Racial and Ethnic Disparities in COVID-19-Like Illness and Impacts of Social Distancing and Working from Home.

Objectives To examine racial and ethnic disparities in COVID-19-like illness (CLI) during March - August 2020 in New York City, and to test effect modification by age, nativity, and working from home vs outside the home, and mediation via social distancing behavior. Design Analysis of the monthly Community Health Survey datasets. Setting New York City. Participants 5,305 adults living in New York City. Main Outcome Measures A binary indicator of having new onset of CLI in the past 30 days. Methods Prevalence of having CLI was compared among racial and ethnic groups using multivariable log-linear regression. Stratified and causal mediation analyses were conducted to test effect modification and mediation, respectively. Results Overall percentage of CLI decreased from 25% during March-May to 14% during June-August. In both periods, there was no increased prevalence of CLI among Black or Latino New Yorkers compared with White New Yorkers. However, in stratified analyses, Latino vs White New Yorkers had 2.05 times (95%CI=1.09, 3.83) higher prevalence of CLI among adults working outside the home. Mediation via social distancing was not statistically significant. Conclusions Excess burden of CLI among Latino adults working outside the home underscores inequitable impacts of COVID-19 in New York City.