ArticlePublic health2021
Association between overcrowded households, multigenerational households, and COVID-19: a cohort study.
Article in Public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Effects of the built environment and human factors on the spread of COVID-19: A systematic literature review.The Science of the total environment · 2022Pooled it
- Transmission of SARS-CoV-2 in standardised first few X cases and household transmission investigations: A systematic review and meta-analysis.Influenza and other respiratory viruses · 2022Pooled it
- Assessing the burden of COVID-19 in developing countries: systematic review, meta-analysis and public policy implications.BMJ global health · 2022Pooled it
- Impact of Social Drivers of Health, Self-Efficacy, and Substance Use on COVID-19 Preventative Behaviors Among Persons Who Inject Drugs with Hepatitis C: The HERO Study.International journal of environmental research and public health · 2026Article
- Strengthening the organizational health literacy capacity of community-based organizations to support COVID-19 precautionary behaviors in marginalized communities.Frontiers in public health · 2026Article
- Home isolation capacity after Covid-19 diagnosis in vulnerable communities of two Brazilian cities: TQT Covid-19 Study.Revista de saude publica · 2026Article
- Household crowding and mortality before and during the COVID-19 pandemic among adults: Findings from longitudinal population surveillance data in rural and peri-urban settings in Limpopo, South Africa.Population health metrics · 2025Article
- Prevalence of COVID-19 and Long COVID by Industry and Occupation: Behavioral Risk Factor Surveillance System 2022.American journal of industrial medicine · 2025Article
- Disproportionate impact of the COVID-19 pandemic on socially vulnerable communities: the case of Jane and Finch in Toronto, Ontario.Frontiers in public health · 2025Article
- Individual, household structure, and socioeconomic predictors of COVID-19 testing and vaccination outcomes: a whole population linked data analysis.International journal of population data science · 2025Article
- Spatiotemporal Ecologic Analysis of COVID-19 Vaccination Coverage and Outcomes, Oklahoma, USA, February 2020-December 2021.Emerging infectious diseases · 2024Article
- Model-based estimates of age-structured SARS-CoV-2 epidemiology in households.BMC public health · 2024Article
- Increased COVID-19 mortality among immigrants compared with US-born individuals: a cross-sectional analysis of 2020 mortality data.Public health · 2024Observational
- COVID-19 Hospitalization in Hawai'i and Patterns of Insurance Coverage, Race and Ethnicity, and Vaccination.JAMA network open · 2024Article
- Overestimation of Severe Acute Respiratory Syndrome Coronavirus 2 Household Transmission in Settings of High Community Transmission: Insights From an Informal Settlement Community in Salvador, Brazil.Open forum infectious diseases · 2024Article
- Article
- Risk Factors for Community and Intrahousehold Transmission of SARS-CoV-2: Modeling in a Nationwide French Population-Based Cohort Study, the EpiCoV Study.American journal of epidemiology · 2024Article
- Association of race/ethnicity and severe housing problems with COVID-19 deaths in the United States: Analysis of the first three waves.PloS one · 2024Article
- Lessons Learned About Trauma Related to Racial Discrimination During COVID-19 in the United States.Advances in experimental medicine and biology · 2024Article
- Spatial distribution of SARS-CoV-2 incidence, social inequality, housing conditions, and density in South-Eastern France: keys for future epidemics.Frontiers in public health · 2024Article
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Authors and funding
13 authors.
Funding
Abstract
objectivesThe role of overcrowded and multigenerational households as a risk factor for COVID-19 remains unmeasured. The objective of this study is to examine and quantify the association between overcrowded and multigenerational households and COVID-19 in New York City (NYC). STUDY
designCohort study.
methodsWe conducted a Bayesian ecological time series analysis at the ZIP Code Tabulation Area (ZCTA) level in NYC to assess whether ZCTAs with higher proportions of overcrowded (defined as the proportion of the estimated number of housing units with more than one occupant per room) and multigenerational households (defined as the estimated percentage of residences occupied by a grandparent and a grandchild less than 18 years of age) were independently associated with higher suspected COVID-19 case rates (from NYC Department of Health Syndromic Surveillance data for March 1 to 30, 2020). Our main measure was an adjusted incidence rate ratio (IRR) of suspected COVID-19 cases per 10,000 population. Our final model controlled for ZCTA-level sociodemographic factors (median income, poverty status, White race, essential workers), the prevalence of clinical conditions related to COVID-19 severity (obesity, hypertension, coronary heart disease, diabetes, asthma, smoking status, and chronic obstructive pulmonary disease), and spatial clustering.
results39,923 suspected COVID-19 cases were presented to emergency departments across 173 ZCTAs in NYC. Adjusted COVID-19 case rates increased by 67% (IRR 1.67, 95% CI = 1.12, 2.52) in ZCTAs in quartile four (versus one) for percent overcrowdedness and increased by 77% (IRR 1.77, 95% CI = 1.11, 2.79) in quartile four (versus one) for percent living in multigenerational housing. Interaction between both exposures was not significant (β
conclusionsOvercrowdedness and multigenerational housing are independent risk factors for suspected COVID-19. In the early phase of the surge in COVID cases, social distancing measures that increase house-bound populations may inadvertently but temporarily increase SARS-CoV-2 transmission risk and COVID-19 disease in these populations.
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