The authors assessed the risks of drug-related death, suicide, and homicide after release from New York City jails in 155,272 people who were incarcerated anytime from 2001 through 2005 and examined whether the mortality rate was associated with homelessness. Using jail records matched with death and single-adult homeless registries in New York City, they calculated standardized mortality ratios (SMRs) and relative risks. After adjustment for age, sex, race, and neighborhood, the risks of drug-related death and homicide in formerly incarcerated persons were 2 times higher than those of New York City residents who had not been incarcerated in New York City jails during the study period. These relative risks were greatly elevated during the first 2 weeks after release (for drug-related causes, SMR = 8.0, 95% confidence interval (CI): 5.2, 11.8; for homicide, SMR = 5.1, 95% CI: 3.2, 7.8). Formerly incarcerated people with histories of homelessness had higher rates of drug-related death (RR = 3.4, 95% CI: 2.1, 5.5) and suicide (RR = 2.1, 95% CI: 1.2, 3.4) than did persons without such histories. For individuals who died of drug-related causes, longer jail stays were associated with a shorter time until death after release. These results suggest that jail- and community-based interventions are needed to reduce the excess mortality risk among formerly incarcerated people.

Background Serosurveys are important to ascertain burden of infection. Prior SARS-CoV-2 serosurveys in New York City (NYC) have used nonrandom samples. During June–October 2020, the NYC Health Department conducted a population-based survey to estimate SARS-CoV-2 antibody prevalence in NYC adults. Methods Participants were recruited from the NYC 2020 Community Health Survey. We estimated citywide and stratified antibody prevalence using a hybrid design: serum tested at the NYC Health Department using the DiaSorin LIAISON ® SARS-CoV-2 S1/S2 IgG assay and self-reported antibody test results were used together. Prevalence was estimated using univariate frequencies and 95% confidence intervals (CI), accounting for complex survey design. Two-sided P-values ≤0.05 were statistically significant. Results There were 1074 respondents overall; 497 provided blood and 577 provided only a self-reported antibody test result. Weighted prevalence was 24.3% overall (95% CI: 20.7–28.3). Latino (30.7%, 95% CI: 24.1–38.2, p<0.01) and Black (30.7%, 95% CI: 21.9–41.2, p=0.02) respondents had a higher weighted prevalence compared with White respondents (17.4%, 95% CI: 12.5–23.7). Conclusions By October 2020, nearly 1 in 3 Black and 1 in 3 Latino NYC adults had SARS-CoV-2 antibodies, highlighting unequal impacts of the COVID-19 pandemic on Black and Latino adults in NYC.

BackgroundA rapid increase of Medicaid expenditures has been a serious concern, and housing stability has been discussed as a means to reduce Medicaid costs. A program evaluation of a New York City supportive housing program has assessed the association between supportive housing tenancy and Medicaid savings among New York City housing program applicants with serious mental illness and chronic homelessness or dual diagnoses of mental illness and substance use disorder, stratified by distinctive Medicaid expenditure patterns.MethodsThe evaluation used matched data from administrative records for 2827 people. Sequence analysis identified 6 Medicaid expenditure patterns during 2 years prior to baseline among people placed in the program (n = 737) and people eligible but not placed (n = 2090), including very low Medicaid coverage, increasing Medicaid expenditure, low, middle, high, and very high Medicaid expenditure patterns. We assessed the impact of the program on Medicaid costs for 2 years post-baseline via propensity score matching and bootstrapping.ResultsThe housing program was associated with Medicaid savings during 2 years post-baseline (−$9526, 95% CI = −$19,038 to -$2003). Stratified by Medicaid expenditure patterns, Medicaid savings were found among those with very low Medicaid coverage (−$15,694, 95% CI = −$35,926 to -$7983), increasing Medicaid expenditures (−$9020, 95% CI = −$26,753 to -$1705), and high Medicaid expenditure patterns (−$14,450, 95% CI = −$38,232 to -$4454). Savings were largely driven by shorter psychiatric hospitalizations in the post-baseline period among those placed.ConclusionsThe supportive housing program was associated with Medicaid savings, particularly for individuals with very low Medicaid coverage, increasing Medicaid expenditures, and high Medicaid expenditures pre-baseline.Electronic supplementary materialThe online version of this article (10.1186/s12913-017-2816-9) contains supplementary material, which is available to authorized users.

Using a population-based, representative telephone survey, ~930,000 New York City residents had COVID-19 illness beginning March 20–April 30, 2020, a period with limited testing. For every 1000 persons estimated with COVID-19 illness, 141.8 were tested and reported as cases, 36.8 were hospitalized, and 12.8 died, varying by demographic characteristics.

Purpose Interpersonal racial discrimination is associated with poor health. Social relationships may moderate the impact of discrimination and represent modifiable behaviors that can be targeted by public health interventions. We described citywide associations between self-reported racial discrimination and health-related quality of life among the overall New York City (NYC) adult residential population and by four main race/ethnicity groups and explored whether social relationships moderated health effects of discrimination. Methods We analyzed cross-sectional survey data from 2335 adults weighted to be representative of the NYC population. We measured exposures to lifetime interpersonal racial discrimination in nine domains using a modified version of the Experiences of Discrimination scale. We performed unadjusted and adjusted regression analyses on four self-rated healthrelated quality of life outcomes including general health, physical health, mental health, and limitations from physical or mental health. Results Overall, 47% [95% CI 44.5, 50.3] of respondents reported having experienced racial discrimination in at least one domain. In the overall population, significant associations with racial discrimination were noted in adjusted models for poor physical health, poor mental health, and limitations by poor physical and mental health. Among those exposed to racial discrimination, the risk of experiencing poor mental health was lower among those who had contact with family or friends outside their household at least once a week, compared with those who had less frequent social contact. ConclusionThis study provides evidence that social relationships may moderate the impact of racial discrimination on mental health and should be integrated into health promotion efforts.