Sliding down the socioeconomic health gradient of COVID-19 in New York City: multinomial regression analyses of disproportionate financial hardship for Black, Latino, and Asian residents and households with children.

Background: Distinct socioeconomic gradients in COVID-19 outcomes were observed across the United States, so an evaluation of individual resident characteristics related to economic deprivation (race or ethnicity, precarious employment, children in the household) was conducted to inform neighborhood reach strategies by the NYC Department of Health and Mental Hygiene. Methods: A cross-sectional survey was fielded to participants from a probability-based sample of South Bronx, North and Central Brooklyn, and East and Central Harlem residents. Responses rates for financial difficulty experienced since the pandemic onset were organized into three categories: "never" experiencing financial difficulty, or experiencing "short-term" or "prolonged" financial difficulty. Controlling for age, gender, birthplace, educational attainment, income level, employment, and financial assistance received, two multinomial logistic regression analyses were used to examine the prevalent association between race-ethnicity or household composition and the type of financial difficulty experienced. Results: We found that Black residents, Latino residents, residents with children in their household, and people living ≥200% below the poverty threshold were most likely to experience financial difficulty. Compared to non-Latino White residents, all other racial and ethnic groups were twice as likely to experience prolonged financial difficulty. Households with children were 40% less likely to avoid financial difficulty and 52% more likely to experience prolonged financial difficulty compared to those without. Conclusions: Delays and premature discontinuation of benefits were correlated to avoidable hardship to those in need. Government policy fosters the inequitable distribution of resources in the U.S. those policies continue to predispose vulnerable groups to harm through economic deprivation and racial residential segregation.