Neighborhood Inequalities in Hepatitis C Mortality: Spatial and Temporal Patterns and Associated Factors

Area of Science:

• Public Health
• Epidemiology
• Health Equity

Background:

• Hepatitis C virus (HCV) infection deaths are increasing in the USA.
• Effective HCV treatments are available, yet disparities persist.
• Neighborhood inequalities create barriers to care for vulnerable populations.

Purpose of the Study:

• To analyze citywide trends in HCV mortality rates in New York City (NYC).
• To identify NYC neighborhoods with disproportionately high HCV mortality.
• To describe factors associated with these elevated rates.

Main Methods:

• Utilized a multiple cause of death (MCOD) definition for HCV mortality (2006-2014).
• Geocoded deaths to NYC census tracts and calculated age-adjusted mortality rates.
• Employed spatial clustering (Moran's I) and joinpoint regression for temporal trends.
• Used Poisson modeling to assess neighborhood associations with sociodemographic indicators.

Main Results:

• 3697 HCV-related deaths occurred in NYC, with a 2.6% annual increase.
• HCV mortality rates varied significantly by census tract, with identified spatial clustering.
• Positive associations found between HCV mortality and non-Hispanic Black/Hispanic populations, poverty, lower education, and non-English speaking households.

Conclusions:

• HCV mortality rates in NYC are increasing and exhibit significant neighborhood variation.
• Geographic inequalities and sociodemographic factors are strongly associated with HCV mortality.
• Place-based interventions are needed in high-need neighborhoods to address social determinants of health and reduce HCV disparities.