal architect of the City Health Dashboard. 

“We also know that there can be huge variations in risk level between neighbourhoods in the same city, sometimes separated by less than a mile or two. Even cities with lower cases of COVID-19 can have individual neighbourhoods with populations at higher risk. Having access to this hyperlocal data is critical for leaders needing to make urgent decisions about re-opening and deploying resources amidst the pandemic.”

The Index incorporates data from multiple sources grouped into three overarching themes, to determine communities with the highest risk of being severely affected by COVID-19: 1) social vulnerability, drawn from the Centers for Disease Control and Prevention’s Social Vulnerability Index, which incorporates variables like income and overcrowded housing; 2) COVID-relevant chronic health conditions, such as obesity, coronary heart disease, high blood pressure, chronic kidney disease, and diabetes; and 3) COVID-relevant demographics, such as age and minority status.

The City Health Dashboard is described as an online resource that allows users to view and compare data on the 750 US cities with populations of 50,000 or more, extracted and analysed from multiple national data sources. Its goal is to guide solutions that create healthier and more equitable communities. Since most health data are reported at the county and state level, the Dashboard is said to be one of the few resources that provides data at the city and neighbourhood level about health and the factors that shape health, such as access to healthy foods and poverty. The COVID Local Risk Index has available data for the 500 largest Dashboard cities – those with populations of 66,000 and above.

Since launching two years ago, city leaders and policy makers have used the Dashboard’s other measures of health and its drivers to identify health disparities, create data-driven health solutions, and benchmark health outcomes against those in similar communities.

“The City Health Dashboard’s new data on COVID-19 local risks provides a map for mayors and city managers on where to focus resources to improve health outcomes,” says David Eichenthal, executive director of the National Resource Network and former city official in New York City and Chattanooga, Tennessee. “At the local level, we’ve known for years that these health disparities exist from city to city and neighbourhood to neighbourhood. But the Dashboard, for the first time, provides city leaders with vital information to take on these challenges to help combat the worst effects of the pandemic and create more equitable communities.”

While the COVID Local Risk Index itself is a valuable measure of COVID vulnerability across the country, having access as well to the other data and visualisations on the Dashboard makes the Index even more useful for city leaders and residents, says Dr Gourevitch. 

The Dashboard already displays more than 35 measures of health and its drivers for cities and neighbourhoods across the US, say the researchers, and the Index can be compared across cities and overlaid with other metrics for a more complete picture of health within neighbourhoods across a city. Cities can also access resources and evidence-backed policies in the Dashboard’s ‘Take Action’ section, to which the team is adding valuable COVID-19 related tools as they become available.